I met Wednesday afternoon (July 1) with two of Representative Harry Teague's (D-NM2) staff (Jake Redfearn and another fellow from the D.C. office whose card I didn't get). They had just come out from another meeting with other health care reform advocates. After meeting with me they were headed to a meeting at what appeared to be Senator Bingaman's office.

I ran down the litany for Jake, and he understood my position. That is, single-payer is far and away the preferable solution. But single payer is impossible because Senators Baucus and Hagan won't allow it out of the H.E.L.P committee.

Both agree that cost-control is going to be more easily achieved with a strong public option. The D.C. staffer believes we can "do better than we are currently" with cost control. What that says to me is that he doesn't understand the situation. Health insurance markets are highly concentrated in almost all the States. The sellers have cartel status in most places, and monopoly status in some. Here in New Mexico, if you want health insurance, your choices are BC/BS, Presbyterian Health Systems, or United. Cigna/Lovelace isn't really a player outside Albuquerque. I ran down the evidence for cartel behavior among the insurance providers (the DC staffer was out of the office when I ran that down).

The bottom line: Congressman Teague recognizes the need for health care reform, he backs a strong public option. He wants health care that is universal, affordable and transferable. He will "examine carefully" any bill that comes to the floor, but will not agree that a strong public option is mandatory. More is the pity.

I have made contacts, though, and I will be combing through whatever comes to the floor. I think that it's possible that Redfern can be convinced that a strong public plan is mandatory for a good bill. Harry won't commit, but it's possible he'll vote against a bad bill (as we define it.) Unfortunately, his staffers don't seem to see that making a stand can prevent the need for a hard-to-explain "no" vote.

I really wish that the HELP committee proposal had been available Monday or Tuesday so that we could have discussed that rather my pounding on the necessity for a public option. Oh well, now it's fodder for next time.

Apparently Nebraska Senator Johanns is scared of the voters:

One day before we celebrate the birth of our nation, Nebraskans gathered at a scheduled healthcare roundtable to call on Senator Johanns to support an American solution to our healthcare crisis.

Instead of greeting the teachers from NSEA, veterans, and SEIU workers Senator Johanns' staff called the police, ordering the Nebraskans to leave the Medical Center grounds.

"Johanns' voters-- teachers, members of the armed forces, and SEIU members-- set up a table with apple pie and signs welcoming the Senator and urging him to support a uniquely American solution to healthcare reform," explained Jane Kleeb, SEIU State Director. "Instead of coming by and saying hello, the Senator walked right by us as we were surrounded by police, and the Senator said 'good luck with that.'"

SEIU received advanced permission from the Nebraska Medical Center to greet the Senator as he started his day of roundtables on healthcare reform. Instead of greeting the healthcare reform advocates at the table, the Senator's staff called the police.

So, what does the Senator have to say about all this? His staff is denying it:

Johann's staff, however, portrays things rather differently. They contend that the organizers were confronted by hospital security and asked to move their protest off hospital grounds. They also deny complaining--either to the police, or to hospital security--about the protesters' presence, and say the roundtable proceeded, with Kleeb's participation, after the controversy was resolved.

Stay tuned....

Yesterday Jane posted about the HELP Committee Bill and CBO score. We've been a little slow to get up an analaysis because the numbers are, well, confusing to say the least.

So, after review of what some of the smarter folks out there have to say about this bill, here's what we've learned.

From Ezra:

The short version is this: CBO estimates that by 2019 the bill will cover 21 million people at a cost of $597 billion. But -- and this is important -- the HELP Committee's bill doesn't include the Medicaid expansion, because Medicaid is under the sole jurisdiction of the Finance Committee. But if Medicaid is expanded to 150 percent, it will cover an additional 20 million at a cost of about $1 trillion. Add in the savings that Finance is expected to get from reforming Medicare and you're looking at a bill that will cost $1 trillion to $1.3 trillion and cover 42 million people (which would mean 97 percent of the legal population in 2019 would have health insurance) by 2019.

