This technique appears to be playing out before our eyes. As Democrats appear poised to abandon their prized “public option” on health care reform the pressure will then shift to Republicans, who will face their own internecine decisions regarding whether or not to support a compromise, such as the cooperative idea -- which would entail the government setting up health care insurance nonprofits to be run by consumers. The chief proponent of the idea is North Dakota Senator Kent Conrad.
To be sure, liberals like Howard Dean, who recently referred to removing the public option as “a great mistake,” would be upset by the maneuver, but the pressure would be on Republicans. Already, conservatives are divided over what to do – and the public option hasn’t even been officially dropped yet. The conservative Heritage Foundation is on record as stating that, “Health care cooperatives can work as private entities in a private market and give another choice to families, but they have to be done right.”
Others see a co-op plan as merely a gimmick to pass a government-controlled plan by a different name. In a strongly-worded critique of The Heritage Foundation, RedState’s Erick Erickson wrote yesterday,
The fundamental problem is that many conservatives are worried the co-op idea is merely a more palatable way to get to a government takeover. This rings true, inasmuch as Senate Democratic Leader Harry Reid, himself said, “We're going to have some type of public option, call it 'co-op', call it what you want.”
The Heritage Foundation, which played a vital part in building conservative support for Romneycare in Massachusetts, is setting the stage for Republican capitulation on healthcare. This is the second time in less than a year that Heritage will have been instrumental in organizing a conservative collapse in opposition to big government. The first time was when Heritage gave conservatives cover to support TARP, calling it “vital and acceptable.”
Now with healthcare, because Heritage is trying to be “helpful”, confusion is starting to crop up among Republicans in Congress at a very critical time in the healthcare debate. Capitulation and compromise are now on the table using a bastardized version of a Heritage proposal.
Fair or not, Erickson is also correct in noting that the fact Heritage is on board with the notion that some co-ops might be good muddies the waters a bit. Phil Kerpen of Americans for Prosperity (AFP) tells me that ultimately the problem is that the word co-op is meaningless: “The term isn’t very telling in itself. There’s a huge range of possible policies that you could implement. Democrats are inclined to do something that’s still a government-controlled plan," says Kerpen.
Kerpen believes conservatives must oppose any proposal that includes employer or individual mandates. But co-ops that do not include either would be acceptable. But even in the unlikely event Republicans were able to hammer out a palatable compromise on health care, another school of thought says that, regardless of whether or not passing a co-op would be good or bad policy, it would most certainly be bad politics for Republicans to give the Democrats a win by helping pass a bill.
Accepting a co-op compromise – especially one which includes mandates -- would most likely deflate the town-hall attending grassroots activists who -- after years in the wilderness during the latter Bush years -- have finally found a reason to rally around the GOP. Today’s town hall attendees aren’t clamoring for conservatives to “slightly fix” Obamacare -- but to kill it.
Ultimately, Kerpen believes that just as liberals will likely be forced to abandon the public option, they will also be forced to abandon their co-op plans once it becomes clear that switching from the public option was merely a tactical move -- not a sincere, substantive change.
The real fight, then, would be fought over whether or not to implement a Massachusetts-type plan, where government mandates that individuals purchase insurance from insurance companies. This could be difficult for conservatives to stop, because, as Kerpen notes, “The insurance companies will support it, as it will be a mandate that people buy their products.”
As always, there are parallels to 1994. Ironically, the conventional wisdom is that by killing the public option and accepting co-ops, we would be moving away from a HillaryCare type plan toward a compromise solution. This is not quite right. While people think HillaryCare was a single-payer plan, it was a “managed competition.“ The Clintons called them “alliances,” not “co-ops,” but that seems a distinction without a difference. For all practical purposes, the Clinton plan was a co-op.
And -- as far as the political concerns that compromising with the Democrats could hurt Republicans electorally -- that almost happened in 1994 when Senator Bob Dole considered accepting several compromises rather than killing HillaryCare, outright.
Were it not for Dole’s concerns that turning his back on grassroots conservatives could have political consequences for his presidential run in 1996, he would likely accepted a compromise. And while it didn’t help Dole become president, it is certainly reasonable to assume that if the Republicans had agreed with a compromise – rather than killing HillaryCare outright – the Republican Revolution of ‘94 might never have taken place.