Hacker in the pass-the-bill contingent

HACKER IN THE PASS-THE-BILL CONTINGENT…. Credit for the idea behind the public option largely goes to Yale political scientist Jacob Hacker, who crafted the policy a few years ago, and which was quickly embraced by Obama, Clinton, and Edwards when they presented their reform plans during the presidential primaries in 2007.

Hacker didn’t seem especially thrilled to see the so-called “Team of Ten” trade the public option away in exchange for the Medicare buy-in, but he nevertheless signaled tacit support for the resulting compromise. Of course, we now know that Joe Lieberman demanded the elimination of both the public option and the Medicare buy-in.

Where’s Hacker now? He described himself as “devastated” by Lieberman’s successful efforts, and offended by the efficacy of obstructionism, but Hacker nevertheless supports the current Senate bill and believes it “could move us substantially toward those goals.”

As weak as it is in numerous areas, the Senate bill contains three vital reforms. First, it creates a new framework, the “exchange,” through which people who lack secure workplace coverage can obtain the same kind of group health insurance that workers in large companies take for granted. Second, it makes available hundreds of billions in federal help to allow people to buy coverage through the exchanges and through an expanded Medicaid program. Third, it places new regulations on private insurers that, if properly enforced, will reduce insurers’ ability to discriminate against the sick and to undermine the health security of Americans.

These are signal achievements, and they all would have been politically unthinkable just a few years ago.

Of particular importance, though, was Hacker’s advice to progressives who disapprove of the Democratic plan:

If and when legislation passes, progressives should demand immediate concrete actions to make the promise of a reform a reality more quickly and more effectively.

So a bill must pass. Yet it must be a better bill that passes. And it must be understood by the President, the Congress and every American as only a step — an important but ultimately incomplete step — toward the vital goal that the campaign for the public option embodied: good affordable health care for every American.