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(h/t Heather)

I can see that Ben Nelson and the Conservadems/Baucus Dogs have a plan. They bitch and moan about the effect a public option would have on the poor, poor health-insurance industry, so if they do have to vote for a public option in the Senate that clearly benefits Americans and not his favorite donors, they will only do it under the provision that the states "opt in" rather than "opt out."

His hair has been saying this for a while now.

Nelson's hair doesn't explain why he favors the "opt in" version and Harwood doesn't bother to ask. And he can count on the media to not inform America what the differences are in an opt in or an opt out version of the PO so when we complain about it the Villagers will attack us. He was interviewed by John Hardwood, a Villager of the highest order on MSNBC.

Here's what Ben Nelson's hair said:

Harwood: You'd agree that unless a comprehensive health care bill would pass that it would cripple his presidency.

Nelson's hair: Well, I don't know that we should conclude that some form of health care reform won't pass. I believe that some form of health care will pass.

Harwood: What in your mind are stoppers, things that, knowing this place, things that either because you oppose them or other senators oppose them, simply can 't be in the final product to have it pass?

Nelson's hair: Well, it's very difficult to see how that CLASS Act that was in the HELP committe bill would make it [that's long term care provisions] I think also any kind of public option that would undermine or destabilize the private insurance that 200 million Americans have, I don't see that that would make it. But some version such as an opt-in, for the states with a state option, that could very well be in.

Digby alerted me to this clip and she astutely writes:

But I am still suspicious that there might be a play to make opt-in the reasonable alternative to opt-out. It just keeps cropping up in all kinds of places, often from White House reporters. It's worth keeping an eye on anyway.

Harwood thinks that Nelson will stick with them on cloture and I haven't heard otherwise. (and if Harwood asked him he didn't say, the putz.) But he certainly keeps dangling himself out there as a vote for opt-in, so if this thing really comes down to the wire I could see it happening. Again, I don't think the village media have clue about just how different the two things are. It's just bumper sticker slogans to them.

The Hill reports that Sheldon Whitehouse also trumpeted the same thing.

The Senate health bill is drifting toward ending up with an "opt-in" provision versus an "opt-out," one Democratic senator said Friday.

Sen. Sheldon Whitehouse (D-R.I.) predicted that healthcare reform in the upper chamber would shift from its current construction, which allows states to opt out of a public option, to a version that forces states to opt into such a plan.

"I think it's falling into an opt-in, versus opt-out," Whitehouse said during an appearance on MSNBC. "You have a public option, but it's up to a state to take an affirmative act to take advantage of it."

Whitehouse suggested the opt-in as a potential compromise on the public option to win enough Democratic votes in the Senate, where Sen. Joe Lieberman (I-Conn.) has said he will vote against a bill containing a public option, and several other centrist Democrats have been reluctant to support the current proposal.

I'm doing some digging around to see what's really happening and I'll have news soon. Reid is already having the "opt out" scored by the CBO, but my sources indicated that the Senate has not sent out the "opt in" to be scored. From what I'm hearing. The "opt in" would not pass the House conference.

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House Speaker Nancy Pelosi was firm today: A public option will not be included in the reconciliation package. After reminding reporters that she has been for single payer health care since "before most of [them] were born", she explained there would be no public option in the reconciliation bill. Expanding that answer, she pointed the finger at the Senate, saying,"[the Senate] does not have the votes."

We can argue about whether the Senate has the votes or not, but as TPM reports, Senate support has diluted as more Senators make qualified commitments. Of those making some sort of commitment, only 24 have actually signed the Bennet letter. The rest have given only qualified nods.

But the latest support rests on increasingly unstable grounds, with recent additions to the list naming multiple caveats. Sen. John Tester (D-MT), for example, said, "It depends on how it was designed." Sen. Byron Dorgan (D-ND) said he wouldn't vote for a public option that reimburses doctors at the Medicare rate. Sen. Russ Feingold's office told TPM he'd only support a public option that lowers the deficit by $25 billion.