As for the confusion? Ezra explains:

The importance of this set of numbers can be understood only in terms of the catastrophe that was the last set of numbers. On June 15, the Congressional Budget Office scored an incomplete version of this bill. The office estimated that it would cost $1 trillion over 10 years and cover 16 million people. It would've cost, in other words, 70 percent more and covered 20 percent fewer people. The big question, then, is what accounts for the change? And luckily, there's a simple answer: the employer mandate.

From Jon Cohn:

According to the official CBO estimate, which a Capitol Hill source provided late Wednesday afternoon, the provisions over which HELP has some jursidiction--which include employer contributions and subsidies to people who can't fully pay for insurance on their own--would bring insurance to 21 million additional people by 2019, the end of the ten-year budget window. (Erosion of job-based coverage would be virtually zero.) An expansion of Medicaid, something HELP supports but can't officially legislate--because of committee jurisdiction--would cover another 20 million.

So what does that mean in context? The official CBO projections suggest that, given current trends, there'd be 54 million uninsured people in America by 2019. Therefore, the reforms HELP envisions would reduce that number by three-quarters. Overall, if my math is correct, 95 percent of the population would have health insurance; more than 97 percent if you discount undocumented workers.

OK, how about the cost? CBO says the net outlays are around $600 billion. But that's based strictly on what's in the bill. It doesn't appear to include the cost of the Medicaid expansion, because--again--that is outside HELP jurisdiction and thus not in the legislation HELP submitted.

So if you want the true cost of reform, you have to account for that Medicaid expansion, too. If my back-of-the-envelope calculations are correct, that puts real price tag somewhere between $1 and $1.3 trillion. Again, that's a rough guess, based on just a few conversations, although it is is more or less what the experts have predicted all along.

And Tim Foley on the Public Option:

Among the plans offered will be the new “Community Health Insurance Option,” aka the public plan (sec 3106). It’s open to those without coverage through their employers, and small businesses (under 50 employees), and would be entirely voluntary. Similar to the House and the Schumer model, it would rely on negotiated rates with providers, and would be self-sustaining through premiums and the same subsidies available to any other plan in the Gateway. The government would give it a loan to get started, which it would pay back once it was actuarially sound. It’s not as generous as the original Kennedy version, but it still has enough leverage, cost savings and incentive to offer a real choice between public and private.

Whipping works--just try it and see!

Maxine Waters takes the pledge. Six down, thirty-four to go.

From the Citizen Whip Count:

Mack says Doggett is undecided:

I called the local office first and they claimed they didn't know his position and told me to phone the D.C. office - I called D.C. twice and was told both times they don't know if he has a position.

Chris says George Miller won't say:

Spoke to person answering the phone. Mentioned the bill from the House committees has a public option. mentioned that Miller is a cosponsor of 676, the single payer bill. Absolutely would not state whether Miller would vote no on a weak bill even though I pushed a lot.

T says Peter Welch will get back to them:

Did not get her name, she apparently had no idea what his position is. "He'll get back to you in writing" I'll update when/if I hear anything more

John says Mike Doyle's staff doesn't know:

Amy knew nothing. Said she hadn't heard of FDL. She didn't know if Doyle supported single payer. I even offered to fax her a copy of an FDL post, since she wasn't interested in going out to FDL's site. She didn't bite on that one either.

John also says Patrick Kennedy is an undecided:

Pratik (guy) was helpful and smooth. He said he was not familiar with FDL, but he asked me to fax him. I offered to show him the whip tool on the web and he claimed to be following along. I have more confidence that staffers/interns are really going out to FDL if it takes them time to log in and they tell me what they're seeing. Not sure about Pratik.

