Senate bill


The Democrats’ Tangled Web

In 2009, Democrats chose to proceed with a health-care bill under the regular order — that is, they sought to pass the legislation under normal House and Senate rules. They did not put together a budget reconciliation bill with health care in it, something that could have passed the Senate with a simple majority vote. They conceded that such an approach would likely produce a flawed product, as many non-budgetary provisions in a health-care plan would not survive the reconciliation process. And so they decided to try and pass a bill without resorting to reconciliation, even though they knew they would need sixty votes in the Senate to succeed. It worked. They passed a bill in the House in November, and a somewhat different version in the Senate in December.

Then came Scott Brown. His stunning election to the Senate on January 19 upended the Democrats’ end-game. They were going to work out the differences between the House and Senate-passed bills in January and proceed to pass an agreed-upon version in both chambers as expeditiously as possible. But that plan was contingent on getting sixty votes again in the Senate. With Brown’s election, Senate Republicans increased their numbers from forty to forty-one, thus forcing Democrats to find at least one Republican Senator to support their final bill.

For the past two months, the White House and Democrats in Congress have been weaving ever-more complicated legislative webs all with the express intent of avoiding at all costs any need to negotiate with the now slightly enlarged Senate minority. In effect, what Democratic leaders want to do is — at the very end of the legislative process — switch from regular order to a reconciliation process in order to avoid having to deal seriously with any elected Republicans.

But it’s become increasingly clear that the Democratic scheming and maneuvering necessary to pull off such a high-wire act has created a web of entanglements that could very well doom passage of the entire effort.

In particular, there now appear to be two huge hurdles standing directly in the way of a plan to jam a bill through in the coming days.

First, there is the matter of the liberal abortion provisions in the Senate bill. As the Catholic Bishops conference has noted, the Senate-passed bill includes several provisions that would allow taxpayer funding of elective abortions. Consequently, the Bishops opposed passage of that bill when it was considered in the Senate, and now oppose its passage by the House. The problem for House Democrats is that every version of the end-game they are now considering is predicated on having the House take up the Senate bill and pass it unchanged for presidential signature.

That is entirely unacceptable to the Catholic Bishops. They oppose House passage of the Senate’s pro-abortion health bill. Period. And their opposition hasn’t come with procedural loopholes that would let members off the hook if they promised to pass a fix separately. That would be fool’s bargain, and the Bishops know it. So pro-life House Democrats, led by Congressman Bart Stupak, really have no choice here. They can’t support the Senate bill unless they want to be known for supporting the most pro-abortion bill ever considered in Congress. Their only real option is to force House leaders to amend the Senate bill before passing it to include strong restrictions on funding of abortion. Yes, that would mean the bill would have to go back through the Senate again before going to the president, but so be it. That’s not the Bishops’ problem. It would mean the president and the Democrats would have to really negotiate to get some Republican support, which is of course the norm for sweeping and important legislation.

The Democrats’ problems don’t end with abortion, though. Today, the Senate parliamentarian confirmed to Republican members that the Senate health-care plan must first be signed into law by the president before the Senate can take up a reconciliation bill making changes to it. This is the House Democrats’ worst nightmare. That means they can’t pass and hold the Senate health bill pending clearance by the Senate of a reconciliation bill making fixes. If the House votes to approve the Senate bill, that’s it.  The Senate bill will become law, signing ceremony and all.  Congress may or may not follow through by amending it later. In the meantime, House members will have voted to approve the Cornhusker Kickback, the Louisiana Purchase, the special treatment for Florida seniors, countless special deals for hospitals, a new tax on many collectively bargained health plans, not to mention a massive tax increase, Medicare cut, and job-killing mandates.

In short, if congressional Democrats are bound and determined to pass a sweeping government takeover of American health care on an entirely partisan basis, their only way forward is for the House to accept without change the highly unpopular Senate bill, and suffer the consequences. That will be a very bitter pill for many rank-and-file members to swallow.

There is an alternative, however. The White House and House and Senate Democrats could abandon reconciliation, fix the problems in the Senate bill, and then work with some Senate Republicans to produce a plan that can get a supermajority in the Senate. No doubt it would require more than cosmetic changes to the government-heavy plan Democrats have drafted. But it is not impossible. It has been done countless times before on major legislation. And it is certainly what the public is telling their elected leaders they want to see happen.

