Legal Commentary

Why Not Just Pass MedicAid Expansion?

By Big Tent Democrat

Chris Bowers argues that MedicAid expansion is the key provision in the health insurance premium assistance bill for progressives:

The largest public option in the health care bills is, and has always been, Medicaid. In terms of the number of people it covers, it dwarfs any other public option currently on the table in either bill. In terms of the type of people it covers, compared to the other public option expansions it includes a much higher percentage of Americans who are currently uninsured and a much higher percentage of Americans who are currently in poverty. [. . .] Providing 15 million low-income, uninsured Americans with public health insurance is also why so few House Progressives carried through on their earlier threat to sink any health care bill without a new public option program tied to Medicare rates. After all, House Progressives both want to help people in poverty, and they disproportionately represent districts that would have been impacted by the new Medicaid coverage.

So, why not just pass MedicAid expansion then? Hell, throw in the subsidies to purchase private insurance too if you want. Use the House funding mechanism (the very popular "tax the rich" approach) and voila - we have a good progressive bill. Are there not 60 votes in the Senate for that? No problem. As was contemplated in 1997 for S-Chip, pass it through reconciliation:

[T]he bill had to comply with the existing balanced budget agreement between Congress and the White House, something that Lott said it did not. The Clinton administration had a deal with the Republican leadership in Congress that forbade the administration from backing any amendments to the budget resolution.

Guess what? The Democrats control the Congress now. Medicaid expansion (and the financing mechanisms) can simply be added to one of the budget bills. Since budget bills are not subject to filibuster, you pass MedicAid expansion and declare victory.

If I was in the Progressive Block, that is what I would hold as my final line in the sand if the Senate keeps fiddling.

What? No exchanges? No Mandates? No Excise Tax? No Stupak Amendment? Well, I guess we would just have to live with that, wouldn't we?

Speaking for me only

Full post as published by TalkLeft on December 10, 2009 (boomark / email).