Editore"s Note
Tilting at Windmills

Email Newsletter icon, E-mail Newsletter icon, Email List icon, E-mail List icon Sign up for Free News & Updates

October 25, 2009

WHY PULLING THE 'TRIGGER' IS A BAD IDEA.... Bloomberg's Al Hunt told George Stephanopoulos that the trigger measure in health care reform may be "the compromise everyone has to rally around."

Maybe, maybe not. We've talked before about the problems with this idea, but since the measure is lingering around, and may even generate more votes than any other approach, it's probably worth re-stating the policy issues here. Jacob Hacker, who helped craft the idea of the public option in the first place, explained the other day why the trigger is the wrong way to go.

A workable trigger would, at a minimum, need to achieve three goals: (1) establish a reasonable and measurable standard for private plan performance that sets out clear affordability and cost-containment goals for a specifically defined package of benefits, (2) assess this standard in a timely fashion with information available to policymakers after reform legislation passes, and (3) if this standard were met, quickly create a public health insurance plan that would effectively remedy the situation.

The modifier "quickly" in the third goal is crucial: Runaway health costs are a grave and growing threat to federal and state budgets and to the health security of workers, their families, and their employers. Waiting longer than absolutely necessary for affordable coverage is certain to cause great harm. Indeed, it might actually compound the current crisis. Without an imminent threat of public plan competition, private insurers are likely to raise premiums in anticipation of the implementation of reform -- as suggested by AHIP's recent prediction of big premium increases if reform passes. Delaying a public plan may also jeopardize the cause of reform itself, because requiring Americans to buy unaffordable coverage has the potential to provoke a political backlash. (Polls show that Americans are more supportive of a mandate when they know they will have the choice of a public plan.)

In short, we cannot wait for a public plan -- and one of the biggest problems with a trigger is that it virtually guarantees we will have to.

The whole idea of a trigger hasn't gained any real traction in recent months, in part because it has so few fans. Republicans hate it -- they oppose any competition for private insurers, even if it's put off for some future standard -- and Democrats are at least skeptical about it, for all the reasons Hacker explained.

What's more, Ezra explained the other day, "One of the reasons I assumed Olympia Snowe's trigger proposal was dead was, well, it looked dead. It was just lying there, unmoving. There were no meetings between Snowe and Schumer, or Snowe and Rockefeller, to try and craft a stronger trigger that would be acceptable to more liberal members. There were no modified proposals coming out of Snowe's office, or statements from her spokespeople indicating a willingness to entertain changes. The White House kicked around some ideas internally, but none of them, so far as I or my sources know (or at least will confirm), ever saw the light of day, or even a dark room on the Hill."

And yet, the idea still lingers, because Snowe still likes it.

Now, the talk over the last couple of days is that President Obama may actually prefer the trigger to the public option with the opt-out compromise. That may be true, but there's reason for some skepticism. As we talked about yesterday, the issue here may be an entirely pragmatic one for the White House: Obama thinks a) center-right Dems won't vote for reform without Snowe; b) Snowe won't vote for reform without a trigger; so c) a trigger, while not ideal, will at least get a bill to his desk. The president is reportedly skeptical about whether a 60-vote Snowe-less majority is possible for the opt-out P.O. -- not on policy grounds, but as a matter of legislative strategy -- despite Harry Reid's confidence that it will come together.

But as long as the competing strategies continue to play out, the inconvenient truth is, the trigger is almost certainly the wrong answer to the right question.

Steve Benen 11:55 AM Permalink | Trackbacks | Comments (35)
 
Comments

There are three reasons al hunt is wrong about the trigger-option:

1) Al Hunt is so full of shit it is painful to listen or read him ever.
2) He works for corporate media. Everything he says is to sew chaos or encourage the corporate agenda.
3) And the actual answer to the god damn question, Alex, is: "What is Medicare-plus-five."

This government really really sucks. But the teevee sucks so much worse.

