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The President and the Senator

by: E.J. Dionne Jr., Op-Ed

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President Barack Obama and Sen. Olympia Snowe (R-Maine) have powerful roles in the next phase of crafting the final health care reform bill. (Photo Illustration: Troy Page / t r u t h o u t)

    Washington - Now, two people will have to choose. The fate of the health care bill is largely in the hands of Barack Obama and Olympia Snowe.

    The Finance Committee's vote on Tuesday to send its bill to the Senate floor vindicated President Obama's strategy of giving Congress wide latitude to write the early drafts. Major health reform has advanced further than it ever has before.

    But Obama must now abandon his preference for intervening forcefully only after House and Senate bills go to a conference committee. Instead, he needs to focus on the core goals of insuring as many people as possible and expanding, rather than contracting, the choices Americans will have under a new system.

    However policy experts judge the final product, reform will be sustainable only if beleaguered citizens feel more secure, not less, and more confident than they are now that health insurance will be priced within their reach. Obama has said he will own this thing in the end. He's right, and he has to make clear what kind of system he wants to buy.

    So does Olympia Snowe. Against much conventional thinking, she realized that being the only Republican senator to vote for the bill would vastly enhance her ability to shape the outcome. Now that Democrats have gotten their lone Republican vote, they don't want to lose her - in part because Snowe's support will give cover to the more reluctant moderate and conservative Senate Democrats who must vote "yes" if a bill is to get through.

    But what does Snowe really want? It's not clear that even she knows the answer to that question. Many on the left are worried about how she'll use her power. The irony is that it might take a Republican from Maine to advance causes dear to progressives - if she makes those causes her priority.

    One of Snowe's fears about the bill that emerged from Sen. Max Baucus' committee is that it still does not make insurance affordable enough for many in the middle class. She is absolutely right to worry. The subsidies in the bill are too low - held down by Obama's unfortunate insistence that, largely for cosmetic reasons, the final cost had to be held to around $900 billion. For an extra $30 billion or so per year, the bill could put insurance in reach for many more people.

    The subsidy shortage is creating a vicious cycle. It's not fair to impose a mandate on people to buy insurance if doing so will break the family budget. So Snowe and Sen. Charles E. Schumer have moved both to lower the penalties on those who don't buy coverage and to protect more people from the mandate. That's the fair thing to do, except that lower penalties mean more people opting out of insurance. This, in turn, means that more will be uninsured.

    The subsidies have to rise, and if Snowe makes affordability her highest priority, as she has suggested she will, she'll be doing everyone a favor.

    Snowe also has sympathy for Sen. Ron Wyden's desire to give those who already have coverage access to the insurance exchange the bill would establish. Here again, Snowe could do good by helping to expand people's choices.

    She could do the same by showing flexibility on creating a public insurance option. At the moment, Snowe favors only a trigger that would bring the option into being if insurance proved unaffordable for too many. But Schumer, who has emerged from this process as a champion negotiator, has been working with Snowe for months to find a middle ground acceptable both to her and to public option advocates. Much depends on the success of their partnership.

    It's true that Snowe could also make the bill worse, especially if she persists in her opposition to a strong employer mandate. The Finance Committee bill has a bizarre "free rider" provision that would penalize only businesses whose employees get government-subsidized insurance. This creates a perverse incentive for employers not to hire lower-income people, particularly single mothers. A stronger employer mandate is needed to hold the system together, and to provide financing.

    Still, a bill reflecting Snowe's core concerns would be better in most respects than a bill that didn't, and how she chooses to use her influence will owe a great deal to how Obama chooses to influence her. It's another reason why Obama needs to take ownership of a bill that he'll eventually own anyway.

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    E.J. Dionne's e-mail address is ejdionne@washpost.com.

    (c) 2009, Washington Post Writers Group

  

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Comments

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The Post has refused to

The Post has refused to discuss Single Payer - with any where near an approximate definition of how to save money. The Post has lost all credibility for allowing a payola scheme; an invitation with cash, for the Insurance Companies to lobby - who are in fact, controlling the debate.

If health care reform goes

If health care reform goes forward with a "trigger" it will be no reform at all. I would hope that Snowe's constituents thank her for her efforts by retiring her in favor of an actual moderate in 2012.

To jerryt - I am one of her

To jerryt - I am one of her constituents, and I would love to retire her. However,she is viewed as an institution in our state. People's lack of understanding of the 'workings' of Washington allow her to be voted in again and agin. The national and local media have contributed to her being re-elected, by referring to her as a moderate Republican. Truthfully, these days - I don't think there are any moderate Republicans left in Washington. I am digressing - Olympia Snowe is a strong supporter of the private health insurance industry. They have given her enormous amounts of money over the years - as they they have Senator Baucus.

EJ, are you nuts? I usually

EJ, are you nuts? I usually like you, but your remark: "The Finance Committee's vote on Tuesday to send its bill to the Senate floor vindicated President Obama's strategy of giving Congress wide latitude to write the early drafts" is just crazy. Obama's "give Congress wide latitude" allowed the worst of the worst to write this bill. Of course they were aided by Rahm + Obama's unconscionable "deal" with the insurance companies. Obama has failed miserably on this important issue. As a result of his incompetence and unbending desire for a "Rose Garden Signing Ceremony" -- signing a bill, ANY bill -- the Democrats are likely to be identified as the party that REQUIRED folks to get crap insurance, launched the IRS on them to enforce this requirement, failed to rein in either insurance premiums or abusive practices and generally was owned by the drug companies and insurance magnates. When, of course, they weren't owned by Wall Street. Really, EJ, you've got to have a better eye on this that what you're saying here. And what's with this insane need to get Olympia Snowe's vote?????