Opt-out is bad solution to health care reform impasse

Commentary By Norm Bell

Senate Majority Leader Harry Reid is, at his core, a dealmaker. That’s how the Democrat rose in rough and tumble Nevada politics and how he ascended to his current power perch in the capitol.

He’s not the polarizing figure of Nancy Pelosi, the San Franciscan who is his counterpart in the House. Yes, he too has shown he can wield sharp elbows, but he has shown a more discerning eye in picking his battles. He also knows political cover when he sees it. And his latest deal making proposal – the opt-out scheme to save the public option in the health care reform bill – is a tour de force.

Make no mistake, this opt-out scheme has little to do with health care reform and everything to do with the realities of Washington politics. The idea is that a trigger mechanism would be put in place to monitor competition in the health insurance marketplace. If competition isn’t perceived to be sufficient – and arbitrary construct at best -- a public agency would step in and offer insurance. If individual states don’t like that solution, they can opt out of the public system.

As health care policy, opt-out is a non-starter. Even in a best-case scenario, it would create a red state/blue state division that would subvert the underlying principle of coverage portability, one of the concepts that enjoys near unanimous agreement in this divisive debate. It also would create an intolerable situation in which federal tax money collected from states that opt out would be used to subsidize a benefit that would not flow to that state’s taxpayers.

Opt-out, however, has everything to do with politics. Reid sees the finish line clearly. The polls say Americans want health care reform; the left wing of his party is ready to pass a House bill containing a public option; he needs to find a way to get 60 Senate votes to head off a potential Republican filibuster that could paralyze government and keep President Obama from the policy and political victory he so desperately craves.

So Reid has crafted a skillful plan to deliver 60 votes – and only that. The cosmetic fairness of allowing states to opt out undercuts the strength of the Republican fear campaign. If it’s that bad, just opt out – you won’t be harmed – or so the argument goes. It also gives a handful of conservative Democrats a way to support cutting off debate and forcing an up-or-down vote on health care reform, even if they then end up voting no on the bill itself.

Along the way, it may drive finally kill the illusion of bipartisan support. Sen. Olympia Snowe, the Maine Republican who has long been considered the most likely to cross party lines and vote for the final health care bill, says opt-out is a disappointing development.  But in Reid’s math, her vote is no longer necessary. In the final analysis, 60 votes are 60 votes, wherever they come from

Opt-out is as cynical a compromise to attain an end as any in American history. And cynical compromises run deep in our history, starting with the three-fifths compromise on counting slaves that allowed the 1787 Constitutional Convention to bridge a sticking point at the nation’s birth.

We are at another historic juncture. The clearest route to avoiding another cynical compromise would be for conservatives from both parties to abandon the strategy of no in favor of offering policy alternatives that will push the debate back onto substantive ground.

The question is whether they can rise to the occasion before the opportunity slips away.

Leave a Response