How Progressives Strengthened HCR
In his OpenLeft post, "Yes, Congressional Progressives won major public option concessions in the health reform bill," Chris Bowers has a potent antidote for a defeatist meme that has popped up here and there on the progressive blogosphere: that progressive activists got rolled, and consequently, the Democratic HCR package ain't worth spit. To which Bowers responds:
...That entire line of "argument" is just demonstrably false, and either intellectually dishonest or blinded by egregious cynicism...Here are two huge public option concessions that ended up in the Senate bill as concessions to progressive activists and members of Congress:
1. Four million additional Americans covered by Medicaid
Back in July, the health reform proposal in the House (PDF, p. 17) expanded Medicaid coverage by 11 million compared to current law. In an attempt to win over the 60 House Progressives who demanded a public option tied to Medicare rates, Speaker Pelosi increased the Medicaid coverage in the health reform proposal to 15 million more than current law. This was done entirely as a sweetner to Progressives, most of whom come from districts with a disproportionately large number of constituents who would be eligible for Medicaid expansion. Furthermore, even though it was accomplished through a slightly different policy means, that expansion of Medicaid to 15 million more people than current law remained in the Senate bill (CBO report, PDF, page 20)
The House Progressives who signed the infamous July 31st letter demanding a public option tied to Medicare rates did not just fold and walk away with nothing. They got four million, uninsured, low-income Americans public health insurance. They were additionally given a chance by the leadership to whip the entire House caucus on a Medicare +5% public option in the insurance exchange. They came close, but failed to reach 218. That was also a concession they won from the July letter.
2. Twenty-five million additional Americans provided public health care
On December 16th, Senator Bernie Sanders was still threatening to vote against cloture on the Senate health reform bill. Three days later he was on board, but only after securing public health care (not health insurance, health care) for 25,000,000 million, largely low-income Americans:
To amplify the latter point, Bowers flags the following from Sanders' website:
WASHINGTON, December 19 - A $10 billion investment in community health centers, expected to go to $14 billion when Congress completes work on health care reform legislation, was included in a final series of changes to the Senate bill unveiled today.
The provision, which would provide primary care for 25 million more Americans, was requested by Sen. Bernie Sanders (I-Vt.).
He said the additional resources will help bring about a revolution in primary health care in America and create new or expanded health centers in an additional 10,000 communities. The provision would also provide loan repayments and scholarships through the National Health Service Corps to create an additional 20,000 primary care doctors, dentists, nurse practitioners, physician assistants and mental health professionals.
Very importantly, Sanders also said the provision would save Medicaid tens of billions of dollars by keeping patients out of emergency rooms and hospitals by providing primary care when then needed it.
Bowers adds that "This was won as a direct concession for Sanders' vote on cloture," and
...Given a chance to pass a bill that is the largest expansion of public health insurance and health care in 45 years, and when netroots progressive activism campaigns played vital roles in improving those portions of the bill, you're damn right I want to it passed.
We were fighting to expand public health insurance. We got public health insurance for 15,000,000, uninsured low-income Americans, and we got public health care for 25,000,000 low-income million Americans. Much of what has won was directly the result of the public option campaign. And yes, we are still fighting for even more, no matter the odds. No matter the outcome of that campaign, however, if the health reform bill passes, then the public option campaign was a success.
Bowers expanded his argument with a 9-point rebuttal in his post yesterday, "The complete list of ways progressives strengthened health reform legislation," also a tonic for checking cynicism and despair about HCR among progressives.