Despite the lack of a public option, some little-recognized provisions in the Senate bill do actually serve the purpose of offering lower-cost insurance. Policies negotiated by the OPM which cannot be operated or priced for profit is one way to force competition, particularly when it requires companies to spend 95% of the premium paid on actual benefits. I have issues with the state opt-in provisions the Senate attached, but I still expect rates to be lower than ordinary commercial policies in states where they're offered.

If the effort put into the public option was redirected into pushing Congress to remove the opt-in provisions and make the insurance exchange national as part of future legislation it would be a better use of energy. Or alternatively, push toward Grayson's solution of offering at-cost buy-in option to Medicare to everyone. Either idea has a better chance than beating a horse that's died, been laid to rest and had the coffin nailed shut by none other than Speaker Pelosi.

Alan Grayson came to the House Floor today to introduce the Public Option Act, which would allow all Americans to buy into Medicare at cost. The bill is 4 pages long, and calls for an unsubsidized option for any American to choose Medicare over private insurers.

The bill would require the Secretary of Health and Human Services to establish enrollment periods, coverage guidelines, and premiums for the program. Because premiums would be equal to cost, the program would pay for itself.

“The government spent billions of dollars creating a Medicare network of providers that is only open to one-eighth of the population. That’s like saying, ‘Only people 65 and over can use federal highways.’ It is a waste of a very valuable resource and it is not fair. This idea is simple, it makes sense, and it deserves an up-or-down vote,” Congressman Grayson said.

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Back in September, a study by Harvard Medical School found that over 44,000 Americans die each year due to lack of health insurance. Now, in a complete reversal of both logic and the truth, Senate Minority Leader Mitch McConnell (R-KY) announced that it is the availability of a public insurance option which could prove fatal. Of course, McConnell's announcement that the public option "may cost you your life" should come as no surprise. After all, in July he echoed George W. Bush and Tom Delay in declaring that thanks to the emergency room, Americans "don't go without health care."

Mitch McConnell's latest fear-mongering came during an appearance on Dennis Miller's radio show. Blasting the "opt-out" version of the public option in the Senate bill, the Senator from the state ranked 45th in health care performance insisted access to coverage could be deadly:

MCCONNELL: Well, it doesn't make any difference frankly whether you opt-in or you opt-out, it's still a government plan. You know, Medicaid, the program for the poor now, states can opt-out of that, but none of them have. I think if you have any kind of government insurance program, you're going to be stuck with it and it will lead us in the direction of the European style, you know, sort of British-style, single payer, government run system. And those systems are known for delays, denial of care and, you know, if your particular malady doesn't fit the government regulation, you don't get the medication.

MILLER: Right.

MCCONNELL: And it may cost you your life. I mean, we don't want to go down that path.

While he has generally left the myth-making about "death panels" and "pulling the plug on grandma" to Sarah Palin, Chuck Grassley and other tall tale tellers in the GOP, Senator McConnell has otherwise been fabricator-in-chief when it comes to Republican talking points on health care.

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d r i f t g l a s s: Nobody left but the crazies (h/t Frank Chow)

Burnt Orange Report: Lawyers speaking out in response to Todd Willingham's "utterly disgraceful" trial attorney

Abu Maqawama: The most important article on Afghanistan you'll read this week

Open Left: A second fire has started on the public option fight, this time in the House.

TPMMuckraker: Pelosi's claim that the CIA misled her is validated by the House Intel Committee

The Satirical Political Report: Bush breaks the mold as a motivational speaker

Looks like we're going to see a push to open the public option. Get on the phones and let your congress creatures know you're behind it:

Sen. Ron Wyden has doubts about the scope of the public option plan announced Monday.

"I agree with Senator Reid that health reform should give Americans more options. Now, I want to work with him to ensure that all Americans can choose those options," Wyden said. "The bottom line is that the public option can’t really hold private insurers accountable if it is only competing for 10 percent of the insurance market, because private insurance companies aren’t going to change their business practices if 90 percent of their customers can’t take their business elsewhere.

