Let’s make a deal

LET’S MAKE A DEAL…. After several days of talks between five center-left Democratic senators and five center-right Democratic senators — the so-called “Team of 10” — the principals emerged from negotiations last night with a conditional deal. The members have been reluctant to talk about the details, but the preliminary leaks offer a sense of what the senators agreed to.

The headline in most of the media will focus on one aspect of this: “Senate tentatively agrees to remove public option.” That’s partially true — the Senate bill has featured a watered-down public option with a state opt-out, and the new compromise scuttles that provision.

It’s what the center-left Dems got in exchange that matters. The deal appears to include the Medicare expansion and OPM plan that’s been rumored throughout the week. Brian Beutler’s report is the must-read account.

As has been widely reported, one of the trade-offs will be to extend a version of the Federal Employees Health Benefits Plan to consumers in the exchanges. Insurance companies will have the option of creating nationally-based non-profit insurance plans that would be offered on the exchanges in every state. However, according to the aide, if insurance companies don’t step up to the plate to offer such plans, that will trigger a national public option.

Beyond that, the group agreed — contingent upon CBO analysis — to a Medicare buy in.

That buy-in option would initially be made available to uninsured people aged 55-64 in 2011, three years before the exchanges open. For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized — people will have to pay in without federal premium assistance — and so will likely be quite expensive, the aide noted. However, after the exchanges launch, the Medicare option would be offered in the exchanges, where people could pay into it with their subsidies.

It appears as if liberals lost out on a Medicaid expansion that would have opened the program up to everybody under 150 percent of the poverty line. That ceiling will likely remain at 133 percent, as is called for in the current bill.

In addition to the new insurance options, the group has tentatively agreed to new, and strengthened, insurance regulations, which the aide could not divulge at this time.

The Medicare news looks very encouraging; the trigger looks awfully hard to pull; and I’ll look forward to learning more about those new regulations on the insurance industry. As for the OPM plan — a national, non-profit health plan along the lines of the Federal Employee Health Benefits Plan, administered by the Office of Personnel Management — Ezra argues that the system would comparable, in a practical sense, to “the compromised public plan in the House version of the bill.”

All of this, of course, has been sent to the Congressional Budget Office, which will hopefully produce a score in a few days.

As for the political implications, how on-the-fence senators will respond to the compromise is anyone’s guess. Will Lieberman balk because there’s a trigger? Will Snowe reject it because of Medicare expansion? Will House Dems oppose it over changes to the public option? Will Ben Nelson move away from the bill just because?

Even senators within the Team of 10 aren’t sure. Sen. Jay Rockefeller (D-W.Va.) was delighted with the deal, but Sen. Russ Feingold (D-Wis.) hinted that he’s now on the fence because of changes to the public option.

Senate Majority Leader Harry Reid (D-Nev.) told reporters the compromise “has something that we think should satisfy everybody.” Here’s hoping that’s true.