“Senator Nelson is strongly pro-life and was pleased the Stupak amendment passed with such strong support,” Thompson said in a statement. “He believes that no federal money—including subsidies or tax credits–should be used to buy insurance coverage for abortion. This is a very important issue to Senator Nelson and it is highly unlikely he would support a bill that doesn’t clearly prohibit federal dollars from going to abortion.”

It is a good thing NARAL and Planned Parenthood did not put up a fight before the Stupak amendment was added to the House bill. It is always so much easier to push things to the left in the Senate. . . .

If these groups are serious about protecting a woman’s right to choose, they better start looking into reconciliation.

Cecile Richards, President of Planned Parenthood says:

Planned Parenthood condemns the adoption of the Stupak/Pitts amendment in HR 3962 this evening. This amendment is an unacceptable addition to the health care reform bill that, if enacted, would result in women losing health benefits they have today. Simply put, the Stupak/Pitts amendment would restrict women’s access to abortion coverage in the private health insurance market, undermining the ability of women to purchase private health plans that cover abortion, even if they pay for most of the premiums with their own money. This amendment reaches much further than the Hyde Amendment, which has prohibited public funding of abortion in most instances since 1977.

Nancy Keenan, President of NARAL says:

It is unconscionable that anti-choice lawmakers would use health reform to attack women’s health and privacy, but that’s exactly what happened on the House floor tonight. Even though the bill already included a ban on federal funding for abortion and a requirement that only women’s personal  funds could pay for abortion care, Reps. Stupak and Pitts took their obsession with attacking a woman’s right to choose to a whole new level. We will hold those lawmakers who sided with the extreme Stupak-Pitts amendment accountable for abandoning women and capitulating to the most extreme fringe of the anti-choice movement.

That’s a pretty damn bad bill.  Some are calling it the worst assault on a woman’s right to choose since the passage of Roe v. Wade.   And now we hear Ben Nelson wants the Stupak language in the Senate bill.  As I told Rick Klein and David Chalian on ABC’s Top Line this morning, I don’t think the Democrats want to spend the political capital to fight for choice.  Good thing NARAL and Planned Parenthood are scoring the House bill, because that will be a very good incentive to keep members of the Senate from coming out in favor of it.

Wait…Planned Parenthood and NARAL are scoring the bill, right?

Laurie Rubiner, Planned Parenthood’s vice president of public policy, declined to say whether her organization would consider a vote in favor of the bill as an vote against abortion rights on its congressional scorecard.

Evidently “the organization must tread carefully to promote reproductive rights without sabotaging a health care bill they would otherwise find generally beneficial.”

They may be able to sell that in the weekly Common Purpose veal-pen roundup, but I’m not sure it’s going to go over so well with women who just lost control of their uteruses to Bart Stupak.

This is what Frank Wolf had to say on Friday in opposition to the health reform bill that ended up passing the House of Representatives on Saturday night. “Frank”ly, Wolf sounds no saner than Michele Bachmann and her merry band of “Obama is a Communist” tea partiers. I’ve gotta say, Wolf also sounds like his next line is going to be, “you kids get off my LAWN!!!” All kidding aside, though, check out this craziness from Frank Wolf and judge for yourself. Also, as you’re listening, note that Frank Wolf never opposed George W. Bush as he cranked up our national debt by trillions of dollars in order to give huge tax breaks to rich people and to launch a war against a country that had nothing to do with 9/11. Hypocrisy, thy name is Frank Wolf!

This happens to be Uncle Sam, he is saying, “don’t let the debt defeat a great nation.” We are obligated to China, China holds a large portion of our debt. The Saudis hold a large portion of our debt; the Saudis, who funded the radical madrasas up on the Pakistan-Afghan border and some who were on the airplanes that killed the people on 9/11, 30 more or so from my congressional district, hold our debt. We need to get control of this debt and the health care bill will not lower costs, the health care bill will cost over a trillion! What kind of a legacy are we leaving for our children…

In short, Frank Wolf believes that if health reform passes, more priests are going to be locked up, the country is going to sink into an abyss, we will be funding radical madrasas, and there’s going to be another 9/11. Wow. What next, comparing health care reform to the Nazis? Oh wait, I’d better not give Wolf any ideas! Heh.

That’s why we’re joining with CREDO Mobile and Democracy for America to call progressive Members of Congress and find out where they stand all this week.  Specifically, will they oppose a final bill that has triggers or state opt-outs?

