Three-Ring Circus at the Senate Finance Committee

On today’s installment of “I watch C-SPAN so you don’t have to,” the Senate Finance Committee has been convening “roundtable” discussions to focus on different aspects of the health care reform legislation that they’ll begin drafting in a matter of weeks. Today’s topic was “Expanding Healthcare Coverage.” Last week’s roundtable on the healthcare workforce and delivery system was pretty sedate. This one was filled with fireworks.

Now don’t get me wrong, multiple hours were taken up by senators from the finance committee (most of them white men) asking questions that really telegraphed the senator’s own policy views to a panel of experts (also mostly white men). The level of content was as deep as you would expect from C-SPAN. The panel or experts was an extraordinary mixture of opinions, equally accommodating to Stuart Butler of the Heritage Foundation and Len Nichols of the New America Foundation, with unions, advocate groups, business interests and, yes, more insurance company leaders than you can shake a stick at all offering conflicting notions on insurance regulation and the public plan. You can read their prepared statements at your leisure, but here were the three highlights for me.

3.) What’s a Senate Committee hearing without a protest?

Sen. Max Baucus, chair of the Senate Finance Committee, has been a target for single-payer advocates for so clearly shutting out any discussion of single-payer as a viable option. Sure enough, his roster of speakers for today included no one vouching for HR 676 or any other single-payer bill.

So members of Healthcare-Now and Physicians for a National Health Plan, in a move that sent a message of “Media Blackout THIS” disrupted the proceedings. And, sure enough, it covered on Wall Street Journal’s Health Blog (with video!)

2.) AHIP undermines the Republican argument

Karen Ignagni of America’s Health Insurance Plans (AHIP) spent a lot of time pushing their main message of partnership and cooperation, as she has for all of her previous public appearances at health care reform forums this year. Now granted, a lot of this posturing is clearly to throw into relief the points that the industry is dead-set against, a public plan being Numero Uno.

But it struck me how often she completely undermined some of the anti-reform messages we hear from conservatives. Within her first answer, she, on behalf of private insurance, had said that she was willing to accept guaranteed issue (no exclusion on the basis of pre-existing condition), community rating, ending different prices for those who are sick, ending different rates for gender, flattening state-by-state variance in prices, etc. It was sort of breathtaking how much she was willing to concede in terms of regulations. Having read Rep. Tom Price’s anti-regulation pitch, and remembering all the conservative talking points about too much regulation on health insurance, it was truly a surprise to see Ignagni, in essence, begging for more regulation. I wrote this sentence down about the wherefore for increased federal regulation: “We’re not asking them [consumers] to trust us, we’re asking them to trust the government.”

So I have to ask – does this make AHIP a bunch of socialists?

1.) His name is Schumer. Chuck Schumer.

As mentioned, Ignagni’s pleas for federal regulation to impose order on the wild, wild West of state insurance regulations largely served to contrast with her staunch opposition to a public plan. This wasn’t the traditional arguments of crowd-out, or the impossibility of quality health care coming from the government (except for Medicare, Medicaid, the VA, etc…) Instead, Ignagni attempted to frame the debate as “If federal legislation can correct the market in a way it’s never been corrected before, why would we need a public plan at all?”

That’s about the time the senior Senator from New York walked in the door.

Now keep in mind, some of Schumer’s past comments showed somewhat cagey or soft support for the public plan, or at least seemed like a man trying to play “Let’s make a deal." So it was a surprise that the first article I read in The New York Times this morning was entitled, “Schumer Offers Middle Ground on Health Care,” laying out a set of conditions to achieve a level-playing field. Except these principles aren’t all that new. They’re very similar to the work that health care economists Len Nichols and Jacob Hacker, both proponents of the public plan, have already done on the question. They’re similar to the signals coming from the White House on how the plan could be structured.

And based on Schumer at today’s hearing, I wouldn’t say he’s “offering” it. He’s demanding it. Ezra Klein found this quote to be the most striking, and I agree: “Just as bad as a public plan with an unfair advantage is no public plan at all. My colleague from Kansas said the American people don't want the government involved. Well, let me tell you, the American people have some problems with the government. But they have a lot more problems with private insurers.”  And did we mention that Schumer has a name for the public plan option that's better than the perfunctory but vague "public plan"?  He calls it, "Plan USA."

He then went on to, basically, demolish Ignagni’s main argument. Thanks to Igor Volsky at Think Progress, we’ve got audio. Listen for yourself:

So the day began with protesters shouting for single-payer and ended with Schumer hammering the private insurance industry. The only thing we were lacking was popcorn.

(Photo credit:  propublica on Flickr.)