Illinois Progressives, Blue Dogs Clash On Health Care

On Capitol Hill this week, there were some major developments in the ongoing health care battle. For a full rundown of what went down in both chambers, be sure to read this comprehensive recap from The New Republic's Jonathan Cohn. But let's focus in on the negotiations in the House, where Illinois Democrats are right in the thick of things.

On Wednesday, Congressional leaders and representatives from the conservative Blue Dog caucus reached a deal that cleared the way for a unified vote in the House Energy and Commerce Committee. The specifics of the compromise are still under wraps, but sources say lawmakers have agreed to (arbitrarily) cut $100 billion from the cost of health-care reform proposals to satisfy moderate Democrats like Illinois Reps. Dan Lipinski and Melissa Bean who are worried about the cost of expanding access. Under this plan, the public option would be forced to negotiate its own payment rates -- similar to private insurance companies -- as opposed to the so-called "tri-committee" bill, which allowed the government plan to use cheaper Medicare payment rates in its first three years of operation. States would be asked to cover 7 percent of the Medicaid expansion, which will add to the enormous debt many already carry. The employer mandate was made less stringent for moderately-sized businesses. And finally, it was promised that a full House vote would be pushed back until after the August recess. This was a big deal for lawmakers would didn't want to make a politically difficult vote without first seeing what concrete plan emerges from the Senate Finance Committee. (Of course, many of the most vocal Blue Dogs are in no way politically vulnerable, but that's an argument for another day.)

The new package essentially confirms that whatever reform bill is finally approved will cost more money and insure less people. Igor Volsky, however, calls the tweaks "rather minor." And the deal succeeds in bringing Blue Dogs aboard for the ride.

But the ability of conservative Democrats to hold legislation hostage until the leadership caves to their demands is really irritating House progressives. And rightfully so. Ezra Klein explains the dynamic:

House liberals are afraid of the dynamic in which good bills face Blue Dog opposition in the final mile and are aggressively watered down. Senate liberals are afraid of the same. And throwing this final compromise with the Blue Dogs into doubt is a show of strength. After all, House liberals feel they've already compromised plenty: Coming down from single-payer is a compromise. Cordoning the public plan off on the Health Insurance Exchange is a compromise. The whole bill is one big compromise, and every subsequent iteration is a compromise stacked atop a compromise placed upon a compromise. At some point, the compromises have to stop. Or, better yet, they have to go in the other direction.

Illinois Reps. Phil Hare, Jesse Jackson Jr., and Luis Gutierrez are doing their best to fight back. Along with 54 other House liberals, these three signed a letter to Speaker Nancy Pelosi condemning the compromise and warning they would vote against any bill that contained the rumored changes. The Nation's John Nichols has more:

The progressives say "the agreement is not a step forward toward a good health care bill, but a large step backwards." That's because it would, according to their savvy analysis, "reduce subsidies to low-and middle-income families, requiring them to pay a larger portion of their income for insurance premiums, and would impose an unfunded mandate on the states to pay for what were to have been Federal costs."

Which wing of the party will the administration side with? According to The Hill, the president called up Rep. Jan Schakowsky hours after the letter was sent alerting her that he thinks the compromise should go forward. We'll see how much additional pressure the White House applies over the August recess. But it's encouraging to see progressives banding together and pushing back, especially when a broad consensus of economists and policymakers reject the approach to public investment that their intra-party adversaries support.

On a related note, be sure to check out Rep. Maxine Waters' recent comments that the Blue Dogs obstruction of meaningful reform represents Rahm Emanuel's "chickens coming home to roost."

Comments

If this is such a good health insurance plan the it ought to include federal employees and congress to participate. The president wants to rush into it he should be required to also be included.

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