Click here to get progressive Representatives’ numbers and call now.

Jane emailed FDL activists this morning:

You can see how far Blue Dogs are willing to go to derail the health care bill.  Progressives are going to have to show just as much conviction and resolve or they’re going to be making one concession after another to the Blue Dogs’ corporatist agenda.

Your Representative has previously committed to a public option – now we need to find out where they stand on triggers and state opt-outs in the final bill.  Please call now and ask where your member of Congress stands on a real public option.

Some folks have already reported their calls.  Here’s a sampling:

• Rep. Yvette Clark (NY-11): Definitely opposed to triggers, undecided on opposing opt-outs.
• Rep. Raul Grijalva (AZ-07): Definitely opposing a final bill with triggers or opt-outs
• Rep. Lloyd Doggett (TX-25): Definitely opposing triggers, unknown on opt-outs.  The caller wrote: “I also expressed my concern with a state opt-out since I live in Texas.  They agreed that would be an issue for us.”
• Rep. William Macy Clay (MO-01): Undecided on triggers and opt-outs.  The caller wrote: “Person answering the phone said Clay did not want opts outs and triggers, but said regarding triggers he was waiting to see what would develop. Got the impression he did not want either, but might be swayed on triggers to get a bill through.”

If a public option – available nationwide on day one – is to be included in the final health care bill, we need at least 40 members of the House of Representatives to promise to vote only for it. It’s the only way we can make sure that President Obama signs a public option into law.  To do that, we need Congressional phones to ring.

We need to find out where progressive Members of Congress stand on a bill with triggers or opt-outs.  Can you call now?

Click here to get the numbers of progressive Reps. and let us know what they say.

Due to my disgust about how terribly these women’s organizations failed in legislative and media battle on the issue, I spend three hours on Saturday craft which should have been their counter proposal.

Original Proposal
The exchange would allow insurance companies to sell plans at four coverage/cost sharing levels. They are basic, standard, premium and premium plus. The original abortion language would have let someone who is using tax credits to help afford insurance select any plan at any level they wanted. If the plan covered abortion, it would need to set aside some money that came only from direct consumer premium payments into a special fund. Abortion providers could only be reimbursed from this special tax payer money-free fund.

With Stupak Amendment
Individuals can still use their tax credits to help them afford any plan at any benefit level on the exchange. But if a plan had even one customer that uses even one dollar of tax credits, the plan could not cover elective abortion. Effectively no plan on the exchange could cover abortion. (Or, in theory,  the Stupak amendment could be used to discriminate against low income Americans.)

The Stupak amendment would allow individuals who bought an insurance plan with tax credits to buy a stand-alone rider that covers only abortion with their own money. For economic reasons, no insurance companies would sell these abortion riders. But this provision is important for a strategic counter proposal. The anti-abortion Democrats have admitted that it is not the government funding abortion if some get help buying insurance plans but buy supplemental insurance on their own that covers abortion.

Strategic Counter Proposal
Change the way the exchange works slightly. Insurance companies would only be allowed to sell basic level coverage and people could only use tax credits to buy basic level coverage. Basic level coverage plans can’t cover elective abortion. But insurance companies can sell three levels of supplemental coverage to any of their customers that bought their basic plan. The supplemental coverage would bring the total coverage to where it would have been if they were selling standard, premium, or premium plus plans like originally proposed. Supplemental coverage packages could only be bought with private money, and therefore could cover abortion.

The way tax credits are calculated would need to be slightly tweaked, but the net effect on cost, coverage, and cost sharing would be basically zero. Instead of getting tax credits equal to 80% the cost of a standard plan, the individual would get tax credits equal to 100% of a basic level plan and could pay an additional 20% to get supplemental insurance to make it equal to what would have been a standard level plan. Their out-of-pocket cost for premiums would be the same.

We know this system would work because this is how insurance is sold in Switzerland. There is a basic plans and supplemental insurance packages for people who bought a company’s basic plan. It is true the basic plans would not be allowed to cover abortion in this counter proposal. The implications should be minor since basic plans are meant to be the absolute cheapest plans competing on the lowest price, it is very unlikely that they would have ever covered anything like abortion that was not directly mandated. With my counter proposal, it is still likely that many insurance companies on the exchange would sell supplemental packages that included abortion coverage and most people would not buy only basic plans. The critical thing is the strategic counter proposal would have technically the same funding firewall that the Stupak amendment uses.