Posted by: neill on October 25, 2009 at 12:01 PM | PERMALINK

I just read an article in Time that theorized on the evolution of dogs and their ability to socialize with humans. One very interesting portion spoke of dogs’ ability to read human gestures, such as pointing. One thing the author of the study discovered early on was that chimpanzees don’t have the ability to read gestures without a lot of training, whereas dogs can do it as puppies, showing its inheritance. The theory is that other animals have not learned to share; it is a sign of social evolution for an animal to get over fighting for dominance and possessions.
If I understand this correctly, the greedy bastards that sit upon their piles of money and poo poo the sharing of everything by all are nothing more than a bunch of screeching monkeys jumping up and down on their piles of bananas.

Posted by: nuttylittlenutnut on October 25, 2009 at 12:06 PM | PERMALINK

If our current health care "system" doesn't constitute a trigger already, then I don't know what does. And if our legislators truly have no idea of that, then I do not see much hope for addressing this issue. The car has already plowed into the tree - there's no pointing in suggesting the driver slow down on the next curve.

Posted by: Roddy McCorley on October 25, 2009 at 12:11 PM | PERMALINK

I guess what all this means is that basic insurance reform, without any form of public option, is a slam-dunk. Reform is going to happen, and that is grounds for some celebration irrespective of the public option's fate.

Posted by: bob h on October 25, 2009 at 12:12 PM | PERMALINK

@bob h: and let us celebrate the freeness of air (except at gas stations) -- so far...

Posted by: neill on October 25, 2009 at 12:16 PM | PERMALINK

This is all noise, no signal. The senate does not need 60 votes to pass a bill that is to the Democrats' liking. They never have. They need 50+ Biden, either by persuading the stallers to vote for cloture (when push comes to shove, I don't think any will vote against it), or through reconciliation. We will have precisely the bill that the Democrats want, no more and no less.

Posted by: dr. bloor on October 25, 2009 at 12:45 PM | PERMALINK

I agree with Roddy - the current health care insurance industry is a failed industry. If that's not a "trigger" then what does it take?

But now the President wants to mandate that we all buy insurance when AHIP has already announced that rates will skyrocket.

I've already watched Obama bail out failed banksters with our tax dollars, now he's going to make me spend my own money propping up another crooked failed industry.

You know, I hate to be a real kill joy here, but failed Wall St banks and failed health care insurance companies DON'T VOTE. Obama and the Democrats are going to get their a$$es handed to them in 2010 and 2012 if they force the middle class to eat another $hit sandwich to prop up rich people.

Posted by: Glen on October 25, 2009 at 12:56 PM | PERMALINK

The trigger doesn't have to be at all complex. Right now, more than 40,000 Americans die every year because they don't have health insurance. Congress just needs to come out and clearly state how many of us have to die annually due to lack of insurance before there's a robust public option.
The politicians are obviously comfortable with having 40,000 a year die to protect the profits of the health care industry. What's the number boys and girls, 50,000, 60,000, 100,000, a million? Just let us know how many lives it's worth to continue to line the pockets of your benefactors.

Posted by: Dennis-SGMM on October 25, 2009 at 12:56 PM | PERMALINK

A trigger option is ridiculous. Think about it. We have a serious problem that has been steadily growing worse over several decades and the official Congressional solution is to WAIT LONGER?

This is a gross parody of legislation. Obama and the Democrats will pay dearly. It's one thing to do nothing, it's quite another to pass a bill that officially does nothing.

At this point, I propose we replace the senate with 100 donkeys. They're clearly not interested in being anything more than jackasses anyway.

Posted by: inkadu on October 25, 2009 at 1:15 PM | PERMALINK

If Obama wanted a trigger, wouldn't he be working behind the scenes to get one? But it doesn't seem like that is the case. Ergo the reader above who said this is "all noise [and] no signal" is correct.

Posted by: sjw on October 25, 2009 at 1:24 PM | PERMALINK

It looks as if the Democratic leadership in the Senate is stepping up to PO without a trigger, it's the WH that wants the trigger:

"The major point of contention between the White House and congressional Democrats is now whether a public option for insurance coverage has the 60 votes needed for passage in the Senate. In reporting our piece on the state of play in the health care reform debate, Ryan Grim and I heard the same refrain from a number of sources: Majority Leader Harry Reid's office thinks it can get the support needed to pass a public option with an opt-out provision for states. The White House thinks that Reid's whip count is too optimistic.

