About the Author

James C. Capretta

James C. Capretta

New Atlantis Contributing Editor James C. Capretta is an expert on health care and entitlement policy, with years of experience in both the executive and legislative branches of government. E-mail: jcapretta@aei.org.


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James C. Capretta’s Latest New Atlantis Articles

 Health Care with a Conscience” (Fall 2008) 

 Health Care 2008: A Political Primer” (Spring 2008) 

 The Clipboard of the Future” (Winter 2008)

 

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Text Patterns - by Alan JacobsFuturisms - Critiquing the project to reengineer humanity

Friday, September 4, 2009

A “Narrowing” Experience 

Is the administration really willing to compromise?

We learned this week that President Barack Obama’s aides are negotiating directly with Republican Senator Olympia Snowe of Maine to strike a deal on a “narrower” health-care bill.

It’s easy to see why the White House would be eager to secure Senator Snowe’s support for something. She signed onto the so-called “stimulus bill” earlier this year, and throughout her career has voted quite frequently with Senate Democrats on social and economic issues. If the White House is able to get her vote — again — they will be able to claim “Republican support” for the health-care effort, even if it is just one Republican with a voting record that is anything but conservative.

But would an Obama-Snowe deal mean something like the bills now moving through Congress will definitely pass?

Far from it.

The political problems with these bills are deep and structural. Democrats very self-consciously set out at the beginning of this year to pass something akin to the next New Deal or Great Society. Their goal is a dramatic and historic signing ceremony at which they take political credit for finally passing so-called “universal coverage.” They weren’t thinking “narrow” in January.

But passing “universal coverage” means a lot of additional political baggage that Democrats are now finding is not so easy to carry. Covering everybody means forcing Americans to buy government-approved insurance, whether they want it or not. And that means an expensive new subsidy program for lower income households, as well as a new tax on employers who don’t provide qualified coverage. The additional federal costs for the new subsidy program and an expansion of Medicaid will be at least $1 trillion over ten years, which means the bills also raise taxes by as much as $500 billion over a decade and impose cuts in Medicare and Medicaid of a similar magnitude. All of this is highly unpopular, as town hall meetings around the country over the last month have demonstrated. Moreover, many Americans rightly sense that the bills being written by the majority in Congress would amount to a federal takeover of U.S. health care, which they fear and adamantly oppose.

It should be clear based on what has taken place around the country this summer that the Obama administration and Democrats in Congress massively overreached on health care and now find themselves in a position where they can’t pass the bills they have been working on since the beginning of the year.

Leaks of pursuing a “narrower” bill are an indication that the administration finally understands this. So far, the only detail about what “narrow” might mean is the possible inclusion of the so-called Snowe “trigger.” Senator Snowe has suggested that the bill should not, at the outset, include a new government-run insurance option. However, if cost escalation does not slow and insurance coverage does not increase as expected, then in perhaps five years a new “government option” might be stood up. That kind of “deal” would find no support among Republicans other than Snowe, but it might placate some House liberals who are now threatening to jump ship if the bill were to drop the possibility of a “public option” altogether.

But even if the administration solves their “public option” problem, the bills as currently constructed still can’t pass unless they really do become much, much narrower. Is the president ready to drop the individual mandate and the Democratic goal of “universal coverage”? If he were to do so, many possibilities would open up. If not, the bill will still include massive new entitlement spending and taxes, deep cuts in Medicare, onerous requirements on employers, and far too much federal control. Which also means it will be near impossible to pass.

posted by James C. Capretta | 10:27 am
Tags: trigger, Snowe, mandate
File As: Health Care