It Happened Last Night: Nelson Amendment Nixed, Public Option In LimboS

The votes from last night are in, and the U.S. Government's Magic 8 Ball appears to have settled on "Reply hazy, try again."

The Associated Press' explanation of events is forcing me to read between the lines (emphasis mine):

After agreeing tentatively to jettison a key liberal priority - a full-blown government-run insurance option - Democrats say they are getting close to pushing President Barack Obama's health care bill through the Senate.

So we agreed to drop the public option?

Greater government involvement would potentially kick in if private insurance companies declined to participate in the nationwide plan, although details weren't available. One possibility was for the personnel office to set up a government-run plan, either national in scope or on a state-by-state basis.

Wait - is this that trigger thing Olympia Snowe was so insistent on? We're waiting for insurance companies to decide to throw in to our plan before we get more coverage?

The health legislation passed by the House last month includes the tougher abortion language as well as a government insurance plan; those differences would have to be resolved, assuming the Senate passes its bill.

But a little bird tells TPM not to be so quick to declare the public option off the table:

As you know, the AP and NYT reported tonight that the new deal dumped the Public Option. Our Brian Beutler, up there on the Hill was not so sure. And Sen. Reid said definitively this was not true. And now the Times seems to be backing off their report. And we're getting hints that those reports may have been premature.

TPM also has more details on this potential-kinda-sorta-maybe-perhaps a public option thing:

As has been widely reported, one of the trade-offs will be to extend a version of the Federal Employees Health Benefits Plan to consumers in the exchanges. Insurance companies will have the option of creating nationally-based non-profit insurance plans that would offered on the exchanges in every state. However, according to the aide, if insurance companies don't step up to the plate to offer such plans, that will trigger a national public option.

Beyond that, the group agreed—contingent upon CBO analysis—to a Medicare buy in.

That buy-in option would initially be made available to some uninsured people aged 55-64 in 2011, three years before the exchanges open. For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized—people will have to pay in without federal premium assistance—and so will likely be quite expensive, the aide noted. However, after the exchanges launch, the Medicare option would be offered in the exchanges, where people could pay into it with their subsidies.

It appears as if liberals lost out on a Medicaid expansion that would have opened the program up to everybody under 150 percent of the poverty line. That ceiling will likely remain at 133 percent, as is called for in the current bill.

And, in keeping with the no one is going to be happy theme, both Snowe and Nelson are jabbing at the bill with a sharp stick:

Nelson has said he won't support a final bill without the tougher language in his amendment, but he also has signaled his stance could change.

Other ideas in the health care reform package under discussion include expanding the Medicaid program more than currently called for in the bill and expanding a proposal in the bill that would give states money to cover low-income people through existing programs instead of Medicaid.

Snowe flatly rejected a possible expansion of Medicaid.

"It's a huge burden on the states," Snowe said. "It is without question and without a doubt a very expensive proposition."

Can we deny health insurance from all of the members of Congress until this is resolved? I mean, they can afford to pay right? Just like they assume all of us over 133% of the poverty line can? (By the way, to meet the guidelines for coverage at 133%, a family of four would need to bring home less than $29,327.)

The more we see how this debate is shaping up, the more I'm inclined to agree with G.D., who wrote:

Like [Leigh Graham, blogging for Change.org] said, members of Congress live in a world with relatively high job stability. They pull in $170, 000/yr and make use of an extremely generous healthcare plan in which the government pays up to 75 percent of the premium. The major legislative players in health care reform have never worried about their employers switching to an inferior plan with a higher contribution or dropping their insurance outright. Their plans have no lifetime caps, they face no rescissions or any of the constellation of obstacles that are par for the course for their fellow insured Americans (to say nothing of the folks with no coverage at all). And then there are folks like John McCain, who despite his considerable wealth would have a hard time getting covered on the individual market thanks to his history of cancer, and has been insulated from from that reality by receiving government-funded care as a member of the Armed Forces, a veteran, and a U.S. Senator. Or Dick Armey, the former House majority leader-turned-professional-healthcare-reform-obstructionist, who received public health care as a young professor at a state university in Texas before spending the next several decades in Congress.

If the impression you've gotten from the way our lawmakers have handled the health care debate is that this whole thing is a big abstraction to them, that's because it probably is.

G.D. titled the post "They Don't Understand the Language of People With Short Money." It's one of those things that would hysterical if it wasn't true.

In other this-battle-isn't-over news, Bart Stupak has taken to the op-ed pages to let us know that's he's really not a bad guy! He's just maintaining the Hyde Amendment:

Under our amendment, women who receive federal subsidies will be prohibited from using them to pay for insurance policies that cover abortion. The amendment does not prevent private plans from offering abortion services and it does not prohibit women from purchasing abortion coverage with their own money. The amendment specifically states that even those who receive federal subsidies can purchase a supplemental policy with private money to cover abortions. [...]

The language in our amendment is completely consistent with the Hyde Amendment, which in the 33 years since its passage has done nothing to inhibit private health insurers from offering abortion coverage. There is no reason to believe that a continuation of this policy would suddenly create undue hardship for the insurance industry - or for those who wish to use their private insurance to pay for an abortion.

For example, the Federal Employees Health Benefits Program provides health insurance through a variety of companies to more than eight million Americans - but it does not allow abortion coverage in any of its policies. Yet the same companies that offer these abortion-free plans to federal employees also offer plans with abortion coverage to non-federal employees. Given that insurance companies are able to offer separate plans with and without abortion coverage now, it seems likely that they would be able to continue to do so on the newly established health insurance exchange

.

So, in sum, no one knows what we're getting, Stupak is still looming like some super villain resurrected for multiple franchises, and the news still sucks.

Senate Dems near agreement on health care bill [MSNBC/AP]
Maybe Not [TPM]
Democrats Agree To Tentatively Trade Opt-Out For Trigger, Medicare Buy In, And More [TPM]
White House lauds Senate Democrats' health care deal [CNN]
2009 Federal Poverty Level [Coverage for All]
They Don't Even Understand the Language of People With Short Money. [PostBourgie]
44% of Congress are millionaires [Change.org]
What My Amendment Won't Do [NY Times]