Part of the administration's reasoning is that if you don't have Sen. Olympia Snowe (R-Maine) on board, you end up losing the votes of a handful of conservative Democrats. So White House officials are pushing an alternative proposal that would have the public plan "triggered" in by economic conditions."

Whole article here:

http://www.huffingtonpost.com/2009/10/25/feingold-no-public-option_n_333012.html

and more here:

http://www.huffingtonpost.com/2009/10/24/leaderless-senate-pushes_n_332844.html

I don't know who's calling the shots in the WH, but triangulating is so 90's. It's time for the WH to think and act like it's been given a once in a generation mandate to make real change rather than playing it safe. Because playing it safe when the economy was running good is not going to work when the economy goes in the $hitter and the middle class gets vaporized.

Posted by: Glen on October 25, 2009 at 1:41 PM | PERMALINK

The trigger has already been pulled. That's why health care reform is so important now. The old way has failed. The health care industry has had its finger on the Uzi trigger for a long time cutting down thousands of people with lack of affordable insurance.

Posted by: Dale on October 25, 2009 at 1:52 PM | PERMALINK

This is a gross parody of legislation. Obama and the Democrats will pay dearly. It's one thing to do nothing, it's quite another to pass a bill that officially does nothing.

It does plenty: it transfers more wealth to the health insurers. And it provides subsidies (More transfer of wealth to the same people) that will supposedly enable low income individuals to buy health insurance. Are the subsidies going to go up at the same rate that the cost of health insurance is going up? I wouldn't count on it. That's when you see people who simply can't afford the insurance getting fined for being too poor. Think about that for a second: people will get fined for being too poor to do their part in supporting a wasteful, inefficient monopoly.
It is, however democratic; a rich man who forgoes health insurance will be fined just as heavily as a poor man who does so.

Posted by: Dennis-SGMM on October 25, 2009 at 2:44 PM | PERMALINK

I think the media is getting punked, and the Huffijngton Post is the biggest victim/offender. 24 hour cable news stations that need to fill hour after hour. On line news sites and blogs that have to constantly refresh their content all day long lest anyone get bored. Huffington Post changes it's hysterical headlines several times aday: Pelosi has the votes to pass the public option, Pelosi desperate as Democrats abandon public option, Obama pushing for the public option, Obams trying to kill the public option, Harry Reid rolling over, Harry Reid takes control. Anything and everything is posted and printed with no fact checking or research. Any annonymous source can say whatever they want and it's instantly thrown out for public consumption. I think alot of these
sources" are fucking with the media big time. Right now I'm not believing anything I read.

Posted by: Saint Zak on October 25, 2009 at 2:49 PM | PERMALINK

The rub that chafes me raw

Benen: And yet, the idea still lingers, because Snowe still likes it.

Exactly. And that's the rub isn't it?
So once again let me ask:

Who are the bright sons-of-democratic-bitches who has raised Snowe's opinion to such Olympian levels?

We have a majority of Senators who say the public option is an idea whose time has come. We have a majority of American who say the public option is an idea whose time has come. And we have Olympia Snowe and her democratic enablers who are saying "No, it is an idea whose time has not come."

WTF?

Explain to me: How is this open transparent government? How is this "change you can believe in"?


Posted by: koreyel on October 25, 2009 at 2:55 PM | PERMALINK

I'm glad someone feels the "fierce urgency of now"

Triggers, Feingold added, are "just an invitation for the insurance industry to manipulate the situation for a couple of years just so they can avoid the trigger and so they can convince members of Congress to delay it again. We need to do something now."

Posted by: koreyel on October 25, 2009 at 3:06 PM | PERMALINK

So the stats in some state indicate that the public option is triggered. So that state gets Fedicare. It works. Then it's not needed, so it closes. Then it isn't there so it gets triggered again. Then that state gets Fedicare. It works. Then.....
Can someone explain how it's actually supposed to work?

