Support for HCR Increasing, Particularly Among Dems

Greg Sargent has the details:

[T]he internals of the new CNN poll contain a striking finding: Support for the Senate bill is up among Democratic voters. What's more, Obama's support has increased among liberals.

The poll finds that support overall for the Senate health care bill has jumped six points, to 42%, since early December. That's a sizable jump, though overall 56% oppose it.

But here's the interesting part: The poll also found that approval of the Senate bill has jumped 10 points among Dems in the same time period -- a time period during which the Medicare buy-in was dropped. That's a faster rise than overall. What's more, it has jumped by the same number among young voters -- who are presumably more liberal.

On top of that, the poll also says that Obama's overall approval among liberals has gone up, to 81%.

This isn't a perfect bill. But it's also not a bad bill, either. And the American public, particularly Democrats, appear to be warming to the proposal. To a large extent this coalescing of support is tied to the procedural success of the bill; as the bill moves closer to becoming a law, and thus a procedural success, more are jumping on the bandwagon. That said, as the public sees that the legislation nearly through the Senate expands healthcare coverage for 31 million Americans while greatly reducing the deficit, it's understandable that more would come around to supporting the bill.

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Health Reform Passes Major Procedural Hurdle

Update [2009-12-21 1:22:22 by Jonathan Singer]: Healthcare reform passed a major procedural hurdle overnight as the Senate invoked cloture on the leadership amendment outlining final agreement on the legislative package. The vote, as expected, was 60 to 40, with every member of the Democratic caucus voting in favor of cutting off debate and every single Republican voting to filibuster. More votes remain, but the vote, occurring after 1:00 AM, signaled that the reform package should have enough support to move out of the Senate this year.

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The Senate is moving towards a cloture vote on the leadership's healthcare amendment, a key procedural hurdle on the path towards getting reform through the chamber by Christmas. You can watch on C-SPAN 2 or at C-SPAN.org. Consider this a thread on the healthcare debate, which I'll also be covering over on Twitter @jonathanhsinger...

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Senate Bill Would Reduce Deficit by $1.4 Trillion

The CBO score (.pdf) of the manager's amendment to the Senate healthcare reform bill is out, and according to the document, "Relative to the legislation as originally proposed, the expected reduction in deficits during the 2020-2029 period is larger for the legislation incorporating the manager's amendment."

To put that in plain English, I turned to a source close to the Senate leadership, who explained to me that deficit reduction in the second decade of the healthcare reform legislation now before the Senate would amount to $1.3 trillion, in addition to the $132 billion reduction in the deficit during the first decade of the bill. That's right, the Senate healthcare reform bill would reduce the deficit by more than $1.4 trillion over 20 years.

More as we hear it...

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Dems Strike Deal to Get 60th Vote in Senate

With Ben Nelson signing on to the Senate leadership's healthcare reform package, the Democrats now appear to have 60 votes in favor of their bill. Here's The Washington Post on the deal, which you can read in full as a very large .pdf here:

Under the new abortion provisions, states can opt out of allowing plans to cover abortion in insurance exchanges the bill would set up to serve individuals who don't have employer coverage. Plus, enrollees in plans that do cover abortion procedures would pay for the coverage with separate checks - one for abortion, one for rest of health-care services.

Nelson secured full federal funding for his state to expand Medicaid coverage to all individuals below 133 percent of the federal poverty level. Other states must pay a small portion of the additional cost. He won concessions for qualifying nonprofit insurers and for Medigap providers from a new insurance tax. He also was able to roll back cuts to health savings accounts.

Per The Post, the ultimate bill looks a great deal like the bill initially released by the Senate, expanding coverage to an additional 31 million Americans while reducing the deficit by about $780 billion over 20 years. The manager's amendment, however, does not include a public option.

Instead of a public option, the final product would allow private firms for the first time to offer national insurance policies to all Americans, outside the jurisdiction of state regulations. Those plans would be negotiated through the Office of Personnel Management, the same agency that handles health coverage for federal workers and members of Congress.

The Associated Press calls such a provision "a consolation prize for liberals, who failed to include a government-run alternative." For more details on the bill, here are links to coverage from The Post, The AP, The New York Times, the Los Angeles Times, and The Hill.

Update [2009-12-19 12:29:57 by Jerome Armstrong]:

My favorite part of the deal with Nelson is his effort to install an entirely federally-paid government-run Medicaid plan forever, for Nebraska alone:

As part of the deal to win Nelson's support, the federal government will pay for Nebraska's new Medicaid recipients. It's a provision worth about $45 million over the first decade. Medicaid is usually paid for with a mix of federal and state funding, but Nelson's carve out means that any Medicaid beneficiaries who join the program after the bill passes will be paid for in full by the federal government. It's a sweet deal considering that many governors are worried that the Medicaid expansion will further strain already stressed state budgets. The deal is emblematic of the kind of horse trading that gets done to win votes on any landmark piece of legislation. Senate Majority Leader Harry Reid sent $300 million in Medicaid funds to Louisiana as a sweetener to secure Landrieu's vote to begin debate on the bill. Nelson would not comment on the provision, saying that he would leave it to Reid to discuss details. "I'm comfortable it is taken care of," he said of his state. Reid defended Nebraska's special treatment saying, "You’ll find a number of states that are treated differently than other states. That’s what legislating is all about. It's compromise."Isn't that a giant step toward a government run healthcare? The polls are showing a slippage of about 5-7% week over week for HCR, now in the low 30's. I'm wondering what sort of earful that they are going to get outside the DC bubble that reflects that reality. What would probably suffice for more unity is for the House re-insert something of the Medicaid language, rolling back Lieberman, if that can be done. I think there's a strong case for putting the deal on the back of Lieberman if he wants to kill HCR or not.

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Covering 30 Million Americans

That's what the bill being debated in the Senate would do. It wouldn't have a public option, and it apparently wouldn't enable those age 55 and older to buy-in to the Medicare program.

To provide some context, though, it's worth noting what wasn't on the table coming into the Senate debate: A robust public option, the type of program that would have a significant impact on the overall healthcare market. The leadership in the House of Representatives tried to pass a robust public option, one tied to the rates set by Medicare, but it just couldn't find the votes.

Unable to get a robust public option through the House, the Senate looked to other opportunities, including Medicare buy-in and a non-robust public option. The latter, as scored by the CBO, would enroll only 3 or 4 million people -- not too dissimilar from the 6 million number the CBO projected would enroll in a similar non-robust public option in the House. As designed by either the House or the Senate, such non-robust public options would have higher premiums than private plans available under the exchange.

So the question stands, is it better to kill a bill that would provide 30 million Americans with health insurance (in addition to the 4.1 million American children already extended coverage under the expanded SCHIP legislation passed through the Congress and signed into law by President Obama earlier this year) for lack of a non-robust public option, the premiums of which are projected to be higher than in private plans, or to back a bill without either a non-robust public option or a Medicare buy-in provision? Frankly, I'm not sure I ultimately come down the same as Howard Dean on this one, though I'm still hoping to learn more.

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Diaries

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