On Sunday morning, Senator Joe Lieberman announced on CBS "Face the Nation" that he would "have a hard time voting for" a reform bill if it allowed some workers over 55 to buy Medicare coverage. Later, in a private meeting with Majority Leader Harry Reid, Lieberman delivered an even stronger message.
According to two Senate sources briefed on the discussion, Lieberman indicated he was prepared to filibuster health care reform--that is, not merely vote against it but block a vote on it altogether--if it included the Medicare buy-in.
Whether this was a surprise, or should have been, is a matter of some dispute. More than a week ago, while the so-called Gang of Ten was still hammering out a compromise over the public option, Lieberman and Reid met. At that time, according to one senior Senate aide, "Lieberman told Reid personally he could support the Medicare buy-in."
The statement Lieberman released after the Gang of Ten announced its compromise seemed consistent with such sentiments. In it, Lieberman expressed concern about the measure but, pointedly, did not reject it outright:
Regarding the "Medicare buy-in" proposal that is being discussed, we must remain vigilant about protecting and extending the solvency of the program, which isnow in a perilous financial condition.
It is my understanding at this point there is no legislative language so I look forward to analyzing the details of the plan and reviewing analysis from the Congressional Budget Office (CBO) and the Office of the Actuary in the Centers for Medicare and Medicaid services.
But Lieberman communications director Marshall Wittmann, reached on Sunday night, said that Lieberman had expressed the same "serious misgivings" all along. As for Lieberman's current position--and what he told Reid privately--Wittman said, "The Senator does not believe that the Medicare buy in or the public option should be in the bill."
Whatever Lieberman conveyed to Reid, and when, these latest statements make the prospects for including the Medicare buy-in awfully slim. And that's a shame.
The idea of opening up Medicare to older workers has real potential to make insurance more reliable while simultaneously reducing its price. At best, it is a chance to prove that a well-run public insurance plan can serve working-age Americans just as well as it has served the elderly--the basis, in other words, for a public plan into which someday many more Americans could enroll. At worst, it is an insurance alternative for millions of older workers that simply might appreciate the option.
Where on that spectrum the proposal falls depends entirely on the policy specifics, many of which are not yet public. Until the CBO produces its estimates, we can't know exactly how many people it would likely reach--or what it would likely cost, either to the taxpayers or those who might choose to buy it.
But Lieberman isn't waiting for CBO or anybody else to weigh in. He says he's worried that the Medicare buy-in would be the first step towards a single-payer system--and that it would bust the budget. (At least, that's his latest argument. As Steve Benen has noted, it's changed a few times.) Ergo, it doesn't have his support.
Lieberman wasn't always so skeptical about the Medicare buy-in. In fact, as a vice presidential candidate in 2000, he endorsed the idea. But that was before his bitter split with the Democratic Party--and the effort, widely supported by liberals, to unseat him in 2006.