Baucus: A Game Changer?


Yesterday, Ezra noted the truly surprising data in the Baucus bill - data that could prove critical to passage:

According to the CBO, the provisions of the bill that cost money -- the Medicaid expansion, the subsidies and so forth -- will grow by 7 percent annually over the second decade. But the tax on high-cost insurance plans, which doesn't raise all that much money in the first 10 years, would grow by 15 percent a year. The savings in Medicare and Medicaid would grow by 10 percent to 15 percent. In other words, if you're worried about the deficit, you should vote for, rather than against, health-care reform, as health-care reform actually improves the deficit.

Now I'm not an expert on subsidies, but if this bill will provide enough support to enable the working poor to get reliable health insurance, then this fiscal outlook strikes me as a game-changer.

The major resistance to healthcare reform at this point is, understandably, fiscal. If healthcare reform actually lowers the deficit over the long run according to the CBO, then resistance on that score should crumble. That's why this bill may have more legs than it first appeared. It will appeal to fiscal worry-warts like yours truly. It will be manna for Independents. And if the GOP opposes a bill that both removes some of the current injustices and reduces the long-term deficit, then the joke in the end is on them.

I might add I think this agonizing process has been helpful in the long run.

Most of us who are not Ezra Klein are not versed up to the gills in healthcare terminology and policy wonkery. The debate back and forth has been clarifying to me in a very complicated area which once bored me to death but has become increasingly interesting the more I've learned about it. Allowing the Congress to present different options, from several committees, letting the debate unfold as it has, allowing legitimate fears to be expressed (along with nutty Palin-style lies), bobbing and weaving between parties and senators ... this is the system working. The system in America is not supposed to create massive sudden change. Maybe if the TARP and bank bailouts had been subject to this kind of to and fro, more errors would have been avoided.

To those who say the president has been too passive, may I suggest making that judgment once this process ends? I find Obama's style to be more constitutionally appropriate than the president-as-decider model. I think that beneath the tea-party loopiness, we've made strides toward grappling with one of the biggest and most complex policy challenges there is. Even the tea-parties serve a purpose: they channel unease with the vast changes we have absorbed in the last year, and vents it. A democracy that cannot vent is less stable in the long run.

And there's scope for more manuevring. Why not add Wyden's more competition-friendly ideas into the final bill, as he suggests in the NYT this morning? Maybe there's something I'm missing, but it seems to me that the Baucus plan may be fiscally solid but doesn't do enough to enable patient and consumer power to bring down costs. Is Wyden's proposal a helpful fix? Or a step too far at this point?

(Photo: Mark Wilson/Getty.)

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