Reid’s risky gamble
WASHINGTON There is an air of desperate improvisation to Sen. Harry Reid’s scheme to pass a “public option” as part of health care reform, but at the same time provide an easy exemption for any state that objects to it. The warning flags ought to be flying for anyone who can count to three—let alone 60.
The Democratic majority leader embraced this odd idea in hopes of satisfying two conflicting imperatives.
On one hand, he is under relentless pressure to satisfy the labor-left of his party in Washington, where a government-sponsored insurance plan has become the symbolic prize in the game, and back home in Nevada, where he needs union support to survive a scary election next year.
On the other, he needs 60 votes to pass any kind of health care legislation, so he must provide some comfort for moderate Democrats and possibly one or two Republicans.
Rather than bring a bill without the public option to the Senate floor and then hope to merge it in conference with a House bill almost certain to include such a provision, Reid bent to the political pressure and put his own needs first.
Even if he could make the tactic work, there is every reason for liberals, of all people, to reject it.
Consider the precedent that would be set if a major piece of social legislation were to be passed with a states’ rights provision. Imagine, for example, FDR had signed the first Social Security law with the proviso that any states with Republican governors and legislatures could exempt themselves from its coverage.
This might have seemed a minimal concession to conservative opinion. But what would have followed? How long before some states would have demanded an exemption from the wage-and-hour law that established a minimum wage? And what about the clamor in a broad swath of the country when the first civil rights law was passed?
The principle behind almost all liberal legislation is that there are certain values fundamental enough that they should be enforceable at the national level, even if a significant minority of voters or a certain number of states disagree.
That issue was settled in the realm of economic policy during FDR’s second term, after the Supreme Court seated enough new justices to uphold the New Deal measures an earlier conservative majority had struck down. In the area of civil rights, Lyndon Johnson and a Democratic Congress put an end to the doctrine of states’ rights. Are we now to reopen those issues in order to make it easier for this generation of Democrats to short-circuit the legislative process?
These hypotheticals may seem abstract. But in the real world, the consequences would likely be all too obvious.
To take but one example: If a health-care reform with an opt-out provision were to become law this year or next, one of the first states you might expect to exempt itself would be Texas. Republicans now control the governorship and both houses of the Legislature, and the state had no trouble rejecting candidate Barack Obama.
But Texas is also a state with glaring differences among its residents. There are literally millions of the poor, of Hispanics and African-Americans who give their votes to Democrats. Are the Democrats running Washington prepared to say to them (and residents of who knows how many other states): Sorry about this, but you don’t get what the rest of us get?
I’m not entirely convinced that the public option is as essential as liberals seem to think it is. But if they are right, I don’t see how they can justify abandoning it for an uncertain number of people who have the bad luck to live in states with conservative governors and legislatures.
If a compromise is needed to get the bill to the Senate floor, far better to try Sen. Olympia Snowe’s suggestion of a trigger mechanism that would activate a public option if private insurance policies at affordable rates were not broadly available.
No one should be denied coverage options by virtue of their residence or place of birth.
David Broder is a columnist for The Washington Post. Readers may write to him via e-mail at davidbroder@washpost.com.

Nov 4, 2009 at 1:39 a.m.
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Minan: That's the dirty secret behind this whole thing. United health Care (the largest insurer in the US) is all for this. This whole PR campaign as painting the giant insurance companies as evil, profit hungry, mercenaries, is simply a massive smoke screen. They stand to make out of this like bandits, and is why the giant companies are in favor of the bill. It's your smaller insurers who are raising hell, because they will be the ones run over, and squashed like a bug. This is all part of the new era of Oligarchy; where the governmnet does not take over business "to big to fail" they simply MERGE with them, and it's one huge happy family of powerful elites controlling both governmnet and the large industries of private sector. An arrangement that gives an iron grip of power at the highest level that can not be broken. It has all ready happened with the large banks, and two of the major autos.
Nov 4, 2009 at 1:05 a.m.
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Harry Reid's responce letter to the Republicans, wanting to see the bill he sent to the CBO, is priceless; "In other words, there is no bill to releasse publiclly---it does not exist".
http://www.hsacoalition.org/wp-content/u...
Nov 2, 2009 at 11:48 a.m.
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If the bill does not contain a public option then it should not mandate purchasing health insurance. This bill should not be a give away to the health insurance industry.
Nov 2, 2009 at 11:29 a.m.
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I am all for it not being illegal...why does the government need to tax it?
Nov 2, 2009 at 10:23 a.m.
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legaliza and tax marijuana. we'd be more than happy to pay for health care.
Nov 2, 2009 at 10:03 a.m.
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Nothing this government ever does is paid for. It is bought with our tax dollars, much of it wasted, and most of the times over budget and total spending is always beyond initial "guesses"...this will be no different. The very reason the are going will start taxing now (while people get nothing) is to make people think this is deficit neutral...when in reality anyone can tell you it is not.
Nov 2, 2009 at 9:42 a.m.
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It`s supposed to be paid for, and you can`t give out the subsidies until the money is there. I guess you could, but then the deficit climbs more.
Nov 1, 2009 at 6:38 p.m.
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Very nice of the policy makers to start taking taxes and fees right away for these items yet not institute healthcare change until after the next presidential election...why wait if it is needed now?
Nov 1, 2009 at 10:59 a.m.
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Most of it doesn`t take effect for four years anyway, and as for leaving it up to the states, I didn`t like that idea when Ryan floated it either. Although, I did read an opinion piece in the paper this morning, from a conservative writer, that said states would be foolish to opt out, also pressure from the people would urge them not to.
Nov 1, 2009 at 6:47 a.m.
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Leaving it up to the states...but the states can't do any thing until 5 years from now? How is that going to help?
Oct 31, 2009 at 5:37 p.m.
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It`s been posted since Thursday night, not a big secret. Debate won`t start till the middle, or end, of next week. I guess they left it up to the states to get enough Democrat votes.
Oct 31, 2009 at 5:16 p.m.
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correct that...should be not treated.
Oct 31, 2009 at 5:15 p.m.
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It also says it is a states choice to join or not...limiting choice does not fix problems. Why is interstate commerce for health insurance treated like other commodities...plain stupid.
Oct 31, 2009 at 5:11 p.m.
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I found it section 309. First line "Effective January 1, 2015"
hmmm why should this wait 5 years before it can happen?
Oct 31, 2009 at 5:04 p.m.
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Which part of the 1990 pages is it buried in?
Oct 31, 2009 at 5:02 p.m.
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I guess that bill would be little harry's---not showing it to members http://www.hsacoalition.org/wp-content/u...
Oct 31, 2009 at 4:54 p.m.
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HR 3962
Oct 31, 2009 at 4:52 p.m.
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Yes, the one that is posted online if you want to read it.
Oct 31, 2009 at 4:50 p.m.
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You mean the new house bill that all members of congress have not been given yet?
Oct 31, 2009 at 11:11 a.m.
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The House bill, there is only one now.
Oct 31, 2009 at 7:12 a.m.
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Which version of the house or senate bill? They all do not!
Oct 30, 2009 at 6:23 p.m.
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See,"Top Ten Reasons,Why Republicans Should Support The House Health Bill", by Igor Volsky, at the ThinkProgress WonkRoom 10/29/09.
Oct 30, 2009 at 6:14 p.m.
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I understand that it does allow states to let residents do this if the state wants to.
Oct 30, 2009 at 2:03 a.m.
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"No one should be denied coverage options by virtue of their residence"
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Yet this is exactly the law of today and this bill does not address; allowing people to shop accross state lines for heaalth insurance.
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