"Real reform means empowering Americans to choose insurance that works well for them and their family, while rejecting plans that don’t. Including a public option is a step in the right direction, now let’s remove the firewalls in this bill that prevent Americans from choosing it," Wyden said in a statement.

[...][Jeff] Merkley, for example, said he would be unhappy if more Americans weren't able to select the so-called public option. As a member of one of the committees that wrote a health care bill, Merkley actively supported a government-option as the best way to maintain costs and provide greater choice. Merkley said in an interview Monday that he would press for any public option to be broadly available along the lines of an amendment he successfully offered in July when the bill was in committee.

Merkley's amendment is designed to give small businesses access to newly created health insurance exchanges that, in theory, breed competition by pooling the number of customers in a specific region. Merkley estimated that his amendment would allow nearly 25,000 more businesses – employing 485,000 workers – to enter the exchanges and 32 million people nationwide.

...

That amendment would increase the size of small businesses eligible for enter the national exchange that includes a public options. He also supports giving states the right expand the size of eligible businesses even more.

"What sense does it make to keep companies from going into the exchange?" he said.

So the pressure we brought to bear on Harry Reid's office over the weekend did have some effect. The bill does have a public option, despite mutterings from unnamed sources that the mythic and coveted 60 votes would be a whole lot easier without the public option. But we're not out of the woods yet, not by a long shot.

Now we get to see the Republicans really ramp up the scare tactics--telling the gullible and easily frightened that this is just one step behind the evil Soviet Empire that St. Ronnie slayed, with its government-run health care, all evidence to the contrary. Up until this point, Obama has kept the Senate dealings at arm's length, a political calculus that made some sense, looking at what happened to Clinton's attempt to get health care passed. But it's going to take some seriously strong political leadership now to make it untenable for any member of the Senate to vote against health care reform. As Mike Lux says, "Game On":

We don't yet know whether we will get the best version of the public option in the House bill, and the Senate version is not as strong as progressives have been pushing for. But strengthening the form of the public option can be negotiated over in conference committee, once we get there.

For now, we can thank Harry Reid (HCAN has a page here) and Nancy Pelosi for their gutsy leadership, and fight like hungry dogs to win the floor fight and deliver on this hope. In the coming weeks we will have an all-hands-on-deck, all out public war with the insurance industry over whether we finally pass comprehensive health care reform or once again fall short at the bitter end after coming so far.

Here's where things are as we head into the floor fight:

1. White House staffers confirmed for me this afternoon that they are backing Harry Reid's decision "100 percent." Now that's not to say they aren't a little nervous about it. I suspect that there are still some feelings by some people working in that building that progressives should have given up and rolled over, and let them cut a deal with Olympia Snowe on her trigger-written-never-to-trigger. That would have been easier than sweating what will undoubtedly be a very tough battle to get all 60 Democrats to go along with the rest of the party. But us irritating progressive folk got in the way of doing that, and now Obama knows it's time to stand and deliver. I believe my friends at the White House when they say they will do an all-out fight for this bill. They know that starting down this path, and not being able to pull it off, would be a huge embarrassment and destroy all the momentum we've built by making it this far. They are all-in, and know how much is at stake. Rahm Emanuel and Jim Messina are famous for twisting arms and doing everything in their power to get the votes that are needed, and now is their time to deliver.

That's where you come in. Progressive Change has a petition for you to sign to ask President Obama to stand firm and fight:

"Every day, insurance companies deny care and let people die. Getting one Republican senator's vote is not worth delaying reform -- too many real lives are at stake. We need you to fight and state clearly that anything less than a strong public option is not change we can believe in."

Go. Sign. Make phone calls. Let your voice be heard.

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Harry Reid held a press conference earlier today and said he's including a "public option" in the Senate bill that will have a states "opt out" provision, which means that all the states will have to stay in the bill until 2014 and then have the opportunity to opt out of it.