If, however, the Democrats continue to insist it’s their bill or no bill, the odds are increasing by the day that it will be no bill.

posted by James C. Capretta | 5:53 pm
Tags: reconciliation, Senate bill, House bill, U.S. Conference of Catholic Bishops
File As: Health Care

It’s Not a $950 Billion Plan

The Obama administration has gone to great lengths to convince the press that the plan the president released on Monday would cost “only” $950 billion over ten years. At the moment, there’s no Congressional Budget Office (CBO) cost estimate to contradict the White House’s claim. Nor did the administration provide any cost estimate from its own HHS actuaries, even though the actuaries — not the White House press office — are responsible for developing official health-care spending estimates for the administration. An independent estimate from those who do this for a living showing the plan’s cost at $950 billion would have been very convincing.

But that presumes the actuaries would agree with the White House assessment, which they almost certainly don’t. Their cost estimates over the past six months have consistently shown the health-care bills developed by Congress would cost much more than advertised, and well over $1 trillion over a decade. Worse from the Obama team’s perspective, the top HHS actuary has used every opportunity handed to him to say unpleasant things about the Democratic reform plans. Like, there’s no “bending of the cost-curve” going on in any them. And national health spending would go up, not down. And the deep and arbitrary Medicare payment-rate reductions that the Democrats are pushing would lead thousands of institutions into financial distress, thus jeopardizing access to care for many seniors. The last thing the Obama White House wants to do right now is hand the actuary a microphone.

For its part, CBO’s assessment of the president’s latest plan is likely to look similar to the cost estimate the agency produced for the Senate-passed bill. After all, the White House’s latest proposal is explicitly built on the Senate bill’s framework.

But CBO never said the Senate bill would cost “only” $871 billion over ten years. That’s Democratic spin. CBO said the cost of the so-called “coverage provisions” would cost $871 billion over a decade. But there’s plenty of other spending in the bill that is not directly related to coverage expansion. That spending totaled another $90 billion over a decade.

Moreover, the president has taken the Senate bill’s expansive entitlement promises and made them even more expensive. He would increase the new insurance subsidies, make the Senator Nelson-giveaway for Nebraska available to all states, and close the “donut hole” in the Medicare drug benefit. The White House says the new subsidy structure would add $75 billion to the overall price tag. The Medicaid expansion and the new drug spending would certainly add tens of billions more. If they cost just another $50 billion, that would put the total cost of the White House plan at about $1.2 trillion through 2019.

But 2019 is no longer the appropriate stopping point for budgetary assessment. CBO updates their baseline projections every January, and they extend them by one more year each time they do. So, right now, CBO has current-law projections going out to 2020, and the cost estimates they produce for other tax and entitlement legislation considered by Congress this year will go out to 2020 as well. When CBO finally does assess the latest Obama plan, it will have to look at the plan through 2020, not 2019. Adding one more year to the health-care cost estimate will increase the ten-year price tag by another $220 billion.

And there’s more. The administration wants to provide a permanent fix for the broken Medicare physician-fee schedule, but it doesn’t want to include that fix in the cost of the health-care plan. Never mind that the health-care proposal includes scores and scores of Medicare provisions, touching on just about every aspect of the program. The one provision the White House doesn’t want included just happens to cost $210 billion or more over ten years. It doesn’t matter to taxpayers to whether the Democratic health-care program is passed in one bill, or two, or even three. The total cost will be the same. If the “doc fix” is included in a cost tally of the Obama health plan, as it should be, it adds another $200 billion to the price tag.

So, no, it’s not a $950 billion plan. Not even close. All in all, it’s at least $1.5 trillion through 2020, and probably closer to $1.6 trillion.

But even that’s not the full story. To keep costs “down,” the White House plan starts tax increases and Medicare cuts right away, while the new spending is mostly delayed until 2014. A fair look at the plan’s ten-year costs would include ten years’ worth of spending. The Senate Budget Committee Republican staff expects the Senate-passed bill’s true ten-year cost is $2.3 trillion. The Obama add-ons almost certainly would push that up to $2.5 trillion, and maybe even as much as $3 trillion.

And it would not end there either. If enacted, the Obama health plan would lead to even more entitlement spending down the road. The Democrats want to extend a new health-care entitlement to low- and moderate-wage workers — but only some low- and moderate-wage workers. Not all of them. In particular, the Democrats would provide generous new insurance subsidies to those who get their insurance through the so-called “exchanges.” Lower- and middle-class families who continue to have job-based plans would get no additional help even as the government imposed new mandates and burdens on them. But providing federal support to some but not all workers in defined income categories is a completely unsustainable political proposition. One way or another, the entire middle class will end up becoming eligible for the new entitlement, pushing the costs of the Obama plan well above anything that has been discussed to date.