And he indicates Steve Cohen won't commit:

Adam knew exactly what I was talking about when I mentioned "the pledge" about the public option. Cohen is still firmly in "no position," but I sensed no animosity or lack of openness. I asked Adam if he knew when Cohen might take a position on the pledge, he did not. I emphasized that from a leadership perspective, it hurt to have Cohen in the "undecided" category.

David puts Sander Levin in the "leaning yes" category:

Janet says Kendrick Meek is "leaning yes" too:

I spoke with Mr. Meek's office receptionist and she declined to identify herself and said any official statement needed to come from Adam Sharon. Mr. Meek signed onto HR 676 but is unsure of his position on the Public Option. He's still fact finding, but at this time he's leaning toward supporting a strong Public Option.

Florindo says Rangel "needs more pressure":

Charlie is trying to sleaze his way through this one, too. I spoke with Ms. (inaudible) and she gave me the usual routine about strongly favors public option with the characteristics of the 3 points but won't commit to any vote until the final bill is on the floor.

I said, "But if 40 dems commit to vote no against any bogus public option, then they can influence the content of the final bill."

Yes, but .... blah blah blah.

Needs more pressure.

And just for kicks, John D. called Mark Kirk's office:

They all laughed.

That is a good one.

I'm changing the chart slightly. Progressives we're talking to aren't really "refusing" per se to vote for a public plan, but they're refusing to say they will vote against a bill that doesn't have one. Since fondness for a public plan and a buck fifty will get you a cup of coffee, it amounts to little more than a back door to a sell-out. So we're now calling it the "weasel words" category.

Maxine Waters spoke with Robert Greenwald of Brave New Films.  Per Robert, she pledged to vote against  any bill that does not have a strong public option.

She also went on record encouraging people to keep up the pressure:

Let me just say to all of our friends out there, that a sustained effort, directed at public officials, demanding no less than a public option, can be very successful.  So go to work.

She expressed admiration for the campaign against Mary Landrieu in Louisiana, saying "I loved it," and underscored the urgency of the situation:  

The least we can get is a public option. And I understand that's under review at this time.  But that's the LEAST we can take. 

You heard the lady, so go to work!

h/t nedrichards

When senators head home for the Fourth of July parades, the fireworks, and the time with "regular folks" around their states, some of them will find some interesting ads running on the radio:

During the Fourth of July congressional recess, a faith-based ad campaign will launch nationally to address the need for health care reform. The campaign includes airing radio ads featuring local pastors June 30 to July 4 in Arkansas, Colorado, Louisiana, Nebraska and North Carolina, as well as meetings with members of Congress and building a grassroots movement to raise awareness of health care issues.

The radio ads will air on Christian and mainstream radio stations featuring pastors from each of the five states. In the ads they ask their senators "to support health care reform that makes quality coverage affordable for every American family," according to the campaign organizers.

The ads are being run by a collection of religious groups including PICO National Network, Faith in Public Life, Faithful America, Sojourners, Gamaliel Foundation, and Catholics in Alliance for the Common Good.

The thrust of the ads is quite simple (audio at the link):

Well it is quite the day for health care activism: Not only does Senator Kay Hagan (D-NC) relent in the wake of activist pressure to allow a public plan out of the HELP Committee, but Representative Jerrold Nadler (D-NY) takes the pledge:

The best-case-scenario solution that I have long advocated is a single-payer system to efficiently and affordably provide everyone with quality health care coverage. I am a proud co-sponsor of H.R. 676, Congressman Conyers’ bill to create a single-payer system– an approach which would ensure each of us access to health care that is paid for through one government fund, instead of through multiple private insurance companies. Unfortunately, there simply are not enough Members of Congress willing to vote for a single-payer system.

As the second best alternative, we are working to create a robust and competitive public health insurance option. The aim is to make sure that among the many health insurance options from which Americans can choose, one of these options is a “public option”– a health insurance plan not run by a private company but by the government, much like Medicare.