Posted by: emjayay on October 25, 2009 at 3:28 PM | PERMALINK

If the Democrats think that they can get off the hook by passing a crappy law with a hypothetical trigger, they will find that their current majority status will be very short lived.

Posted by: qwerty on October 25, 2009 at 3:34 PM | PERMALINK

If Obama or congressional Dems think the masses will settle for a trigger they need to get out of Georgetown. We should be buying up the pitchfork supply, because if a lousy bill passes with a mandate AND no real Public Option then a lot of us will be going to the barricades. The middle class has watched its wealth evaporate in the last 10 years and its retirement security collapse, all while politicians feed at the public trough. With excellent healthcare we pay for, with their own private pharmacy and clinic on site.

It's disgusting, and enough to drive me back to being an Independent. Who won't be donating any more time or money to Obama. I really hope he's playing 15-dimensional chess, because if this is just checkers than I've had it with him. He could make history at this moment, and change the lives of all Americans for the better - he'd better not settle for pumping more of our money into a deceptive, depraved industry like health insurance.

Posted by: nyc on October 25, 2009 at 4:53 PM | PERMALINK

A trigger is a horrible idea. It means a public option will never happen. It also means that if it was likely to, it would only happen in one small region of the country at a time, which completely undermines what the public option is trying to accomplish - twice.

A trigger should be avoided at all costs. Opt-out slightly less so. Both proposals only weaken the public option. We don't even need center Dems, much less Snowe. Why is everybody so intent on avoiding reconciliation?

Posted by: Rian Mueller on October 25, 2009 at 5:23 PM | PERMALINK

And I have another question. Right now the bills are in conference. No committee voted for a bill that includes a trigger. How can the conferees that are trying to put together the bills consider an idea that isn't in either committee's bill?

Can they really do things like produce a bill for the senate floor that has a trigger?

Posted by: Rian Mueller on October 25, 2009 at 5:30 PM | PERMALINK

A trigger is a kill switch!

Enjoying your low-priced Canadian drugs yet? That trigger is just that the drugs have to be certified as safe.

There is no single instance in history of this kind a trigger actually being pulled! Triggers are an inside-the-beltway scam whenever congress is being forced by the public to pass something big money strongly opposes. It has been working for at least 60 years.

A vote for a trigger is a "no" vote on the public option. Let your congresscritter know that you are wise to the scam, and that you will treat their "Yea" vote for a bill with a trigger as opposition to the public option. It will make it just a bit harder.

Steve, please! People listen to you! NEVER fail to mention this when you write about the subject.

Posted by: UnEasyOne on October 25, 2009 at 5:36 PM | PERMALINK

Good analysis, but I think you missed one point. It's a bit premature for the White House to conclude that they don't have the votes for the public option when they haven't lifted a finger to get a single vote for the public option. And, as an aside, we're not talking about getting the votes for the public option, we're talking about getting the votes to shut down a filibuster. Conservative dems could still vote to close down the filibuster and end up voting against the final bill - fine with me, and everyone else involved, and it still gives the conservative Dems cover back home, they can say they voted against the horrible communist health care bill inspired by all those mean people who won the war 150 years ago.

Posted by: John Aravosis on October 25, 2009 at 5:41 PM | PERMALINK

It has to got to be "reverse psychology":

The notion that the White House is pushing against Reid's opt-out public option (PO) that is very close to gaining the 60 votes needed for straight passage, just to get Snowe on board, makes Obama seem so dumb that I must conclude that there is more to this than we know about. My sense is that this a ploy between Obama and Reid. It's been decided that Obama would play the "fall guy": He'll appear to oppose the compromise bill that he actually favores in order to build support for it. Got it? Since so many people have been against good ideas just because Obama endorsed them, what is the best way for Obama to get what he actually wants than to take a position he does not really support just so that his detractors would flock to the position that he does support deep down. It is simple Reverse Psychology: Build support for a bill you favor by opposing it because your detractors would then support it. It is the only thing that would make sense of the White House's apparent mindless push against Reid's opt-out PO just as support is building for it.

