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Where We’re at on the Lieberman Health Care Industry Profit Protection Act of 2009

Thanks, Senator Lieberman. Thanks a bunch. (photo: AlmazUK via Flickr)

Thanks, Senator Lieberman. Thanks a bunch. (photo: AlmazUK via Flickr)

After last night’s epic cave-in on the Lieberman health care bill, I thought I’d just give a big-picture view of where we’re at right now:

• As has been reported everywhere, Lieberman basically got everything he wanted with staggering speed. While there are no specific lists of what’s now in the bill and what’s out, all indications are that every piece that liberals swapped in exchange for the public option will be removed, and the public option won’t be triggered but eliminated.

• And that’s not all. Another major addition in the mystery “deal” on the public option, the extension of the medical loss ratio to 90% (meaning that insurance companies would have to spend at least 90% of premiums on medical care), took a major hit from the CBO, and an ideological one at that. Doug Elmendorf basically said that such a medical loss ratio would make the private insurance industry into a government entity, “so that all payments related to health insurance policies should be recorded as cash flows in the federal budget.” This would make the health care bill cost several trillion dollars in CBO’s eyes despite the fact that nothing would have materially changed, and so this arbitrary decision basically killed the medical loss ratio, at least at 90% (it’s unclear what the magic MLR number is that turns the private insurance market into a government entity; Elmendorf didn’t explain it, just saying that it was somewhere between 85% and 90%).

One question for those who argued that liberals could easily bargain away the public option for something really valuable and good – how does “nothing” sound to you?

• This, of course, has made Lieberman beam with joy, thrilled with the prospect of making every liberal in America eat dirt.

Mr. Lieberman could not be happier. He is right where he wants to be — at the center of the political aisle, the center of the Democrats’ efforts to win 60 votes for their sweeping health care legislation. In short, he is at the center of everything and he loves it.

“My wife said to me, ‘Why do you always end up being the point person here?’ ” he said, flashing a broad grin in an interview on Monday.

And he finished off this with a dash of circular logic:

“People have said to me, including some people in the caucus: ‘We know you are for health care reform. You know how important this is to the president. Would you yourself stop this from happening?’ ” he said.

“So I say: ‘There is a wonderful core health care reform bill on the Senate floor. Would my liberal friends in the caucus stop that from happening and prevent the president from getting this major goal that he has set because they want to add more on to that? Why won’t they be reasonable?’ ”

It’s not even worth rebutting this, considering how every single compromise in this legislation has come from the liberal side of things.

• The other thing we know is that Lieberman really doesn’t like anyone mentioning his wife’s long history torpedoing health care reform:

One thing he wouldn’t tolerate were questions about his wife’s longtime connection to the health care industry, and whether she should keep her position with a breast-cancer advocacy organization.

“I just think that’s over the edge and offensive to me. My wife is a private citizen and she’s working for a movement that aims at reducing or finding a cure for breast cancer,” he said. “It’s just deeply offensive to me.”

Yes, it’s those darn uncouth liberals who are the source of all the problems. Not the woman lobbying with pharmaceutical interests who are fighting generic versions of life-saving drugs for, among other illnesses, breast cancer.

• At his press conference after last night’s meeting, Sen. Reid said this bill would pass the full Senate next week, without explaining what in blue blazes the bill is. But Chris Bowers gets confirmation of the schedule:

The cloture motion on health care reform will be filed either tomorrow or Thursday, setting up a vote two days later. With a very crowded legislative schedule, and demands from the White Hosue to pass the bill in 2009, there really isn’t any other option. My bet is that Olympia Snowe will probably vote for the bill now, as will Roland Burris. All of this makes even the unlikely prospect of a no vote from Bernie Sanders on the cloture motion irrelevant. Barring further mendacity, this bill now has sixty votes.

The cloture motion Bowers is talking about is just the first of three. The other two cloture motions that would have to be filed and surmounted, given the one legislative day between filing and the vote, puts final passage right around Christmas Day. And since the Senate’s on a White House-set schedule all of a sudden to secure passage by the end of the year, they had to give Lieberman basically everything to stay on that schedule.

• About the only avenue left to improve the Senate bill at all is a vote on the reimportation of prescription drugs from Canada and other countries abroad, which gets a vote today, per unanimous consent agreement. However, side by side with that vote on the amendment sponsored by Byron Dorgan is that “safety” amendment from Frank Lautenberg, a poison pill which would tangle reimportation in so many safety and feasibility studies that it would kill the intent of the bill.

Dorgan said Lautenberg’s amendment is “designed to kill our effort to allow the reimportation of drugs and put the brakes on skyrocketing drug prices.” He called the safety argument “completely bogus.”

Given that the Senate leadership has stripped the cost-control provisions of the public option and Medicare buy-in, they arguably NEED the Dorgan amendment to pass just to get a favorable CBO score. PhRMa has reportedly been renegotiating its deal under the threat of this amendment, and last night Reid and others vowed to move toward the House’s version of closing the Medicare Part D “doughnut hole” on prescription drugs. This is clearly designed to give Democratic Senators an out to vote against Dorgan’s amendment while still doing something to cut away at drug industry profits. We shall see if it’s enough to block passage.

One other tidbit from Reid and company’s vow to close the doughnut hole – they plan to do this through conference committee. Meaning there may actually be one with the House, instead of ping-ponging the bill to the lower chamber.