[]

I urged that the public option should be effective immediately, open to anyone, run through a government or independent agency, and based on Medicare. I also advocated for additional insurance reforms that include ending discriminatory practices against people with pre-existing conditions, or based on gender or geography, and establishing a baseline of coverage that includes mental health and preventive measures.

[]

In May, I began whipping my colleagues on the absolute necessity for a public option and convinced many of them to commit, as I have done, to voting against any health reform bill that excludes the public option. This commitment will give us leverage to oppose the insurance company lobbyists, and force inclusion of a robust public option in the developing health insurance reform plan.

(full statement on the flip)

This is huge. Nadler is not only committed to voting against any health care bill that does not have a public option, he gives a definition to that term -- it must be 1) open to anyone (nationwide), 2) effective immediately (no triggers), and 3) run through a government or independent agency, and based on Medicare. It's an even STRONGER commitment then we were asking for. And he's been urging his colleagues to do likewise.

A far cry from Rosa DeLauro's progressive weasel words, Donna Edwards' sudden attack of netroots amnesia.

I can tell you that NYCEve's post about her call to Nadler's office was heard loud and clear, and that the release of this statement was a direct result of her picking up the phone and taking action.

And Kay Hagan's newfound embrace of the public plan comes the day after breast cancer survivors of North Carolina announced they would personally be delivering a letter asking her to support a public plan.

You can add your signature in support of their efforts here (whether you're a cancer survivor or not).

When we began this effort, we knew that the lobbying interests aligned against a public plan were strong. They had already made single payer impossible, as Nadler notes, by preventing it from getting out of committee. But single payer can grow from a public plan. And we need a place to start.

A very big thank-you to Rep. Nadler for making a statement that all others will be judged by, and for responding to calls for help.

With 76% of the country in favor of a public plan, it's good to know that leaders like Keith Ellison, Raul Grijalva and Jerrold Nadler are willing to stand just as firmly as the anti-choice crooks on the Ag committee who call themselves Democrats.

Keep the calls coming!

On Day 6 of the Whip action, Jane P called Rosa DeLauro's office and reported:

I was informed that Rosa DeLauro is in favor of a public option. She is committed to voting against a bill that does not contain one.

Adriana Surfas of DeLauro's office emailed to clarify:

Understand you were asking about Congresswoman DeLauro’s position on health care reform legislation and the inclusion of a public plan option.  Below is a comment from Rosa.

“The conversation about health care reform could not be more urgent – families and businesses are hurting.  We have to make health care more affordable and lower costs for families, businesses, and the nation.  Meaningful health care reform must include a public insurance option that competes with private health insurance to lower costs and expand choice for consumers.   I strongly support the public option that is central to the draft proposal put forward by the House committees on Education and Labor, Energy and Commerce, and Ways and Means.  I will be fighting to make sure the bill that comes out of the House includes a public health option and look forward to voting for that bill.” —Congresswoman Rosa DeLauro

To which I responded:

Thanks for sending me this.  I appreciate that Congresswoman DeLauro is in favor of the public option.  I'm in favor of world peace, but I'd be a bit disingenuous if I allowed people to think that my favorable opinion of it was likely to make it happen.

Sen. Kay Hagan (D-NC)

So says HCAN:

On the conference call announcing the measure, Senators Dodd, Brown, and Whitehouse said that all 13 HELP Democrats would be voting for this bill. That's right, every single one.

Betsy Muse at Blue NC thinks Hagan is owed an apology. But Kay Hagan opposed a public plan quite openly. If she's supporting this, she changed her mind -- which means the activism worked, and everyone who picked up a phone and called, or took the time to write and let her know how they felt should take a bow. Excellent work.

It still appears to be a very flawed bill that is inferior to the House bill. I'm sure everyone will still be working hard to make it better, and that means keeping the pressure on Hagan.

Breast cancer survivors will be delivering signatures to Hagan from people all over the country who want a public plan. You can add your support and sign here.