As someone noted earliern we do not need a "triggered" PO because the current system already represents that "trigger." Is it not precisely because that "trigger" has been set off by the current system that there is such an urgency to reform health care?

Mr. President, please tell us you are not that dumb...

Posted by: dcshungu on October 25, 2009 at 6:03 PM | PERMALINK

To Senator Snowe:

Please come right out and tell us that just like your brethren on the right you really do not support health care reform, instead of playing Russian roulette with the well-being of Americans. Without a public option, any reform bill that passes would not be too different from what exists and has already proved to be catastrophic. That being the case, how many more "triggers" would it take before you understand that the current system is already a trigger, is unsustainable and must be replaced with one that has an integral public option? You can always go back to Maine, after you support health care with the promising opt-out public option, to lobby your constituents to have Maine opt out. My sense is that they would opt YOU out of the Senate if you tried such a stunt. Please try it and prove me wrong, Senator...I dare ya.

Posted by: dcshungu on October 25, 2009 at 6:22 PM | PERMALINK

Why are we talking about 60 votes? Whatever happened to reconciliation?

Posted by: craigie on October 25, 2009 at 7:42 PM | PERMALINK

The trigger is unacceptable because it is one more attempt to sustain an unacceptable status quo. Her argument is lets give the insurance industry one more chance. Lets let private enterprise one more time to get it right and if they don't do whats right the trigger will kick in. Its utter non-sense. If she and the blue dogs want to kill universal health insurance let them. And let them face the wrath of their ANGRY angry unemployed constituents who will throw them out. As Lara Ingram said today in the 90's we had jobs. Its intolerable to pay the salary of someone who has the best insurance benefits money can buy while they are denying benefits to their fellow citizens.

Posted by: aline on October 25, 2009 at 7:54 PM | PERMALINK

RE: ABC's 'THIS WEEK'

* Hunt claimed "They don't want to pass a bill with 60 Democrats. That's really not a very good idea politically for them"

Has he SEEN the polls or has he been in Cheney's undisclosed location cave ?


* WOW. Since when did Laura Ingraham start looking that skanky ?

YEESH.

Posted by: Joe Friday on October 25, 2009 at 8:26 PM | PERMALINK

Trigger this.

Posted by: SteveR on October 25, 2009 at 8:34 PM | PERMALINK

Of course, regardless of the validity of any wonkish defense, the trigger is a terrible idea for nothing more than the very reason that it is almost universally despised as a cop-out by 99% of Democrats across the left-to-center-left spectrum. It would be a political disaster that will destroy the Obama mystique among those most susceptible to it.

When Blue Dog Ben Nelson and "Radical" Howard Dean both support the opt-out concept, it is obvious we have a political winner. It's a concept that Snowe as a supposedly principled Republican cannot oppose in the long run.

That raises the obvious question: why has the White House apparently said nothing positive whatsoever -- not even saying something as non-committal as calling it "intriguing" -- for something with such a wide spectrum of support? The absence of any response to something that seems to break the logjam is strange indeed.

Is there some hidden agenda here? Could it be something as petty as the supposed hate-on Emanuel and Axelrod have for anything Howard Dean would support? Could it be something even more sinister, such as a secret promise to the industry to scuttle a genuine public option even while keeping the "left wing" at bay by saying Obama "favors" it? Let's hope dcshungu has the real answer. There's a point, though, when such trickery (if that's what it is) becomes dangerous for undermining the promise of greater transparency. Whoever keeps pushing the absurd trigger concept is playing with fire.

Posted by: urban legend on October 25, 2009 at 9:50 PM | PERMALINK

It would be a political disaster that will destroy the Obama mystique among those most susceptible to it.

