Health-Care Bill with Public Option Still Possible     Permalink

While there has been little public news about the health-care bill lately, behind the scenes, much is going on. The two bills that passed Senate committees are now laboriously being merged by majority leader Harry Reid. Although a recent poll shows that 57% of all Americans now back a public option, a handful of Democratic senators are opposed to it, making it difficult for Reid to assemble the 60 votes needed to invoke cloture to stop a promised Republican filibuster. However, it now appears that the opposition of some of these senators is more parochial than ideological. For example, Sen. Kent Conrad (D-ND) has objected not because he fears a government takeover of health care, it is simply that the proposed plan will pay hospitals the same as Medicare does, which is below the national average in low-cost North Dakota. Pay the North Dakota hospitals more and Conrad's vote is available. Of course, paying hospitals (and doctors) more, raises the total cost of health insurance and one of President Obama's goals is to reduce that cost. Sen. Ben Nelson (D-NE) is "intrigued" by the possibility of a public option that entire states could opt out of. Surely Nelson knows that any state that opted out would end up paying higher premiums than states that didn't opt out and the citizens thereof would undoubtedly notice this fairly quickly, but this idea gives him cover to vote for the bill. So what Reid is doing is trying to thread the needle, adding and deleting very specific provisions to get all 58 Democrats and 2 independents on board. One of the independents, Sen. Joe Lieberman (D-CT), may be the hardest of all to get to support the plan, again for parochial reasons. On domestic issues, Lieberman is generally fairly liberal, but the insurance industry is largely headquartered in Connecticut and he is trying to protect its profits. If the industry abruptly picked up stakes and moved to New Jersey, he would suddenly become he big supporter of health-care reform.

To some extent, the potential loss of Lieberman's vote is why Reid is courting Sen. Olympia Snowe (R-ME) so frantically. If Snowe is in and Lieberman is out he could still get to 60. If 60 votes are not available, Reid could use budget reconciliation, which requires only 51 votes (or 50 and Joe Biden), but despite the fact that reconciliation has been used 19 times since 1980, Reid is afraid to go this route because it would enrage the Republicans and he is facing a very tough reelection battle in Nevada in 2010.

Over in the House, Speaker Nancy Pelosi wants a public option based on Medicare rates but she still lacks the 218 votes she needs to pass the bill. Again here, many of the Blue Dog (conservative) Democrats oppose the bill simply because hospitals in their low-cost rural districts are paid less than hospitals in big cities. However, given that only that about a quarter of the Blue Dogs are needed, Pelosi could compromise with them and go for a bill that allowed the public plan to negotiate rates with health-care providers. This strategy would raise the cost of the bill but might get enough votes. Also, a Medicare+5 option, which would pay Medicare rates plus 5% might have enough votes. So when push comes to shove, providing 5% more money to hospitals could magically overcome deep-seated ideological objections from enough members to pass the bill. In the end, politics is all about money.

Well, not entirely. It is also about perception. Many people perceive a government-run health-insurance system as a Bad Thing. But they perceive Medicare (which is a government-run health-insurance system) as a Good Thing. So some House Democrats are now proposing to rebrand the public option as "Medicare Part E." The argument for this is that the public does not understand what a "public option" is but the public knows what Medicare is and likes it. It may seem crazy that just renaming the public option could matter, but it could. In fact, many liberals have pushed for "Medicare for All" from the beginning, and now it is starting to gain (a little bit of) traction.

DNC and RNC Fundraising Roughly in Balance     Permalink

The Democratic National Committee has raised $62 million this year compared to the Republican National Committee's $69 million. For the third quarter, the DNC outraised the RNC $24 million to $23 million. Historically, the RNC has generally outraised the DNC, but controlling both the White House and Congress gives the Democrats an edge since they can promise more to special interest groups and potentially deliver. All the Republicans can do is promise.

McDonnell Takes Commanding Lead in Virginia but New Jersey Tied     Permalink

A new SurveyUSA poll shows Republican Bob McDonnell with a 59% to 40% lead over Democrat Creigh Deeds in the Virginia gubernatorial election to be held two weeks from now. This is the biggest lead McDonnell has held all year. Over in New Jersey, it is too close to call. A Monmouth University poll just released shows Gov. Jon Corzine (D-NJ) and Chris Christie (R) tied at 39% with independent Chris Daggett at 14%.

Democrat Owens Leads in NY-23     Permalink

With the Republicans likely to win the Virginia governorship and the Democrats having a decent shot at hanging onto the New Jersey governorship by their fingernails, the tie breaker on Nov. 3 could be the special election in NY-23, the seat vacated by John McHugh (R), who is now Secretary of the Army. The most recent poll there shows Democrat Bill Owens at 33%, Republican Dede Scozzafava at 29% and Conservative Doug Hoffman at 23%. This race has split the Republican party badly, with the party establishment naturally backing the official Republican candidate despite her moderate positions on many issues but conservative activists backing the red-meat conservative Hoffman, who is running on the Conservative Party line.

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