It's going to be difficult to get the Democratic coalition behind behind this bill unless a Medicare Choice Buy - In is included.
The stated problem at this point is the Senate. However, I would contend that the votes are there for the taking. We have 37 Senators on board with the public option through reconciliation, including Feingold and Dodd. 6 more have every reason to support a Medicare Choice Buy - In, especially one with the President's support behind it (Akaka, Carper, Dorgan, Harkin, Kohl, and Rockefeller). Tester, Baucus, Conrad, Hagan, McCaskill, Webb, Warner, Byrd, and Begich would give us 52 Senate votes -- two more than we need.
If vulnerable House members are the problem, adding this element only strengthens their chances for re - election. No bill or an individual mandate without a public choice are both bad politically. It's time for some real pragmatism. The policy benefits of a public choice are obvious. Why is a Medicare Choice Buy - In so important politically?
- MCBI would enable the grassroots to feel comfortable rallying around what is on the table now.
- MCBI would help energize the base in time for November.
- MCBI would be very popular, especially with Dems and swing voters. "Medicare Choice Buy - In" is almost certain to poll somewhere between 65% and 75%.
- MCBI would put Republicans on the spot over their commitment to Medicare, because it would strengthen Medicare over the long - term.
UPDATE:
This version corrects the earlier post that failed to make it clear that an MCBI couldn't be done until next year if it isn't included in this effort.
Also, McJoan has a really good post on maximizing the popularity of the legislation that passes.
Rep. Eric Massa's resignation moves the number for passage in the House back to 216.
Rep. Anthony Weiner isn't giving up on an up or down vote for the public option.
If there isn't a vote on a meaningful public option / Medicare Buy - In, the spotlight is going to come back to the White House's deal with private hospitals.
Bottom line: I have a very hard time believing that there aren't at least 50 votes in the Senate for a Medicare Buy - In. And I know I'm not alone.
The final package, while improved in some very significant ways from what the Senate passed, will be deeply flawed both policy-wise and politically. At this final moment of decision, though, I think progressives need to say yes to getting the bill passed.
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For all the disappointments, for all the flaws, this legislation does some critically important things, and I believe it sets the stage for doing better things down the road. If Democrats can't get this passed now, the lesson that Democrats will learn is to never try anything big or difficult again. If we get this legislation passed, it begins to change the psychology of Democrats just a little: that they can succeed at being ambitious and that they can make big changes if they persevere in the face of big money and political challenges.
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To all my progressive friends who have been fighting this long, hard fight on health care: I know not all of you agree with me that this bill should be passed. But I think on balance that this is the right thing to do, not only in terms of health care but in terms of our broader progressive agenda. Because of you, not even the fight for the public option is over (although it's way uphill). Let's stay on the field, keep fighting, get this bill done, and then keep fighting for better things in the future.
Rep. Raul Grijalva, co - chair of the House progressive caucus, talks to Ed Shultz about yesterday's meeting with President Obama.