The Obama team that says all of the lavish new promises it is extending can be paid for with new taxes and Medicare cuts. But that’s already been shown to be a very dubious assumption. Under pressure from his union patrons, the president pushed the starting date for the so-called “Cadillac tax” to 2018 — well past the time when he will have left office. This was supposed to be his signature “bend-the-curve” reform. If he can’t impose this tax, why should we expect later administrations will? And there’s no way Congress will withstand the pressure that will come when some facilities head toward insolvency with inadequate Medicare payments.

At the beginning of 2009, the president told the country we needed to reform health care in large part for fiscal reasons. The federal budget cannot sustain the rapidly rising costs of the health programs already on the books. But at each stage of this year-long odyssey, the bills being pushed by Democrats have become increasingly on heavy entitlement promises and light on anything resembling true reform. The president’s latest proposal continues the trend. After a year of giveaways, this is not a reform effort at all. It’s nothing more than another massive entitlement expansion, and one the country most surely cannot afford.

posted by James C. Capretta | 8:50 pm
Tags: budget, White House plan, Senate bill, actuaries, CBO
File As: Health Care

Why the Senate Bill Makes No Sense

In the new Weekly Standard, my colleague Yuval Levin and I discuss the bill that has emerged from the Senate. An excerpt:

The [Democrats' original] goal was to get a large swath of the public insured by the government, and so gradually create a socialized insurance system. Conservatives opposed this scheme because they believe a public insurer would not be able to introduce efficiencies that would lower prices. Liberals supported it because they think a public insurer would be more fair and more effective.

But in order to gain 60 votes in the Senate, the Democrats have now had to give up, for all practical purposes, on any version of that public insurer, while leaving the other components of their scheme in place. The result makes no sense whatsoever — not to conservatives, not to liberals, not to anyone. Rather than reform a system that everyone agrees is a failure, it will subsidize that system and compel participation in it — requiring all Americans to pay ever-growing premiums to private insurance companies, most of which are for-profit, while doing essentially nothing about the underlying causes of those rising costs. The thought that, after all of this, a Democratic Congress is going to force Americans to send their premiums to the despised insurance industry and then subsidize that industry to boot has sent the left into such a state of frenzied recriminations it could sink the whole enterprise yet.

And that is by no means the only problem for the left in this bill. The mad rush to pass something obscures a crucial component of the bill's design that could prove very problematic for Democrats. For all of President Obama's insistence that we must have action now, and all the talk by congressional Democrats about the terrible costs of delay, the key components of the Senate bill would actually not go into effect for four years. Essentially all of the spending provisions and insurance reforms — including the individual mandate to purchase health insurance, the employer mandate to provide it, the state insurance exchanges, the federal subsidies for coverage, and the Medicaid expansion — would only go into operation in 2014....

This timeline of tax and spending implementation corresponds rather awkwardly to the political calendar confronting the Democrats.

The entire article is available here.

posted by James C. Capretta | 8:16 pm
Tags: Yuval Levin, Harry Reid, Senate bill
File As: Health Care

Reid 2.0: It’s Still a Budget Buster

The Obama White House and its congressional allies have tried all year to push their various bills through to passage by truncating the time between introduction and a decisive vote to the bare minimum. They figure the only way to get something passed is to minimize public review and scrutiny of whatever their latest idea is to engineer American health care from Washington, D.C.

To date, that tactic hasn’t worked out so well. In July, House Democrats tried to unveil a bill on the 14th for a planned vote on the 31st. A firestorm erupted, however, pushing back the vote into November. In the Senate, meanwhile, a series of self-imposed deadlines have been missed as Democratic pronouncements of inevitability have bumped up against the reality of steadfast and growing public opposition.

Nonetheless, Senate Majority Leader Harry Reid is running the same play again today, and very possibly with different results. He unveiled the latest version of his reform legislation this morning, filled to the brim with outrageous payoffs to buy the votes of holdout Senators. Virtually no one else has seen the bill before today, much less had a chance to give it the scrutiny it deserves. And certainly the public has not had a chance to weigh in. No matter. Senator Reid has simultaneously set in motion the procedures necessary to force a vote on his new health-care plan in a matter of hours, not weeks.

