Editore"s Note
Tilting at Windmills

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October 22, 2009

ROCKEFELLER SIGNALS WILLINGNESS TO COMPROMISE.... No senator has been more enthusiastic in his support for the public option that Sen. Jay Rockefeller (D-W.Va.). And so it came as something of a surprise yesterday when he acknowledged that he's open to a compromise proposal that's been making the rounds.

"I think there's one way that could work very well and could pick up some of the moderates," Rockefeller told reporters. "I'm looking very much now at this opt-out public option." Under the alternative proposal, the public option would be available nationwide but individual states could decline to participate.

Democratic Sens. Tom Carper (Del.) and Chuck Schumer (N.Y.) -- himself a big cheerleader for the public option -- have been working on that proposal for the last few weeks and the idea has received tentatively positive reviews from some liberal and centrist Democrats.

Rockefeller's purported interest in this compromise is notable given his staunch support for the liberal gold standard for the public option: a nationwide program that would pay medical providers based on Medicare rates, a proposal Rockefeller said would save the government more than $50 billion over 10 years. "An opt-out would still save money," Rockefeller said.

Rockefeller specified that he's talking about the opt-out measure, not the opt-in. "So you start out with a public option, and if you don't like it you can opt out," he said, adding, "That has a sense of freedom."

This is a definite shift for Rockefeller, who said just last week that the opt-out compromise sounds "sort of like [a] trigger," adding, "I don't think it really is" a good idea.

Now, Rockefeller has not gone into any detail about what prompted the shift. It's possible that someone like Schumer spent some time with him, and persuaded him of the idea's merit. It's equally possible that Rockefeller has surveyed the landscape and has determined that this is the strongest public option he can get out of the Senate.

Either way, the practical result is largely the same: strong supporters of the public option -- Rockefeller, Howard Dean, even Rep. Anthony Weiner (D-N.Y.) -- believe the opt-out compromise is tolerable, and strong skeptics of the public option -- Ben Nelson, Max Baucus -- seem to feel the same way.

At this point, talk of the opt out is still fairly new, and the framework of how the idea would be structured would need to be fleshed out much further before it became viable. But when liberal Dems and conservative Dems start talking up the same compromise measure, it's something to keep an eye on.

Steve Benen 8:00 AM Permalink | Trackbacks | Comments (26)

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Honestly, I think its a trap. Politicians who decide to opt their state out of it would have hell to pay, and the harshest critics who don't opt their states out would be exposed as hypocrites.

At most only a few states might opt out.

Posted by: SaintZak on October 22, 2009 at 8:07 AM | PERMALINK

Opt-out just means poor and working class people in Texas, South Carolina, and Louisiana will screwed. The Republican leaders of these states have shown that they don't give a damn about anyone but big business

Having said that, I would still support the opt-out if it got the votes to pass a strong public option for the rest of the civilized states.

Posted by: Winkandanod on October 22, 2009 at 8:10 AM | PERMALINK

It's equally possible that he realizes no one is going to opt out (remember the hub-bub about "opting-out" of stimulus money), which puts the select few politicians who are crazy enough to try it in the tough spot of failing their base. Nice play, imo.

Posted by: eadie on October 22, 2009 at 8:15 AM | PERMALINK

@Wink-Maybe they should propose an opt out clause for secession. Seems that was part of the debate not long ago. Seems in the past if you disagreed with the wingnuts, they told you to pack your bags.

Posted by: Dave on October 22, 2009 at 8:23 AM | PERMALINK

Are their time limits and restrictions on opting out? Can the states opt back in? What about real people who are in the plan when the state opts out? I can see it being a ping pong ball as various factions take over and use it for and against the other.

Posted by: martin on October 22, 2009 at 8:32 AM | PERMALINK

What is the mechanism for opting-out? The governor saying so? The state legislatures? A ballot referendum?