Would this counter proposal I quickly thought up have been able to win over the whole regressive caucus of anti-abortion Democrats? Probably not, but most of the regressive caucus who supported the Stupak amendment ended up voting against the final bill even after it was added. I also think at least some of them were not really concerned about the federal funding of abortion. I believe some were happy to  hold reform hostage because they saw this as an opportunity to restrict a woman’s right to choose as much as possible.

If the counter proposal had been able to peel away enough votes, it would have been a success. Even if it had been publicly rejected, it would have also been a success. It would have publicly exposed their lies and true intentions. The counter proposal could then be used to win the media and messaging war, and show how radical the Stupak amendment really is.

I can’t fault the huge women’s reproductive rights lobbying orginizations for not coming up with a similar strategic counter-proposal or attack to undercut Stupak. After all, they are multi-million dollar activist orginizations dedicated to this issue and only had about six months to prepare for this showdown. How can that ever compete with one guy who had three hours to kill over the weekend?

There are several reasons a properly designed public option could survive the Byrd rule. First, the bill saves money. Even the weaker, negotiated rates public option would still reduce the cost of reform to the federal government by roughly $25 billion, according to the CBO. Second, the public option would bring in and pay out large quantities of money in the form of premiums and provider reimbursements. This would all be done in a deficit neutral way, but it would still be related to the budget. If the first two reasons are not good enough to protect the public option from the Byrd rule, other changes could be made. The bill could require the public option to pay the federal government a small profit (i.e. run a surplus) in the first few years. The overall bill could also be slightly rewritten to base tax credits on the cost of premiums for the public option. The important thing is there are ways to get a public option passed using reconciliation.

By the same token, the Stupak amendment would definitely run afoul of the Byrd rule. This rule dealing with abortion is clearly an “extraneous matter” and the Parliamentarian would rule is as such. It violates the first part of the Byrd rule because it does “not produce a change in outlays or revenues.” I see almost no way the Stupak amendment could remain in a bill passed using reconciliation.

There was already good reason for progressives to demand that reconciliation be used. It would protect the public option from the threats of filibuster by Joe Lieberman. It would also not require the public option to be watered down with opt-outs, opt-ins, or other stupid provisions. Thanks to Bart Stupak (D-Mich.) the Democratic base just gained another reasons to push for reconciliation. Remember, if a bill is passed under regular order that does not contain a real public option but contains the Stupak amendment, it is because Harry Reid refused to use reconciliation.

Well, I was going through some documents and found a list of NARAL’s board members in their 2007 990 filing.  Don’t ask me how I missed this, but in 2008, NARAL subsequently invited Chaffee to join their board.

That’s right, the guy who — as part of the Gang of 14 — paved the way for Alito’s confirmation, without whose help it could not have happened, was then invited on the board of NARAL.

Anybody still wondering why NARAL didn’t start organizing pro-choice Dems on July 1, when Stupak wrote his first letter?  Nah, me either.

Kucinich voted against the bill after they didn’t allow a vote on his amendment to allow states to create single-payer health care systems.

I noted that Bart Stupak was able to pull his last-minute hijack of the health care bill because any 39 Democrats could stop the bill from passing. Given the fact it’s been well known for a while now that at least 25 Democrats would vote against any health care bill no matter what was in it, that meant any 14 Democrats could have joined together to block its passage unless either the Weiner Amendment or the Kucinich Amendment made its way to the floor.

I asked Congressman Kucinich if there was any attempt to whip those 14 votes.  He said no, there wasn’t.  Given the fact that H.R. 676 has 88 cosponsors, I asked him if there weren’t 14 who would have supported him in that effort.  He said no, he thought he was the only one willing to make that kind of vote of conscience.

It was hard to be happy about the passage of the health care bill on Saturday given the incredible blow to women’s rights that it represents.  With the exception of Kucinich and Massa, all of the House progressives abandoned their July 30 pledge to vote against any bill that didn’t have a public option with rates tied to Medicare.  Of course, those on the Energy & Commerce Committee abandoned it the next day, led by Jan Schakowsky, which is why we summarily mocked them at the time.  They were never going to take a stand against the Blue Dogs on Medicare reimbursement rates.  They traded it away for a floor vote on single payer, which the Speaker subsequently reneged on.