And yet, despite the unprecedented effort to short-circuit public review and input, it is likely that this latest version of the Reid plan will be just as unpopular as the previous one, and for many of the same basic reasons.

According to the Congressional Budget Office (CBO), the amended Reid plan would reduce the federal budget deficit by $132 billion over the period 2010 to 2019, but that is a mirage.

For starters, as CBO notes, the bill presumes that Medicare fees for physician services will get cut by more than 20 percent in 2011, and then stay at the reduced level indefinitely. There is strong bipartisan opposition to such cuts. Fixing that problem alone will cost more than $200 billion over a decade, pushing the Reid plan from the black and into a deep red.

Then there are the numerous budget gimmicks and implausible spending reductions. The plan’s taxes and spending cuts kick in right away, while the entitlement expansion doesn’t start in earnest until 2014, and even then the real spending doesn’t begin until 2015. According to CBO, from 2010 to 2014, the bill would cut the federal budget deficit by $124 billion. From that point on, it’s essentially deficit neutral — but that’s only because of unrealistic assumptions about tax and Medicare savings provisions. By 2019, the entitlement expansions to cover more people with insurance will cost nearly $200 billion per year, and grow every year thereafter at a rate of 8 percent. CBO says that, on paper, the tax increases and Medicare cuts will more than keep up, but, in reality, they won’t. The so-called tax on high cost insurance plans applies to policies with premiums exceeding certain thresholds (for instance, $23,000 for family coverage). But those thresholds would be indexed at rates that are less than health-care inflation — forever. And so, over time, more and more plans, and their enrollees, would bump up against it until virtually the entire U.S. population is enrolled in insurance that is considered “high cost.”

Similarly, the Medicare cuts assume that hospitals, nursing homes, home health agencies and others can survive with a permanent annual cut in their payment rates for presumed productivity gains. Medicare’s chief actuary has already signaled that this reduction could push one in five hospitals into insolvency, thus forcing them out of the Medicare program.

What’s more, the benefit promises are sure to expand well beyond what CBO has assumed. There are 127 million people living in households with incomes between 100 and 400 percent of the federal poverty line, but CBO assumes that only 18 million of them will get the new subsidized insurance under the Reid plan by 2015 because of rules that make most workers ineligible for assistance. But, if enacted, employers would find ways to push more workers into subsidized arrangements, and Congress would loosen the rules to make more people eligible. Costs would grow much faster than CBO currently projects. In addition, the Reid plan continues to include a new entitlement program for long-term care that every actuary who has looked at it says is a financial disaster waiting to happen. If passed, it would only be a matter of time before another federal bailout would be necessary.

It is now plain as day that the Reid plan has evolved into nothing more than a massive entitlement expansion, which subsidizes more people into an unreformed system with soaring costs. Several Senate Democrats claim to be strong fiscal conservatives. Their votes on the Reid legislation will provide conclusive evidence whether that’s true or not.

posted by James C. Capretta | 6:42 pm
Tags: Senate bill, Harry Reid, CBO, Medicare cuts
File As: Health Care

For Nelson, It Shouldn’t Be a Close Call

Nebraska Senator Ben Nelson announced yesterday in an interview with a home-state radio station that new language regarding abortion coverage in subsidized insurance plans was not acceptable to him, dealing yet another blow to Senate Majority Leader Harry Reid’s mad-dash rush to pass a bill before Christmas.

Of course, it’s crucial that Senator Nelson stick to his guns on abortion. He has always been a self-described pro-life Democrat, and attracted votes accordingly in his election campaigns. So far, he shows every indication of sticking to his guns and insisting on language that is at least as stringent as that offered by Representative Bart Stupak and passed in the House last month. This is no time to go wobbly, or to listen to those who are transparently trying to divide the Senator from his pro-life supporters. If abortion language offered by Senator Reid doesn’t meet the test of the Catholic bishops — and it doesn’t — Senator Nelson owes it to those pro-life voters who have stood with him over many years to stand with them at this critical time.

But, just as importantly, Senator Nelson made it clear in the same radio interview that his concerns with the Reid bill go well beyond protecting taxpayers from financing elective abortions — as they should. Senator Nelson considers himself to be a fiscal conservative too. The Reid bill provides a ready opportunity to prove that he actually is.

