Crunch Time

It really does seem like crunch time on healthcare reform. President Obama's strategy so far seems to have worked--he let the opposition huff and puff themselves out, and the insurance companies expose their own greed. He got bills out of all the committees, including Senate Finance. Now reportedly for the first time, White House reps are working directly with Senators and their staff to craft the final Senate bill, that combines the two that Health and Finance passed.

The crucial element remains the public option, and most especially whether the individual mandate and the public option are linked. TPM reports that Speaker Pelosi, getting the House together for a strong public option in their bill, Pelosi came closer than any member of the Democratic leadership has thusfar to suggesting that the individual mandate should be conditional on the inclusion of a public option.

It's a very dicey situation. The Obama campaign machinery is gearing up to get Congress to pass stuff, but nobody quite knows the White House position on public option and individual mandate. Personally, that constrains me from participating. I'm more likely to work with the groups pressing that linkage between public option and individual mandate. I just don't see forcing people to pay for profit-making health care.

Reports have it that the White House is being sympathetic to the Olympia Snowe proposal for a public option trigger (Kos frontpagers refer to her as President Snowe because she seems to be dictating the final bill.) For awhile I've suspected that some sort of opt-out public option would be what comes out of this--some mechanism for a kind of reverse trigger. The proposal that states could opt out of a public option seemed to get general approval last week, but it doesn't seem many are talking about it now.

Of course the option means that the individual can choose a non-public plan. An opt-out is built in. Not so the individual mandate. It's the smell of forcing everyone to buy insurance that's got the insurance companies so excited, and their greed is such that they are working hard to make sure there is no public plan choice. Not unexpected from a business that considers it an affront when they have to do anything but take in money.

TPM also reports that progressive sources are saying that Senate Majority Leader Harry Reid is "playing an inside game" to get a strong public option. That's contrary to a lot of earlier stories, but if it's true, it may also indicate that the White House--or at least the President--is pushing it, though at the moment behind the scenes. If Reid decides to include the public option into the final Senate bill, its chances increase dramatically, because he probably won't do it unless he's pretty sure it will pass, and because once it's in, it's very hard to get it out. But the drama could be extended if he doesn't, because then it will be up to the conference committee reconciling the House and Senate bills--and Pelosi is said to be positioning to make sure the option gets into the bill then.

So this is crunch time, but not the final crunch time. Still a ways to go.

Update: Krugman on why insurance company greed may have backfired, and Nancy Pelosi saying pretty much what I've been saying about the public option and individual mandate.