But all that was clear on August 3rd when the progressives capitulated in committee.  What wasn’t clear was whether there would be a public option in the House bill at all.  A month ago, it was pronounced dead by pundits and politicians left and right, but pressure from the base was able to stave off the influence of $1.4 million a day in lobbying money being spent by the medical industrial complex and force its inclusion.  No matter what you think of the adequacy of the public plan itself (and it is woefully inadequate), that is a huge tactical achievement.

It was possible, however, because there was already an effort within the caucus, led by Raul Grijalva and Jerrold Nadler, to whip their fellow Democrats to vote “no” on a bill that didn’t have a public option (the questionaire they sent out didn’t mention “medicare rates.”)  The two torpedos that were known at the time — Rahm Emanuel’s triggers, and Kent Conrad’s co-ops — were successfully kept out of the bill.  The White House successfully kept the Common Purpose “veal pen” groups from supporting their efforts, and yet they prevailed.  Online efforts led by DFA, FDL, Credo, Democrats.org and others provided critical support to Grijalva’s and Nadler’s efforts.

Unless you’re Wayne LaPierre and you’ve got the NRA’s huge infrastructure behind you, or you’re AIPAC and you can cut an instant $200,000 check to the challenger of anyone who speaks out against you, it’s not possible to force members of Congress to take a stand on something they’ve got no inclination to do on their own.  Planned Parenthood, with its hundreds of millions of dollars in state and national assets, did not mobilize the 180 members of the bipartisan pro-choice Democrats in July when Stupak first wrote his letter threatening to tank the bill.  Neither did NARAL.

We began whipping in support of the public option on June 23.  With a President who campaigned on having a public option and majority in the House and Senate who expressed public support, it allowed us to spend the intervening months closing the gap between rhetoric and action, and put pressure on those whose actions fell short of their promises.  When H.R. 676 co-sponsors like Charles Rangel, Eddie Bernice Johnson, David Scott and Joe Baca began dropping their support and threatening to vote against any single payer amendments, on the other hand, there was no price paid.

A public option was never anything more than a stepping stone to Medicare for all, a foothold in what would have otherwise been nothing more than a huge transfer of wealth to the insurance industry (which is still by-and-large is).  But it’s going to take a lot more political organizing on the inside before any real headway can be made on that front, and we’re working on that now.  The fact that even 14 of the 89 cosponsors won’t exercise the power they have and stand together to force even a symbolic vote shows how much work has to be done.

I’m not big on party purity tests, but there are something that are so essential that they are at the heart of what it should mean to be a Democrat. Helping those in need, protecting people from the excesses of corporations, universal health care, ending discrimination based on sex, and basic civil rights issues. These things are the foundation of the modern Democratic Party. If you don’t believe in them, then what are you even doing on this side of the aisle?

This conservative House health care bill is far to the right of center. It is not the single payer version favored by liberals. It does not even contain a robust public option. In fact, the public option will be restricted to only the small segment of the population that tends to have the hardest time buying insurance. The weakness of the regulation and the lack of government involvement compared to most countries’ health care systems is stomach- turning to progressives. The only amendment accepted on the floor (aside from the Republican alternative) was the Stupak amendment. It was the most far-reaching federal restriction placed on a woman’s right to choose in decades. It was probably the biggest win for the social conservatives in decades.

At its core, the bill relies on loosely regulated competition between private companies, and tax credits to expand insurance coverage (very stingy tax credits at that). The bill is not only paid for over the next two decades, but would in fact reduce the deficit. The biggest fear among health care reform policy experts is that the bill will fail because it does not go far enough. It is a cheap, deficit-reducing, incremental, market-based health care reform bill. This bill is not liberal, progressive, or moderate. It is an extremely conservative solution to a serious problem that is bankrupting our country.

It has been endorsed by the AMA, AARP, and Consumers Union. If you are willing to vote against this very modest way of achieving one of the longest-held goals of the Democratic party–because it is “too far to the left”–you honestly need to re-examine why you are even a Democrat. How many millions more Americans would the bill need to leave uninsured for it to be conservative enough for you?

2006 and 2008 were wave elections. The Democrats were swept in on a wave of anti-Republicanism, and then on a message of hope and change. In 2010 the wave will ebb, and the loses will be even worse if Democrats fail on a top priority like health care reform. When the tide goes out, don’t expect the Democratic base to do anything to prevent you from getting washed out of office.

