Senate Dems Strike Deal on Health Care

Multiple news outlets now confirm that Democrats have reached an agreement on health care reform legislation. The New York Times describes the deal as an agreement “to resolve a dispute over a proposed government-run health insurance plan.” Yet the deal is not really a public option compromise, because it doesn’t contain a public plan. It does, however, appear to contain a triggered insurance plan.

Broken down to its essence this is the deal:

– Individuals 55 to 64 years of age — and who are eligible to obtain health insurance in the exchanges — can buy in to Medicare. Before the exchanges open in 2014, the buy-in will be open to a smaller group of people. During that time, Brian Beutler reports, those enrolling in the Medicare buy-in would not be eligible for premium assistance.

– The bill establishes national, private, non-profit plans in the exchanges. These plans would have to adhere to various regulations relating to quality and affordability. If these plans fail to achieve their intended objectives, a government insurance plan would be triggered into existence.

I really fail to see how the combination of the Medicare buy-in and regulated non-profit plans could be viewed as anything but a much better deal than the opt-out public plan that used negotiated payment rates. If anything, this proposal is a more dramatic expansion of the government’s role in health care. This, of course, goes to show that the high-stakes battle over the highly compromised public option had become completely symbolic and largely irrational. The key to making this deal even more effective will be opening the exchanges to a larger pool of people — a battle likely to take place on the floor.

As part of the plan, liberal members of the caucus also apparently extracted a promise of more stringent insurance market regulations, the details of which have not been reported anywhere, to my knowledge.

The political questions we need to ask are:

Does this bring Joe Lieberman and or Olympia Snowe on board? Snowe, of course, is the most prominent supporter of a trigger, although she opposes a Medicare buy-in.

Does the absence of a public plan keep Ben Nelson in the fold, the failure of his abortion funding amendment not withstanding?

I can’t imagine Reid, Rockefeller, Schumer, etc., would have accepted this deal if it didn’t deliver 60 votes to break a GOP filibuster.

This story is obviously developing, so I’ll update as more information becomes available.

Update: WaPo reports that “private insurance companies would face stringent new regulations, including a requirement that they spend at least 90 cents of every dollar they collect in premiums on medical services for their customers.”

Photo by Center for American Progress Action Fund