Even before a new health-care entitlement program is stood up, the nation’s budgetary outlook is very grim, and has been made more so by the policies of the Obama administration. CBO projects that the Obama 2010 budget plan will drive federal debt up from $5.8 trillion at the end of 2008 to more than $17 trillion by 2019. And it will only get worse from there. Federal spending on Social Security, Medicare, and Medicaid is expected to increase from 11.1% of GDP this year to 17.1% in 2030, a jump in spending of 6% of GDP in just two decades. To put that in perspective, that’s like adding another Social Security program to the federal budget without any new revenue to pay for it.

The Obama administration and its allies in the Senate keep arguing that the Reid bill will begin to fix the entitlement problem. It won’t. It will make the nation’s entitlement problem much worse.

If passed, here’s what’s certain. Medicaid will be expanded to at least another 15 million people. This is the same Medicaid program that is entirely unreformed in the Reid bill and has been growing, on a per capita basis, nearly 2 percentage points faster than per capita GDP growth for three decades. In addition, Senator Reid’s proposal would create a new health entitlement by subsidizing the premiums for households with incomes between 100 and 400 percent of the federal poverty line. In all, CBO says these “coverage expansion” provisions (including tax credits for small businesses) will cost nearly $200 billion by 2019, and that cost will grow 8 percent annually every year thereafter.

And that’s a lowball estimate. The new insurance premium subsidy program is available only to households getting their insurance through the new “exchanges,” not employees who have no choice but to take the plan offered at work. But, as Gene Steuerle of the Urban Institute and I have pointed out elsewhere (see here and here), this kind of two-tiered system of subsidies creates large disparities in the treatment of households with identical financial resources. As matters stand, CBO says only 18 million people would get the premium subsidies in 2015, even though, in 2008, there were already 127 million people under the age of 65 living in households that would be eligible for subsidization. If enacted, it would only be a matter of time before tens of millions of additional people ended up in the subsidy program.

And what does the Reid bill do to slow the pace of rising costs? The President’s Council of Economic Advisers touts the slowdown in Medicare and Medicaid costs, as scored by CBO. But these spending reductions don’t come from more efficient health-care delivery. The savings are from arbitrary, across-the-board payment-rate cuts for hospitals, nursing homes, home health agencies, and others. These cuts do nothing to improve the efficiency of medical practice. Indeed, in the past, they have led to cost-shifting, and Congress has shown no stomach to sustain such cuts in the face of warnings of reduced access to care, such as was provided by the Medicare program’s chief actuary last week.

The administration also believes the new Medicare commission will work wonders. But, as the Concord Coalition has noted, the commission’s mandate is incredibly limited. It can’t propose any changes to hospital or physician reimbursement arrangements. It can’t restructure the Medicare entitlement. And its targets after 2019 wouldn’t save anything. That means, for a few years, the commission might get to cut home health and other ancillary service payment rates. That’s it. Medicare won’t look any different as a result. Never has so much been made about so little. Moreover, the commission itself represents an incredible admission of failure. At the beginning of the year, the Obama administration was promising to come forward with new whiz-bang ideas to painlessly root out inefficient health care without harming quality. They never did. Now they are saying a new independent commission will do it for them. Don’t hold your breath.

Senator Nelson is clearly uncomfortable with the bill as written. Any fiscal conservative would be. It’s not a close call. As the senator said yesterday, the country would be far better off with a more scaled-back bill. He’s right about that. And it’s in his power to deliver just such a bill. Pushing the discussions into 2010 would not end the health-care debate. It would only make it more likely the Senate voted in the end for something the public — and Nebraskans — would find acceptable.

posted by James C. Capretta | 5:28 pm
Tags: Ben Nelson, Medicare, abortion, Harry Reid, Senate bill
File As: Health Care

Harry Reid's Ticking Entitlement Time-Bomb

Senate Majority Leader Harry Reid is scrambling today to pick up the pieces from his collapsing “breakthrough deal” between moderates and liberals. It seems the Senate’s top Democrat rushed out with a compromise plan that none of the critical players had actually agreed to support.

At the center of the storm is Connecticut Senator Joe Lieberman, who is an independent but caucuses with his Democratic colleagues. Because of how he was last reelected — in spite of, not thanks to, the national Democratic party — Senator Lieberman owes the Obama administration nothing.

For months, Senator Lieberman has warned his colleagues of the dangers of pursuing an excessively partisan health-care agenda. In August, he told CNN that it would “a real mistake” to jam through an unpopular health bill with no Republican support and passionate public opposition. And he has been sounding the alarm for months that the emerging Democratic plan is too heavy with entitlement expansions at a time when the nation’s finances are already drowning in unaffordable commitments. In an interview in October, he said that Democrats were “trying to do too much” in the health-care bill and were unnecessarily creating additional risks for an already over-burdened federal budget.