Below is a list of 37 House Democrats who voted against this very conservative health care reform bill because it was “too liberal.” The link will take you to an analysis of what the bill would have done to help their constituents. (* indicate members who voted for the Stupak amendment but still voted against the over all legislation.)

Adler (NJ)
Altmire (PA)*
Baird (WA)
Barrow (GA)*
Boccieri (OH)*
Boren (OK)*
Boucher (VA)
Boyd (FL)
Bright (AL)*
Chandler (KY)*
Childers (MS)*
Davis (AL)*
Davis (TN)*
Edwards (TX)
Gordon (TN)*
Griffith (AL)*
Herseth Sandlin (SD)
Holden (PA)*
Kissell (NC)
Kosmas (FL)
Kratovil (MD)
Markey (CO)
Marshall (GA)*
Matheson (UT)*
McIntyre (NC)*
McMahon (NY)
Melancon (LA)*
Minnick (ID)
Murphy (NY)
Nye (VA)
Peterson (MN)*
Ross (AR)*
Shuler (NC)*
Skelton (MO)*
Tanner (TN)*
Taylor (MS)*
Teague (NM)*

The bill is not single payer. It does not have a public option tied to Medicare. The bill funnels billions to private insurance companies and foolishly eliminates the SCHIP program. It would prevent life-saving biosimilars from reaching the market in a timely manner. The new exchange is not well designed and lacks the robust risk adjustment mechanism needed to encourage competition based on quality. The annual out-of-pocket limit is far too high, and for many middle-class American families the tax credits are going to be insufficient. The bill did not take some of the huge steps really needed to rein in costs, like creating a single payment setting mechanism. It will not start in earnest for several years. And as a final insult, the Stupak anti-abortion amendment was added at the last minute.

It is important to acknowledge what good this bill will do. The most overlooked but important part of this bill is the expansion of Medicaid to everyone below 150% of the federal poverty level. No longer will there be a confusing patchwork of qualifications and waiting periods between the states. This expansion means that every American in poverty will have health insurance they can afford. Medicaid is not perfect, but it will expand coverage to 15 million Americans who would not have otherwise had health insurance. That is millions of Americans this bill unequivocally help.

The bill also contains many important consumer protections that are long overdue. Some of the most horrendous practices like rescission and not covering pre-existing conditions will be gone. Most importantly, the bill will set an important precedent. As a nation we will have made the commitment to help every American get health insurance if they want it. That is critical. Once a nation makes that commitment, they almost never back slide.

The bill does have a public option that would be available everywhere on “day one.” It is weaker and more restricted than it should be, but I strongly believe in the long term it will succeed. People will like it and it will grow steadily into a real force which will improve our health care system. At the very least, it would make sure right away that there was one decent insurance plan on the exchange not trying to rip off people. That is a huge accomplishment in itself.

What is most important is not how this bill will work, but what foundation it will lay. This will not be the end of health care reform. The system this bill creates is so imperfect that there is no way it will not be heavily modified, and possibly completely overhauled, over the coming years.

This bill will lay other useful foundations. It will make it so that any American who really needs/wants health insurance can get it. No longer will the Americans be denied insurance all together. By setting narrow rating bands the bill promotes the idea of equality in health insurance for all Americans regardless of sex, race, health, or pre-existing condition.  (Unfortunately, on the same token the Stupak amendment lays a strong ant-choice foundation in health care reform; if it remains in the final bill, the damage done by the Stupak amendment will probably never be reversed.)

The most important foundation the bill will create is a public health insurance alternative to hold the private insurance companies honest. The public option will be something the progressive movement can build on. If our new health care system only funneled billions of government subsidies to for-profit insurance plans that all Americans are forced to buy, that would be a foundation for long term disaster. Without the public option, the reform bill will be built solely on a base of greed, profit, and corporate welfare. That will simply not be sustainable and its failure could discredit the whole universal health care movement.

This bill that passed the House is disappointingly weak for progressives; but I’m not fighting to win the whole war with this battle, I’m fighting to lay the proper ground work needed for the next health care reform battle. This bill will at least provide progressives the tools they can use build with. This is why it is important to fight for the critical components like the public option, risk adjusters, and strong community ratings. (It is also why it is important to fight to remove components that will not easly be undone, like the Stupak amendment) It is not about what public option will be right away, it is what progressive can turn it into in the future.