Sen. Kent Conrad And Political Reality

The Washington Post's Ezra Klein interviewed Sen. Kent Conrad about his proposal for state health cooperatives and concluded that Conrad "is very clear about the genesis of this proposal: The Gang of 11 -- the chairmen and ranking members of the Senate's health-related committees, which is to say, the Senate powerbrokers on this issue -- asked him to build this compromise because they don't think the votes exist to pass the public plan."

To underscore this point, Conrad gave the same interview yesterday to a bunch of health care journalists and reporters. He told Atlantic Media Political Director Ronald Brownstein:

"Here's the reality we confront. In the Senate if there is the public option there is virtually no Republican support, and there are a number of Democrats who don't support it either. How do you get to 60?"

Supporters of Conrad's proposal point out that the idea had been discussed in the meeting that Democratic Senators had with President Barack Obama earier in the week. Conrad is nonplussed about the reaction from liberal health reformers who want a robust public plan to compete with and eventually crowd out the private insurance market. Conrad's point: that's not possible, given the political calculus now. If you can change the political calculus, you'll get the plan.

From the perspective of a liberal health care reformer, who's to blame for this state of affairs? The White House. They're not pushing back against Conrad. They're not arguing in private for a tougher public plan. (An insurance industry executive who talks regularly to the White House lauded the administration yesterday for its honest brokerage.) The other reality Conrad confronts is that even the majority leader, Harry Reid, acknowledges that the reconciliation process for passing budget items (50 votes needed only) would take care of, at most, 75% of the reform proposal, excluding most versions of a "public plan."  If you can't get to 60, then you don't have a bill. Sen. Max Baucus and Conrad are still opposed to reconciliation on principle.

Details about the Conrad plan are very vague. It's not clear, for example, that the federal government wouldn't have to be invovled at some level; there'd have to be some (potentially substantial) federal investment to get a national co-op up and running.