CommunityThe Bullpen

Where We’re At On The Lieberman Health Care Industry Profit Protection Act Of 2009

After last night’s epic cave-in on the Lieberman health care bill, I thought I’d just give a big-picture view of where we’re at right now:

• As has been reported everywhere, Lieberman basically got everything he wanted with staggering speed. While there are no specific lists of what’s now in the bill and what’s out, all indications are that every piece that liberals swapped in exchange for the public option will be removed, and the public option won’t be triggered but eliminated.

• And that’s not all. Another major addition in the mystery “deal” on the public option, the extension of the medical loss ratio to 90% (meaning that insurance companies would have to spend at least 90% of premiums on medical care), took a major hit from the CBO, and an ideological one at that. Doug Elmendorf basically said that such a medical loss ratio would make the private insurance industry into a government entity, “so that all payments related to health insurance policies should be recorded as cash flows in the federal budget.” This would make the health care bill cost several trillion dollars in CBO’s eyes despite the fact that nothing would have materially changed, and so this arbitrary decision basically killed the medical loss ratio, at least at 90% (it’s unclear what the magic MLR number is that turns the private insurance market into a government entity; Elmendorf didn’t explain it, just saying that it was somewhere between 85% and 90%).

One question for those who argued that liberals could easily bargain away the public option for something really valuable and good – how does “nothing” sound to you?

• This, of course, has made Lieberman beam with joy, thrilled with the prospect of making every liberal in America eat dirt.

Mr. Lieberman could not be happier. He is right where he wants to be — at the center of the political aisle, the center of the Democrats’ efforts to win 60 votes for their sweeping health care legislation. In short, he is at the center of everything and he loves it.

“My wife said to me, ‘Why do you always end up being the point person here?’ ” he said, flashing a broad grin in an interview on Monday.

And he finished off this with a dash of circular logic:

“People have said to me, including some people in the caucus: ‘We know you are for health care reform. You know how important this is to the president. Would you yourself stop this from happening?’ ” he said.

“So I say: ‘There is a wonderful core health care reform bill on the Senate floor. Would my liberal friends in the caucus stop that from happening and prevent the president from getting this major goal that he has set because they want to add more on to that? Why won’t they be reasonable?’ ”

It’s not even worth rebutting this, considering how every single compromise in this legislation has come from the liberal side of things.

• The other thing we know is that Lieberman really doesn’t like anyone mentioning his wife’s long history torpedoing health care reform:

One thing he wouldn’t tolerate were questions about his wife’s longtime connection to the health care industry, and whether she should keep her position with a breast-cancer advocacy organization.

“I just think that’s over the edge and offensive to me. My wife is a private citizen and she’s working for a movement that aims at reducing or finding a cure for breast cancer,” he said. “It’s just deeply offensive to me.”

Yes, it’s those darn uncouth liberals who are the source of all the problems. Not the woman lobbying with pharmaceutical interests who are fighting generic versions of life-saving drugs for, among other illnesses, breast cancer.

• At his press conference after last night’s meeting, Sen. Reid said this bill would pass the full Senate next week, without explaining what in blue blazes the bill is. But Chris Bowers gets confirmation of the schedule:

The cloture motion on health care reform will be filed either tomorrow or Thursday, setting up a vote two days later. With a very crowded legislative schedule, and demands from the White Hosue to pass the bill in 2009, there really isn’t any other option. My bet is that Olympia Snowe will probably vote for the bill now, as will Roland Burris. All of this makes even the unlikely prospect of a no vote from Bernie Sanders on the cloture motion irrelevant. Barring further mendacity, this bill now has sixty votes.

The cloture motion Bowers is talking about is just the first of three. The other two cloture motions that would have to be filed and surmounted, given the one legislative day between filing and the vote, puts final passage right around Christmas Day. And since the Senate’s on a White House-set schedule all of a sudden to secure passage by the end of the year, they had to give Lieberman basically everything to stay on that schedule.

• About the only avenue left to improve the Senate bill at all is a vote on the reimportation of prescription drugs from Canada and other countries abroad, which gets a vote today, per unanimous consent agreement. However, side by side with that vote on the amendment sponsored by Byron Dorgan is that “safety” amendment from Frank Lautenberg, a poison pill which would tangle reimportation in so many safety and feasibility studies that it would kill the intent of the bill.

Dorgan said Lautenberg’s amendment is “designed to kill our effort to allow the reimportation of drugs and put the brakes on skyrocketing drug prices.” He called the safety argument “completely bogus.”

Given that the Senate leadership has stripped the cost-control provisions of the public option and Medicare buy-in, they arguably NEED the Dorgan amendment to pass just to get a favorable CBO score. PhRMa has reportedly been renegotiating its deal under the threat of this amendment, and last night Reid and others vowed to move toward the House’s version of closing the Medicare Part D “doughnut hole” on prescription drugs. This is clearly designed to give Democratic Senators an out to vote against Dorgan’s amendment while still doing something to cut away at drug industry profits. We shall see if it’s enough to block passage.

One other tidbit from Reid and company’s vow to close the doughnut hole – they plan to do this through conference committee. Meaning there may actually be one with the House, instead of ping-ponging the bill to the lower chamber.

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David Dayen

David Dayen