Posted by: TonyB on October 22, 2009 at 8:38 AM | PERMALINK

The opt-out is a great compromise, if that is what it takes for 60 votes. I think it definitely keeps Olympia Snowe on board, at least for closure, and may pull in Susan Collins.

As a policy measure, it will still be effective as almost all the blue states will stay on board, with more than half the population. Maybe a somewhat surprise blue state like Virginia or North Carolina might opt-out, but not much more. With more than half the US population covered, there should be more than enough people in the public option to give it real market power.

And on a political measure, it really puts southern Republicans on the hot seat. The subsidies in their markets will help the poor regardless. But the upper middle class and businesses will feel the pinch, and they will get a lot of pressure if the public option keeps costs low in the blue states and their costs stay higher. Businesses will leave, putting even more pressure on them. Now, if you just tie in a re-opt-in period with major Congressional or Governor elections, it could be a windfall for the Democrats.

Posted by: Chris on October 22, 2009 at 8:41 AM | PERMALINK

A strong public option is the compromise, anything less is a total sell out.

Posted by: par4 on October 22, 2009 at 8:42 AM | PERMALINK

Rockefeller's willingness to "compromise" comes as a surprise only to those who can't look two years back at his behavior re FISA.

That should have solidly established for all time his lack of trustiworthiness when it comes to protecting the citizen/consumer from corporate abuse. Really, there are some political actions so venal that you can't come back from them.

Posted by: shortstop on October 22, 2009 at 8:43 AM | PERMALINK

How about letting the 'opt out' be individual and renewed yearly? See how many red state voters decide to 'opt in'.

Posted by: Nancy Green on October 22, 2009 at 8:59 AM | PERMALINK

If you don't want millions of dollars, don't take them. Nice move. Finally, nobody's going to opt-out. The bloviators can pass the buck to the states who will, of course, take the money after lots of gas and gesticulating; but the bill gets passed. Stimulus money redux.

Posted by: buddy66 on October 22, 2009 at 9:03 AM | PERMALINK

If the Red states opt out, just look at the effect on uninsured in those states. They'd migrate to other states offering the government-run health care. There go your tax base and employment ranks.

Yeah, that'd do well for the Red state voter base...

The pressure to opt back in would be enormous in a whole lot of ways.

Posted by: Pauline May on October 22, 2009 at 9:05 AM | PERMALINK

If they're going to let states opt-out, let's make sure it costs them federal funds.

Secondly, every state should be allowed to implement single-payer for their state and get all the Federal monies that would be going into the state as the foundation for it.

Posted by: freelunch on October 22, 2009 at 9:17 AM | PERMALINK

the opt-out is the figurative definition of giving Republicans enough rope to hang themselves. Any who dare think about trying to get their state to opt out will become a political pariah, with some very few possible exceptions, like Utah (the Stepford State). But any Republican who DOESN'T try to enact the opt out in their state will face tougher primaries, not to mention taunts from the left about how not-conservative they are: "If you really think this is a conservative state, WHY haven't you pushed to opt out of the national public insurance option? Give the people what they want, right?"

Having said that, once that reality sinks in, look for Republican senators (especially vulnerable ones) to REALLY fight against the public option if it includes an opt-out. They'll fight against it even harder than a public option without the opt-out because it just screws them coming & going. And you know that pusbag Lieberman will fight it too. So we'll need Snowe + 1, unless Reid balls up and FOR ONCE, demand that a filibuster actually be a filibuster. Make 'em stand there, drag all business to a close and make Republicans lie & spin & parse & sweat until they can't do any more.

In short, a robust public option with an opt out is a robust public option, period.