But his warnings have fallen on deaf ears. Ever since the August town-hall meetings, the Obama administration and the Democratic leadership in Congress have been rushing full speed ahead to try to pass a highly partisan and bloated bill that they know is strongly opposed by a majority of voters. Their goal is to pass it as fast as possible so that they can lock in a massive entitlement expansion with time to recover politically before the 2010 midterm election.

Senator Lieberman has done the country a great service by, rather mildly, voicing his concern and disagreement with the prevailing Democratic approach. In recent days, he has said that, to get his support, the health-care bill must drop any and all variations of the public option (including the flawed Medicare “buy-in”), as well as the new long-term care entitlement — the so-called CLASS Act — which would almost certainly lead to unfunded obligations down the road. Senate liberals, not wanting to compromise with Lieberman, are howling at the prospect of having their long-cherished goal of “universal coverage” boil down to forcing tens of millions of Americans to pay premiums to profit-greedy, publicly-traded insurance companies.

But even if Senate Democrats made some concessions to Lieberman, the Reid version of Obamacare would still be a runaway entitlement expansion and budget buster. That’s because the primary entitlement it promises is a ticking budgetary time-bomb certain to go off in a few years time.

The Reid bill promises households with incomes between 100 and 400 percent of the federal poverty level that the premiums they owe for health insurance will be limited to a fixed percentage of their incomes. In 2016, a family at the poverty line would pay no more than 2.1 percent of its income toward health insurance. The premium cap would increase on a sliding scale until it reaches 10.2 percent for families with incomes between 300 and 400 percent of the poverty line. The Congressional Budget Office (CBO) expects this entitlement, plus the Medicaid expansion and tax credits for small businesses, to cost about $200 billion by 2019, and to grow 8 percent annually every year thereafter.

But even that staggering cost doesn’t reveal the true price tag of the Reid bill because, expansive as the entitlement is, Senate Democrats make most workers ineligible for it. Workers who are offered qualified coverage by their employers, with employee premiums below specified “affordability” thresholds, would have no choice but to take their job-based plan with no subsidization. True, the vast majority of the premiums would be paid by their employers — but, of course, when an employer pays for health insurance, it is really the worker who pays in the form of lower cash wages. That is the consensus of credible economists, including those working at CBO. There is a federal tax preference for employer-paid premiums, but it is worth much less for most low- and moderate-wage workers than the subsidies the Reid bill would hand out in the exchanges.

Let’s imagine what this would mean in practice in the year 2016, by which time (according to CBO estimates) the average cost of family coverage will be $14,100. Consider a hypothetical family of four with an income at 200 percent of the federal poverty line (or about $48,000 for a family of four in 2016). Under the Reid plan, that family would pay 6.5 percent of its household income as a premium, or $3,120. Their employer would pay a fee of $750 to cover some of the cost. The rest of the premium — $10,230 in this example — would get paid by the federal government.

By contrast, a worker with the same total compensation from his employer but with job-based insurance would enjoy a tax advantage of about $4,300 from employer-paid premiums. That's nearly $6,000 less in governmental support than the worker who is eligible for direct subsidization in the exchange.

According to the Census Bureau, in 2008 there were 127 million Americans under the age of 65 living in households with incomes between 100 and 400 percent of the federal poverty line. But CBO assumes that in 2015, only 18 million people would get subsidized premiums in the Reid plan.

But of course it will never work. If enacted, employers would find ways to place more low-wage workers into the exchanges, thus driving up the cost of subsidized insurance. Congress would also respond to political pressure and liberalize the eligibility rules. Like almost every other entitlement ever enacted, this one will grow far beyond current projections.

Truth be told, though, that’s what most Democrats want. They just don’t want to face up to the costs at this time, in this bill. Better to get the entitlement in place first, and then let it grow naturally as entitlements always do.

Senator Lieberman has been pushing his colleagues all year to produce a bipartisan and more measured bill that enjoys broad public support. That’s the only sure way to prevent enactment of a runaway entitlement sold on dubious assumptions and gimmickry. It’s now within Senator Lieberman’s power to bring about a major course correction. For the sake of the country, he shouldn’t hesitate to force his Democratic colleagues to do what they would not do voluntarily.

posted by James C. Capretta | 6:04 pm
Tags: Harry Reid, Joe Lieberman, CLASS Act, Senate bill
File As: Health Care