Absolutely true, but if the reports are to be believed, then why does the White House seem to favor it [the "triggered" PO]? This does not seem to me like a suicidal bunch....au contraire! They have shown time and again a great ability to remain cool and collected under duress, and then when the dust settles, they'd have the upper hand. The PO that was supposedly dead during the summer of the right's discontent is now alive and well, revived when the WH decided that the time had come to strike a fatal blow at the naysayers who'd preempted the summer: They sent the Prez to speak to the joint session of Congress and to the country like one would to grown ups, and just like that, it was all she wrote. The summer madness receded and we're now looking at the first real prospect of having the passage of not just a health care bill, but of one that could include a sufficiently strong public option, i.e., the opt-out version. IMHO, this "Reid version" of the PO is just as good as the stronger bill that the House favors, because I do not think that a single state would opt out. The likes of Jindal have learned not to look a gift horse in the mouth after they had pooh-poohed the stimulus money, only to change their minds and even take credit when it turned out to have probably saved us from Big Depression II, and helped constituents across the country.

No, the White House cannot be pushing against the opt-out PO just to get Snowe's lone vote from across the isle so that they can claim "bipartisanship." We're long past the point at which having such a "fig leaf" would have mattered. There has got to be more to their apparent mindless approach to this. You do not hear Reid vehemently protesting this apparent White House opposition to his effort. That might be all that we need to consider to have confidence that the Dems in Congress and in the WH probably know something that we do not, and just relax...or is it?

Posted by: dcshungu on October 25, 2009 at 11:39 PM | PERMALINK

I agree with almost everything you say here (very well, I might add), including in particular that there has in the end always seemed to be method to any madness they seem to display. Their frequent use of the rope-a-dope has been masterful. I'm usually arguing for trusting Obama to do the right thing.

However, last weekend's calculated Sunday talk-show lukewarmness to the PO was disturbing since it seemed so unnecessary and gratuitous. It seemed designed specifically to slow down the momentum that has been building strongly. That's what made me start wondering about the possibility that seeming to favor the PO (while simultaneously saying it's not very important) has been a Kabuki for covering up an inside deal. I certainly hope not.

Posted by: urban legend on October 26, 2009 at 12:50 AM | PERMALINK

Look for the Republicans to start talking up the Trigger notion; not because they actually support it - God, no, they don't support anything that might spell competition for the big insurance companies - but because it has the legs to become divisive. If they can get a little vote-splitting happening, they have a chance of stalling healthcare reform for another generation. Republican phony-moderates might even get to polish their chops while pretending to reluctantly support reform.

Posted by: Mark on October 26, 2009 at 1:10 AM | PERMALINK

F Olympia Snowe. Who the f died and made her god? Why should our fate depend on her whim?

I have no faith in Congress or the current administration. I think they're gonna totally screw up the health care legislation and it's criminal.

People will die and suffer because these incompetent corporate whores masquerading as Representatives and Senators won't do the job they have been elected to do.

Why should Members of Congress enjoy the best socialized health care OUR MONEY can buy, but we cannot?

Congress should be mandated to have the exact same health care plan they legislate for the American People or none at all.

Posted by: GREYDOG on October 26, 2009 at 4:17 AM | PERMALINK

One way to shut down trigger talk is to prove the Administration will pull the trigger quickly. Triggers are viewed as a roadblock because Administrations have been reluctant to pull them. If this Administration makes clear that triggers that fit its agenda will be pulled early and often, talk of a health-care trigger will go away.

California asked in March for the trigger to be pulled on Medicaid payment cuts. http://www.treasurer.ca.gov/10B_BudgetTrigger/comments/letters/caph.pdf If the Administration actively pulls this trigger and others nationwide it will have a galvanizing effect.

Posted by: OKDem on October 26, 2009 at 10:08 AM | PERMALINK
Post a comment









Remember personal info?










 

 
Email Newsletter icon, E-mail Newsletter icon, Email List icon, E-mail List icon Sign up for Free News & Updates

Advertise in WM

Watch Byron Dorgan Video & Read His 1994 Article


2009 College Guide & Rankings






Search Now:
In Association with Amazon.com


Place Your Link Here

---Paid Advertisements---

Free Credit Score

Addiction Treatment

Personal Loan

Payday Loans

Personal Loans

Addiction Treatment

Phone Cards

Less Debt = Financial Freedom

Addiction Treatment Programs

Credit Cards & Debt Consolidation

Vacation Rentals