Posted by: slappy magoo on October 22, 2009 at 9:21 AM | PERMALINK

Several points convinced me that a public option was in the best interests of people. First, most (if not all) would be required to care a minimum amount of health insurance with variable subsidies based on ability to pay premiums. Second, the public option would be an option available to anyone who deemed it in their individual best interest. Third, the combined clout of Medicare and public option participants would enable the gov-mint to posture for group rate costs for services and drugs. There have been reports that lead me to believe I was wrong on some of this. Specifically eligibility to participate in the public option. Now discussion has turned to an option for entire states to decline participation in HCR. Does this mean residents of states opting out will NOT be required to carry a base policy? Is this the equivalent to saying the state prefers their current status quo? Wouldn't the net effect to the state mean a disproportionate number of the poor and healthly would be uninsured? Wouldn't the net effect to the nation be a reduction in collective bargaining clout to reduce costs? Would the loss of premiums of the young and healthy offset the cost of supporting the chronically ill and elderly? Is it possible to make the state's opt-in/opt-out decision available only once every 4 years as a ballot initiative on years we elect a new president? Good grief, have the progressives really received a warm fuzzy over whether this opt-out option is both manageable and in the best interests of the nation?

Posted by: Chopin on October 22, 2009 at 9:53 AM | PERMALINK

I seem to remember that not too long ago certain cities solved their homeless problem by providing one-way tickets to elsewhere and hospitals discharging uninsured emergency room patients with a ride to the front door of other hospitals. Will this become the business model for opt-out states? Will opt-in states who treat uninsured persons of opt-out states visiting on vacation be able to collect expenses from the appropriate opt-out state? I wonder how this discussion would go if the subject was whether or not drivers should be required to be licensed and insured. Or if freight trucks from Mexico traveling on USA roads should be required to abide by local laws. Duh.

Posted by: Chopin on October 22, 2009 at 10:06 AM | PERMALINK

My question is how a state can opt out? It should have to be a ballot measure in said state, now that is a compromise I can live with.

Posted by: Trollopo's Pizza on October 22, 2009 at 10:07 AM | PERMALINK

It is a partisan mailbomb and as such I like it. The GOP has decided that nationally they oppose Health Care Reform. If their state officials do not try to opt-out, they are hypocrites. If they do opt-out, a very solid wedge has been driven between the GOP idealogues and their poor, working class and middle class voters, who can see real benefits being denied them. It will be political suicide for the GOP to pursue opting out.
The beauty of it is that because it is so damaging to the GOP, Red State Dems have every reason to support on partisan grounds, while still preserving their localist veneer.

Posted by: tom in ma on October 22, 2009 at 10:27 AM | PERMALINK

I think this is a great strategy and compromise too for all the reasons that have been discussed but I keep wondering why no one is talking about this other strategy where Reid could actually put the public option in the bill that would then require the famous 60 votes to take it out. And we all know that threshold could not be met. Chuck Schumer pointed this out. Yet no one in the Corporate Media is talking about this possible strategy of course, and no one here either other than Dancer. How come ?

Posted by: stormskies on October 22, 2009 at 11:07 AM | PERMALINK

I'm a red state progressive.

First let me state that I, nor my fellow Georgia Democratic voters, have little, if any, control over the political ideology of those who surround us. If you read the book "Outliers" by Gladwell, you would have read that some cultural norms are passed through generations over decades and even over centuries. Consistent with that theory, my entire family is made up of right-wing ideologues. Even my 14 year-old niece lists her political views as "NoBama" on her Facebook page.

Now, my parents are both from Kentucky, and I've lived in Georgia since I was a child--Texas before that. My wife and I are both gainfully employed. Our children grew up here, my elderly parents live here, and my siblings, cousins, nieces and nephews live here--not to mention my life-long friends. In short, we have roots here.

WashingtonMonthly home page regulars have seen the polls. Those of us who vote Democratic in Georgia don't have the numbers to deliver the electoral college for a Democratic president, nor do we have the numbers to deliver a Democratic U.S. Senator, a Democratic Governor or a Demcratic state legislature (both houses are Republican-led). This is primarly because of the strong ideology of those on the right but also because of the many steps that Georgia has taken to disenfranchise the poor, disabled, elderly, and yes, ex-cons when it comes to voting rights.

