‘Significantly less’

KENT CONRAD AND ‘SIGNIFICANTLY LESS’…. There’s one thing conservative Democratic senators seem to agree on when it comes to health care reform. Despite the big Democratic majorities on the Hill and the Democratic president, they see the need for a bill that’s much weaker, less comprehensive, and less effective than what the Democratic mainstream has in mind.

The Gang of Six members made this much clear late last week, and Sen. Kent Conrad (D) of North Dakota, one of the six negotiators and a long-time opponent of a public option, reiterated the point yesterday. Reform is “going to have to be significantly less than what we’ve heard talked about,” Conrad said.

In terms of “what we’ve heard talked about,” the center-right Democrat was almost certainly referring to Democratic proposals that have already passed the House Education and Labor Committee, the House Ways and Means Committee, the House Energy and Commerce Committee, and the Senate Health, Education, Labor and Pensions Committee. These efforts, apparently, don’t meet Conrad’s standards. Americans and their failing health care system, Conrad insists, need less.

It’s likely that means legislation that costs “significantly” less and does “significantly” less.

Jonathan Cohn explains that the reform bill that’s already passed four of the five relevant committees were already scaled back to satisfy the demands of less-progressive lawmakers.

In order to keep the price tag at or below $1 trillion over ten years, Democrats had to write bills that would roll out reforms slowly, over several years, so that a new system was not fully in place until 2013 or later. That’s a long time to wait for change, particularly if you’re one of the unlucky souls who ends up without insurance — or with inadequate insurance — when illness strikes.

The saving grace of those four bills was that the consumer protections and financial assistance in them remained reasonably strong. If reform ends up looking like those four bills, then financial assistance would be available to people earning up to four times the poverty rate — or around $88,000 a year in family income. (Subsidies would be available on a sliding scale, so that a family making $70,000 would get very little, a family making $60,000 would get more, and so on.) Such a measure would also limit out-of-pocket expenses to $10,000 a year per family, while providing other crucial protections. And, of course, it would include a real public insurance option.

If Conrad and his supporters get their way, the new health care system won’t be nearly as generous — or protective. They’ve made clear they want a package that costs less than $1 trillion. A lot less.

As a practical matter, that means “significantly less” help for the uninsured, and based on the research of the Center on Budget and Policy, many middle-class families that wouldn’t receive any subsidies for coverage at all.

Atrios noted this morning that when all is said and done, Americans will actually have to like the health care bill if/when it comes law. Conrad, whose role is inexplicably critical to the process, insists reform has to offer fewer protections, less coverage, and fewer benefits, especially to the middle class. It wouldn’t only be a lost once-in-a-generation opportunity, it would be a solution that almost no one likes.

Cohn concluded, “You can imagine why Republicans might think this is a dandy idea. But why on earth would Democrats agree?” Sen. Conrad, that’s not a rhetorical question.