Frankly I'm shocked that he stood up to the White House on the public option and said no to President Olympia Snowe. Remember when all the Chuck Todds of the pundit class said that the public option was dead and liberals supported it because conservatives didn't? Wrong again.

Obviously, Reid talked to the Democratic senators and feels like he has the votes, or I didn't think he would have said what he did.

Senate Majority Leader Reid confirmed this afternoon he would include a public option in the overhaul bill that allows states to opt out if they choose. Reid said he plans to send an overhaul proposal to CBO today.

He said he is not asking CBO to score a trigger alternative, one supported by Sen. Olympia Snowe, R-Maine, but added that the bill will include a version of a co-op.

Robert Gibbs from the White House applauds Reid via email:

"The President congratulates Senator Reid and Chairmen Baucus and Dodd for their hard work on health insurance reform. Thanks to their efforts, we’re closer than we’ve ever been to solving this decades-old problem. And while much work remains, the President is pleased that at the progress that Congress has made. He’s also pleased that the Senate has decided to include a public option for health coverage, in this case with an allowance for states to opt out. As he said to Congress and the nation in September, he supports the public option because it has the potential to play an essential role in holding insurance companies accountable through choice and competition."

I agree with mcjoan at Daily Kos when she says:

Everyone is on the same page moving forward, meaning that we're that much closer to having meaningful, comprehensive healthcare reform pass this year.

There is much to still discuss and learn about the merging bills, but I think it's a positive step.

Steve Benen has a nice roundup, and found a statement from Max Baucus:

Perhaps more interesting was the reaction from Senate Finance Committee Chairman Max Baucus (D-Mont.), who has been a public option detractor.

"It is time to make our system work better for patients and providers, for small business owners and for our economy. It is time for health care reform. For more than a year, we've been working to meet the goals of reducing the growth of health care costs, improving quality and efficiency and expanding coverage. There are a tremendous number of complicated issues that go into reform and the public option is certainly one of them. I included a public option in the health reform blueprint I released nearly one year ago, and continue to support any provision, including a public option, that will ensure choice and competition and get the 60 votes needed to pass the Senate. Success should be our threshold and I am going to fight hard for the 60 votes we need to meet that goal this year."

What's fascinating about this is that Baucus was reportedly fighting tooth and nail to keep the public option out of the merged bill. This statement suggests he's on board with Reid's bill, and almost seems to be trying to take some credit for it.

I know there are a lot of questions about the bill and we haven't seen it yet, but the fact the Reid put some form of the public option without a trigger is huge and I didn't expect it from him.

Americans United wrote this about Harry Reid:

Senator Reid's announcement that the Senate health care bill will include a public health insurance option, shows that he has refused to buckle in the face of withering pressure from the big insurance companies and sided instead with everyday health care consumers.

HCAN released their statement.

Today, you stood up and delivered the kind of leadership America needs in the health care fight. You put a public health insurance option in the Senate bill, something the vast majority of Americans support.1

For your leadership, you deserve our thanks.

The Republicans' response is pure comedy gold. They called Harry a "partisan bully." '

A primary reason Harry Reid is one of the most endangered incumbents facing re-election in either party next year is due to the fact that he is viewed by many of his constituents as a partisan bully," said Brian Walsh, NRSC Communications Director.

The idiot known as Michael Steele says he's "the cow on the tracks."

Josh Marshall has a good take on the news. So What Is the 'Opt-Out' Compromise?

Howard Fineman sounded like a blogger when he wrote this about President Obama's obsession with Mount Snowe:

But the pursuit of Snowe is pretty close to obsessive, which is not a good thing either for Democrats or for the prospects of health-care reform worthy of the name. First, Snowe's exaggerated prominence is both the result and symbol of Obama's quixotic and ultimately time-wasting pursuit of "bipartisanship." In case the White House hasn't noticed, Republicans in Congress are engaged in what amounts to a sitdown strike. They don't like anything about Obama or his policies; they have no interest in seeing him succeed. Despite the occasional protestation to the contrary, the GOP has no intention of helping him pass any legislation. Snowe may very well end up voting for whatever she and Democrats craft, but that won't make the outcome bipartisan any more than dancing shoes made Tom DeLay Fred Astaire.

