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A Brief History of the Blue Dogs and the Public Option

Recently, Nancy Pelosi said that she counted about 20 Blue Dogs who would support a public option.  Blue Dog chair Stephanie Herseth-Sandlin disagreed:

"There was some suggestion that there were 20," Herseth Sandlin said. "There clearly are not. From the numbers that I have seen, although not everyone has submitted the surveys, even if they had and they all said yes it wouldn’t be 20. Right now it’s less than a dozen."

It’s a significant figure, because if Herseth-Sandlin is right, the Blue Dogs probably have the ability to block a public option.  If Pelosi is right, they don’t.

There are 53 members of the Blue Dog caucus.  It takes 40 Democrats to keep any bill from passing. If Herseth-Sandlin loses 20 members, her hand collapses.

As an inveterate vote counter, my antenna went up when she said a "dozen."  That figure may well be correct, but if it is, the Blue Dog position has become completely incoherent and they’ve had so many members change their minds so many times that no one should regard them as "principled" in the common sense of the word.  They seem rather to move in a helter skelter fashion to reflect whatever the lobbyist strategy of the day is for maximizing corporate looting of the health care bill, and any expectation that they will reflect what their constituents want is futile.

So without further ado (but with much thanks to the volunteers who helped me put the information together), here is a brief history of the Blue Dogs and the public option:

January 2009 — There are 20 members of the Blue Dog coalition among the 190 members of Congress who signed on to the principles of Health Care for America Now.    By my recollection, most of them had done so by January of this year.  Among the principles:

  • A choice of a private insurance plan, including keeping the insurance you have if you like it, or a public insurance plan without a private insurer middleman that guarantees affordable coverage.
  • Health coverage through the largest possible pools in order to achieve affordable, quality coverage for the entire population and to share risk fairly.
  • Effective cost controls that promote quality, lower administrative costs and long term financial sustainability, including: standard claims forms, secure electronic medical records, using the public’s purchasing power to instill greater reliance on evidence-based protocols and lower drug and device prices, better management and treatment of chronic diseases and a public role in deciding where money is invested in health care.

Public, public public.  Nothing about "protecting insurance industry profits."  Nothing about "if after we give the insurance industry a chance to get it together and they fail" (triggers).  Nothing about small, balkanized state co-ops that were as yet a twinkle in Kent Conrad’s eye, but rather support for using the purchasing power of a large pool to keep costs down. 

Among the 20 were Mike Ross,  Chairman of the Blue Dog Health Care Task Force, and Jim Cooper, who is a member of the Task Force. The other Blue Dogs who signed it were: Jason Altmire (Penn.), Patrick Murphy (Penn.), Michael Arcuri (N.Y.), Joe Baca (Calif.), Loretta Sanchez (Calif.), Marion Berry (Ark.), Sanford Bishop (Ga.), Leonard Boswell (Iowa), Chris Carney (Penn.), Ben Chandler (Ky.),  Jane Harman, (Calif.), Stephanie Herseth Sandlin (S.D.), Tim Holden (Penn.), Frank Kratovil (Md.), Adam Schiff (Calif.), Zack Space (Ohio), Mike Thompson (Calif.) and Charlie Wilson (Ohio).

January — White House Chief of Staff (and Blue Dog patron) Rahm Emanuel, who "runs the [health care] campaign out of his West Wing office,"  begins "floating" the idea of triggers, which would render any health care reform meaningless.

May 11 — Forty-five Blue Dogs led by Mike Ross write a letter to the House Committee chairmen responsible for drafting the health care bill, saying that they are concerned that they have been left out of the process. With good reason — the Sunlight Foundation released a report the next day on the enormous health care lobby contributions being made to Blue Dog campaigns. 

But what were they expected to deliver? Well, the health care industry stakeholders presented their proposals for $2 trillion in voluntary cost reductions to the White House on the same day.  Which turned out to be fantasy savings.  But with the exception of the PhRMA deal, we never got to find out what the White House promised in return.  But to the extent that those deals are known, the Blue Dogs have been critical to stovepipeing them into the House bill.

June 8 — Here’s where it starts to get incoherent.  The Blue Dogs release a "statement of principles" on health care reform, co-authored by members of the Health Care Task Force including Mike Ross and Jim Cooper.