However, Georgia progressives can, and have, made monetary contributions to campaigns all over the country to help deliver a Democratic President and a Democratic Congress. If you recall, we caucused, we canvassed (sometimes traveling out of state to do so), we made phone calls (often out of state calls), we wrote fund raising letters (including letters to out of state voters), we attended Meet-Ups, and some of us were able to even deliver a Congressman or two (my district has a Democratic Congressman) to help the cause.

We didn't do this for health care for people living in blue states. We did this for health care for ALL. But today, and everyday that I read about how giddy some of you are about the opt-out compromise, I want to ask for my time and money back.

I live in Georgia. I know Georgia politics. I know Georgia voters. And I'm telling you, Georgia WILL opt-out. There's no doubt about it. If this state is any indication, if Virginia Democratic gubernatorial candidate Creigh Deeds' recent comments indicating that he would opt-out on behalf of Virginians are any indication, you will not turn red states into blue states.

And no, my wife and I will not quit our jobs and leave our families and migrate to blue states (not something that blue state voters should want). Most who can't afford health insurance, can't afford to leave their family networks to leave, and most who can, won't leave their family networks to chase after health coverage. And it's cruel to expect us to.

So if the opt-out compromise goes through, it will be quality, affordable health care for me, but not for thee. It will be a message to red state progressives, that you don't want our votes, our contributions, our time. It will be the death of the 50 state strategy and the rebirth of the swing state strategy. It will be a big "fuck you" to the poor, disenfranchised, and yes, progressives living in solid red states. It will be this generation's Missouri Compromise, and that it is even being considered is shameful.

Posted by: Chris on October 22, 2009 at 11:11 AM | PERMALINK

To ask again, what mechanism would trigger an opt-out?

Like Chris above (but to a lesser degree) Florida had Republicans running the political show. However, Florida did go for Obama last year, and would certainly not VOTE for an opt out, were it a popular referendum. I don't think even Georgia would vote to opt out, although their politicians surely would.

Posted by: BuzzMon on October 22, 2009 at 11:31 AM | PERMALINK

I'd take a compromise with Rockefeller & Nancy Pelosi. I won't accept a compromise with anyone who doesn't really want health care reform to begin with. (ie - that includes any republican, Senators Baucus, Landreiu, Conrad or what's her face in Arkansas).

Posted by: kindness on October 22, 2009 at 11:31 AM | PERMALINK

Sorry for not having all the details at my finger tips, but isn't there talk about being able to purchase health insurance "across state lines"? Would that then also apply to the public option so that if your state opts out, then you can just get it through another state? Just wondering.

Posted by: emd on October 22, 2009 at 12:41 PM | PERMALINK

I don't really understand this.
What sort of precedent is that to set. The state can keep their citizens in poverty and deny them health care by opting out of a Federal program. What other Fed programs will they opt out of? Medicare? Schools? Elections?
This is just too mean for the people!

Posted by: thebewilderness on October 22, 2009 at 1:24 PM | PERMALINK

How many states opted out of Medicaid? One - Arizona, and it entered the fold after less than a decade (if I'm correct).
Any requirements for opting out should be that the Legislature needs to pass a measure formally stating that the state refuses to participate. And the Governor either needs to sign or have the measure passed over his/her veto as with any other piece of valid state legislation.
Any state that might opt out will "opt in" within two years (the usual term for state legislatures).

Posted by: Doug on October 22, 2009 at 8:27 PM | PERMALINK

One little bit of rhetorical sneakiness: Rockefeller says, "So you start out with a public option, and if you don't like it you can opt out," which is a subtly but significantly different thing from the way the opt-out was originally proposed — initially, it was, "So you start out with a plan to launch a public option on Date X, but if you opt out, it won't be launched in your state."

Wonder if he really means the difference?

Posted by: Suzii on October 22, 2009 at 9:12 PM | PERMALINK
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