--

Worse, the pursuit of Snowe isn't uniting Democrats; it is dividing them. Democrats who haven't been in the room with her as she bargains with the leadership bristle at her role, even as they personally like and admire her. She remains deeply skeptical of a publicly financed alternative to private insurance, in good part because of what she sees as the failure of Maine's version of the idea—and yet some form of a public option is favored not only by most Democrats in Congress but by most of the American people. If Obama and the Democrats really want such a plan, they may as well try to get tough. For inspiration, the president might consider a Longfellow aphorism. "In this world," the poet wrote, "a man must either be an anvil or a hammer."

More coming....

While the Obama White House, Senate Majority Leader Harry Reid and Congressional Democrats debate among themselves whether the so-called "opt out" public health insurance option endorsed by Reid will be included in reform legislation, Minnesota Governor and GOP presidential wannabee Tim Pawlenty has already weighed in. Asked if he would "lead a charge" in his state to opt out, Pawlenty replied, "I think so because I don't like government run health care."

That's easy for him to say. As it turns out, Minnesota is the exception that proves the rule of red state socialism. An increasingly blue state with the 4th best health care system in the nation, the Land of 10,000 Lakes sends far more tax dollars to Washington than it receives in federal spending in return. But for Pawlenty's fellow Republican refuseniks, leaders of red states offering dismal health care and a beneficiaries of a one-way transfer of taxpayer funds from DC, opting out may not be an option.

In recent weeks, Texas secessionists and Georgia legislators have echoed Pawlenty's confused reading of the Tenth Amendment by endorsing a state veto over federal health reform mandates. But just in time for the debate over the merits of a state-by-state "opt out" of a national public health insurance option, the Commonwealth Fund has released its 2009 state health care scorecard. As in 2007, the data reveals the critical condition of red state health care. All of which could present Republican governors and legislatures with a dilemma: Will they refuse to offer lower cost insurance coverage for their residents by rejecting a system funded in part by blue state taxpayers?

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(h/t Heather)

I've been hearing from my sources that the ConservaDems in the House of Lords (The Senate) would rather have states be able to "opt in," rather than "opt out," of the public option in health-care reform. No matter how you feel about these proposals, the one Ben Nelson supports is a far, far worse plan than the other. Here's what he said on CNN's State of The Union:

KING: If there is a vote and Harry Reid needs 60, have you promised him, even if you disagree with the proposal and might vote no on the proposal, you would give him your vote on the procedural issue?

NELSON: I have made no promise. I can't decide about the procedural vote until I see the underlying bill. It would be, I think, reckless to say I'll support the procedure without knowing what the underlying bill consists of. And it's not put together yet. It's a draft -- it will be a draft bill some time next week, submitted the Congressional Budget Office for the review of the cost. And until I've seen a completed draft...

KING: Well, let me -- let me jump in, can you support...

NELSON: ... I'm not going to...

KING: Can you support a public option where states could opt out so there is a public option in the federal legislation, or will you only support a public option where the state would have to opt in, so there is not a national program already created?

NELSON: Well, I certainly am not excited about a public option where states would opt out or a robust, as they call it, robust government-run insurance plan. I'll take a look at the one where states could opt in if they make the decision themselves.

I understand what the other Senators are trying to do with the opt-out proposal -- which comes down to guaranteeing the public option an uphill, state-by-state battle -- but Ben Nelson in particular continually thwarts every effort to include a robust public option in America. I think he uses health insurance payoffs as a form of roughage to keep his bowels clear. And he still won't say if he'll give us an up-or-down vote. Schmuck.

Nelson must be looking to become a health insurance lobbyists once he leaves the Senate and since he takes the most cash from them---I imagine he has a gig already lined up.