It says that a public option must adhere to the same rules and regulations as all other plans:  "community rating; guaranteed issue; limits on marketing; risk adjustment; pre-existing condition exclusions; and transparency."  This would later be the "goody bag" (as Marc Ambinder dubbed it) that would comprise the President’s sales pitch for health care reform in August.

But it also said that a public option "would occur only as a fallback and in the absence of adequate competition and cost containment….should the private plans fail to meet specific availability and cost targets, a public option would be triggered and be allowed to compete on a level playing field subject to the conditions outlined above."  Yeah triggers.

As Ryan Grim of the Huffington Post noted, this represented a complete turnaround for both Cooper and Ross, who had been signatories to the HCAN principles trumpeting the virtues of a public plan.

July 7 — Rahm tells the Wall Street Journal the White House is open to triggers.  Obama yo-yos it back.  They get to have it both ways:  health insurance stocks surge on Rahm’s statement, and Obama gets love for ostensibly smacking him down.

July 8 —  A letter from 22 Democratic House freshmen is sent to Steny Hoyer on the importance of having a strong public option, one that is tied to "an established provider network, like Medicare" (PDF).  Among the signatories are Blue Dogs Leonard Boswell, Joe Baca, Mike Michaud and Adam Schiff.

July 9 — The very next day, more incoherence:  A letter from 40 Blue Dogs states their concern that "a Medicare-like’ public option would negatively impact hospitals doctors and patients."  A letter from 29 members of the New Democrat Coalition expressing concern about Medicare rural reimbursement rates follows shortly thereafter.  Weirdly, the Blue Dog letter is cosigned by Mike Michaud and Leonard Boswell, who also signed the letter insisting on a Medicare-like provider network as part of a public option only the day before.  

July 9 — 70 Democrats, including the Blue Dogs who are supposedly so given to "cost containment," sign a letter telling Henry Waxman to swap out his prescription drug plan for the one the White House negotiated with PhRMA.  Cost to taxpayers:  $63 billion.

July 17 —  Both the House Ways & Means Committee and the Health & Labor Commite vote on H.R. 3200 with a public plan tied to Medicare rates. On Ways & Means, Blue Dog Mike Thompson votes "yes" while  Earl Pomeroy and John Tanner vote "no."  On Health & Labor, Blue Dog Jason Altmire votes "no."

Jult 21 — Mike Ross and his fellow Blue Dogs meet with the White House, demanding that any public plan must not be tied to Medicare reimbursement rates.  He later brags about holding the bill "hostage" on the Energy & Commerce Committee for 10 day.

July 26 — Jim Cooper writes an op-ed stating that he doesn’t support the public option contained in the House bill, he supports some "fantasy" public option that doesn’t exist.  And brags about how much better he and his fellow Blue Dogs are making the bill.

July 31 — Mike Ross submits a co-op amendment to the Energy & Commerce bill.  It passes.   The language is identical to that which appears in the Baucus bill in September, authored by a former Wellpoint executive.

August 1 — Ross cuts a deal for H.R. 3200 to pass the Energy & Commerce Committee, with reimbursement rates no longer tied to Medicare.  The CBO will later estimate that these Blue Dog changes Jim Cooper was bragging about will actually add $85 billion to the cost of the bill over the next 10 years. Blue Dogs Ross, Jane Harman, Baron Hill and Bart Gordon all vote for it.

August 17 — Jim Cooper plays word games, insists that "co-ops" are a public option much like rural electrical co-ops that "worked really pretty well over all the country for 70 or 80 years."  But only last year, Cooper blasted the rural electric co-op model, saying that they had become "anti-consumer" and were cheating them out of money.

September 8Mike Ross says he can "no longer support a public option."  

One thing is certain: "fiscal responsibility" is the last thing the Blue Dogs are interested in.  Their prescription drug and Medicare positions alone add $148 billion to the cost of the bill without adding any value, and their insistence on "paygo" means those cost gets passed on directly to consumers in the form of higher premiums.

Stay tuned for Part II:  24 Blue Dogs Have Said That They Support a Public Option

Many thanks to the researchers who worked tirelessly to help compile this information:  Amy, Kate, Jim, Pat, Jon Walker and Scarecrow.

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Jane Hamsher

Jane Hamsher

Jane is the founder of Her work has also appeared on the Huffington Post, Alternet and The American Prospect. She’s the author of the best selling book Killer Instinct and has produced such films Natural Born Killers and Permanent Midnight. She lives in Washington DC.
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