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Transcript: Health On The Hill – December 7, 2009

Jackie Judd, Kaiser Family Foundation; Mary Agnes Carey, Kaiser Health News; and Carrie Budoff Brown, Politico.

Senate Majority Leader Harry Reid, D-Nev., continues his efforts to find consensus on a health care package that can win 60 votes. He has asked a group of party moderates and progressives to work on several issues, including creating an alternative to the “public option” health insurance plan Reid has in his bill. 

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A transcript of the interview is below:

JACKIE JUDD: Good day. I am Jackie Judd with Health on the Hill, a conversation about efforts to overhaul the health care system. Here to discuss what happened during a rare weekend session for the Senate, and what’s ahead this week, are Mary Agnes Carey of Kaiser Health News and Carrie Budoff Brown of Politico. Welcome to you both. Carrie, over the weekend there was yet another idea for some kind of public option. Fill us in on the details.

CARRIE BUDOFF BROWN: This would be an alternative to the public option that’s in the bill. This idea would essentially replace that opt out, the public option opt out that Senator Reid put in the underlying bill, and what this would do, I think the best way to look at it is it’s modeled after what the federal employees and members of Congress, the kind of plan they have, which is a marketplace of health insurance plans, for profit and non profit.

However this plan, this kind of structure would be a series of non profit options that would be administered by the Federal Government, the same office that oversees the federal employees’ health benefit plan.

Politically this could be a good pitch for lawmakers who are right now struggling with health care reform and it being popular or not because for years constituents have said I want the same health care that members of Congress get, and in some ways they can make that argument, look we are creating this model, we are modeling this new idea after what we have.

I think the jury is still out on whether progressives will sign onto this. In these meetings over the weekend, you have progressive senators who are seeking other types of concessions, if they agree to essentially give up on the public option.

There is also talk of including within this mix a public option fallback where in some way if private plans don’t step up to the plate, don’t participate, OPM, the Office of Personal Management, which would oversee this program, could possibly create a public plan. It doesn’t seem likely, but that’s still in the mix and you have lawmakers or senators looking for tighter regulation of the insurance industry.

There can be other things on the table that they are going to push for if they are forced to walk away from this sort of peer public option that they’ve been pushing for, for months.

JACKIE JUDD: And Mary Agnes, with this new idea, would it drive costs down in the same way that proponents of the more, I will call it traditional public option ideas, would?

MARY AGNES CAREY: I think it remains to be seen. We have to see how the language is drafted. We have to see what the role for the office personnel management is, but as Carrie was noting there is a lot of comfort with having this agency OPM involved.

They administer benefits for millions of federal employees’ and their dependents and so we will have to see what sort of savings they could extract from doctors and hospitals and other providers, and also how many people would be allowed to take advantage of this option.

One factor in the pending public option proposals in the House and Senate Bills, it is a fairly limited number of people that participate. If more people could participate, depending on how it is drafted, then you’ve got better bargaining power to get the kind of savings to drive down costs.

JACKIE JUDD: The other big issue that’s coming up today, Monday, or possibly tomorrow is Sen. Ben Nelson of Nebraska, Conservative Democrat, is going to introduce language that would create some more restrictions on abortion funding similar to what was in the House bill. How tricky is that?

CARRIE BUDOFF BROWN: He is unlikely to have the Amendment passed through the Senate. Nobody really believes the votes are there. So, after that happens, I believe and from what I’m hearing there will be a new effort underway in the Senate to try to come up with some kind of compromise language that’s somewhere between where the House is and where the Senate is.

I think there is not a lot of comfort level with where the Senate is, the language that they currently have in the bill, among some anti-abortion senators who are not quite as adamant as Ben Nelson but there is still discomfort with where that language is.

So I think we will see some compromise being attempted to work out, not necessarily a watering down of the House, or boosting of the strength of the Senate Bill. There could be an entirely different proposal that’s put on the table that you would either see a vote on the Amendment at some point or it could just be put into that manager’s amendment at the end of this debate, which will contain a lot of the changes to this bill.

JACKIE JUDD: And several days ago the Senate Majority Leader Harry Reid appointed another group of ten Democrats, five progressives, five moderates, what is the purpose of this group?

MARY AGNES CAREY: To get consensus among the key groups, the centrists and the progressives, in the Democratic Party over the public option. Look how much time we’ve spent this morning talking about this, how much time we have spent talking about this for months.

It’s a critical stumbling block and until you get consensus within the Democratic Party, you’ve got to get 60 votes for this bill because Republicans in the Senate, there may be an exception of one or two but most of them are not going to vote for the Bill. Senator Reid needs a consensus on this to appeal to the factions of his Party and that’s I think why he’s taken this route.

JACKIE JUDD: And is this group of ten really charged only with trying to reach consensus on public option or is it the range of issues?

CARRIE BUDOFF BROWN: They are not talking solely about the public option. I am told this is a conversation; the public option is the dominant question that they have to answer. But in context of that, in conjunction with that question, they are looking at other issues that, like I said earlier, that progressives can extract a little more concessions out of the negotiators because they are now saying they have to be comfortable with the entirety of the bill and the public option is not being discussed in a vacuum.

Because if they give up on this side of the public option, they are going to want a little bit more, so that means the range of issues are broader. And this group is made up of the five strongest public option opponents and pretty much some of the five strongest public option supporters, so it’s really the extremists.

JACKIE JUDD: The thinking is that they can agree with it, everyone else in between them will agree on it as well.


JACKIE JUDD: And we can’t forget President Obama’s visit to the Senate this past weekend. From everything I’ve read and heard, it seems like this was more about inspiring rather than telling them do X, Y and Z.

MARY AGNES CAREY: That is right. Most of the senators I’ve talked with when they came out from the speech said it was very inspirational, motivational. The president was trying to explain to them the uniqueness of the moment. This is a historic vote. He likened it to the creation of social security and talked about how if this vote, people will look back on this vote for the next 20, 30, 40 years and so don’t squander the opportunity.

JACKIE JUDD: Why do you think he chose this moment, Carrie, to deliver that message?

CARRIE BUDOFF BROWN: Well, in terms of the calendar, he’s supposed to be out of the country twice in the next two weeks and as well as he’s supposed to go to Hawaii right before Christmas. So, just scheduling wise, this may have been the best opportunity but I also think in the scope of this he may look back on this weekend as an important weekend. Really, the major issues really have to be resolved in the next two or three days if they want to start getting the steps going to get this finished by Christmas.

I mean, I know it’s really two weeks away, but they have to start taking procedural steps by the end of the week, and I don’t really think Harry Reid is going to start doing that unless he’s reasonably assured that he has something close to 60 votes or has 60 votes, so he really needs to lock down these issues, I don’t know, by Wednesday or Thursday, so this is crunch time. I mean, we have always talked about how every week is important but my gosh, this week is really, really important.

JACKIE JUDD: You really mean it this week.

CARRIE BUDOFF BROWN: I really mean it this week and it really is true. He does not have much time and he has a lot to do in the next few days.

JACKIE JUDD: Okay, that’s the final word for today. Thank you both very much. And thank you. I’m Jackie Judd.

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