From the mailbag. CAF Newsletter. More good stuff


1. Liberal Dems have 57 votes against Blue Dog plan by Mike Soraghan, The Hill, July 30, 2009

2. Health Care for the Blue Dogs by Jacob Hacker in the Washington Post, July 28, 2009

3. Blue Dogs And Health Reform: Making It More Expensive by Jason Rosenbaum, Health Care for America Now Blog, July 27th, 2009

4. Health Insurance Exchanges: Better United Than Divided by Timothy Stoltzfus Jost, Campaign for America's Future Blog, July 31, 2009

1. Liberal Dems have 57 votes against Blue Dog plan
By Mike Soraghan
The Hill
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Liberal lawmakers who oppose a deal House leaders cut with centrist Blue Dog Democrats have gathered signatures from 57 lawmakers who say they won't vote for the plan.

"This agreement will result in the public, both as insurance purchasers and taxpayers, paying ever higher rates to insurance companies," the letter says. "We simply cannot vote for such a proposal."

If Republicans oppose the healthcare bill on the floor en masse, 57 Democrats voting "no" would defeat the bill.

The agreement between four Blue Dogs and House leaders cut $100 billion off of the price tag of the bill. Under the proposal, reimbursement rates in the government-run "public plan" would not be linked to Medicare. It would also reduce subsidies to make a government-run "public plan" more affordable.

Liberals say those changes undermine the public plan by making it too expensive for people to join.
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2. Health Care for the Blue Dogs
By Jacob S. Hacker
Washington Post: Op Ed Page
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The fate of health-care reform hangs on what President Obama and leading Democrats do in the next few weeks. In particular, it hinges on an effective response to moderate Democrats in the House -- known as "Blue Dogs" -- who are threatening to jump ship.

The main worry expressed by the Blue Dogs is that the Congressional Budget Office has predicted that leading bills on Capitol Hill won't bring down medical inflation. The irony is that the Blue Dogs' argument -- that a new public insurance plan designed to compete with private insurers should be smaller and less powerful, and that Medicare and this new plan should pay more generous rates to rural providers -- would make reform more expensive, not less. The further irony is that the federal premium assistance that the Blue Dogs worry is too costly is the reform that would make health-care affordable for a large share of their constituents.

The Blue Dogs are right to hold Obama and Democratic leaders to their commitment to real cost control. But they are wrong to see this goal as conflicting with a new national public health insurance plan for Americans younger than 65. In fact, such a plan, empowered to work with Medicare, is Congress's single most powerful lever for reforming the way care is paid for and delivered. With appropriate authority, it can encourage private plans to develop innovations in payment and care coordination that could spread through the private sector, as have past public-sector innovations.
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3. Blue Dogs And Health Reform: Making It More Expensive
By Jason Rosenbaum
Health Care for America Now Blog
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Health Care for America Now - the largest coalition working to enact a guarantee of quality, affordable health insurance for everyone in our country - is deeply troubled by the recent proposals made by some members of the Blue Dog Coalition. The stated demands of these Members - and the threat to block health care reform if they are not met - would effectively gut core elements of health care reform, such as:

  • Pull affordability protections out from under millions of middle-income families, and cut assistance to lower-income families.

  • Prevent the public health insurance option from injecting competition into the highly-concentrated health insurance market, and weaken the ability of the public health insurance option to provide an affordable alternative for individuals and small businesses. As a result, costs will rise to families and businesses that purchase private and public health insurance in the Exchange and the health care bill will lose $75 billion in CBO scored savings.

  • Undercut a progressive financing mechanism that impacts only the top 1.2% of all households, and only 4.1% of small businesses, which is central to funding the protections for low and moderate- income families.

Access to health care services by everyone in America in every corner of America is a core HCAN principle, and adjustments in Medicare or other program operations need to be made if access is lacking. But, the willingness of some Blue Dogs to block the broader effort to expand coverage across all of America and lower the trajectory of health care inflation in order to placate their in-state providers is beyond the pale. We encourage members of the Blue Dog Coalition to reconsider this approach, and we encourage this be done before the reform process is even more seriously hindered. Taking health reform down this track is not productive to achieving health reform - and it could very well generate counter-charges that also would do little to advance health care reform and would give license to Republicans in their aim of blocking health care reform.
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4. Health Insurance Exchanges: Better United Than Divided
By Timothy Stoltzfus Jost
Institute for America's Future
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Additional Resources:
Public Health Insurance Resource Page



While much of the debate about health care reform in recent weeks has focused on public plan choice, another key component of reform-the health insurance exchange-has received much less attention. Yet many experts would argue that successful reform rests on whether the health insurance exchanges work. And, the evidence suggests that in sharp contrast with the House tri-committee federally-run exchange concept, the Senate HELP committee exchange concept-which confers substantial responsibility on the states-will not work.

Health insurance exchanges are entities that organize the market for health insurance by assembling individuals and small businesses into larger pools that spread the risk for insurance companies, while facilitating the availability, choice and purchase of health insurance. The exchange concept is relatively noncontroversial and will almost certainly be included in reform legislation.
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