It’s an obscure policy tool that isn’t even written yet, and would be buried deep in the weeds of a thousand page health care bill. But somehow, a “trigger-mechanism” is the talk of Washington right now. How did that happen?
Substantively, the purpose of a trigger would be to delay–perhaps briefly, perhaps forever–the implementation of a public option; making it contingent on the failure of insurance companies to broadly expand access to affordable coverage. The question of how long that delay would be (one year? eternal?) is impossible to answer, and would depend in large part on the way the legislation is written. But it’s that essential lack of certainty that could provide both liberals and moderates enough political cover to get on board.
As Senate Majority Leader Harry Reid said today, the strong preference among Democratic party leaders is to pass a health care bill without resorting to procedural tactics that would shut out Republicans completely. That means coming up with a plan that will win the support of (at least) Sen. Olympia Snowe (R-ME), whose preference all along has been to affix the public option to a trigger mechanism.
Her idea has gotten the nod from Sen. Ben Nelson (D-NE)–perhaps the most conservative Democrat in the Senate, and a good barometer for the sorts of policy objectives that can win the support of all moderate Democrats. His assent suggests that a trigger would allow the party’s right flank to tell their conservative constituents that they didn’t roll over and green light a big new government program. Their support will be necessary when Republicans filibuster. And the provision would, indeed, put the fate of the public option in serious doubt.
So the question now is, Will it provide similar cover for House liberals? For the entirety of the health care debate, congressional progressives have been emphatic about the need for health care reform legislation to create a “robust” public option–a government insurance plan that’s tied to Medicare and, ideally, available the moment the bill takes effect. No triggers.
But the public option on offer in House legislation has already veered from the “robust” entity these progressives had in mind. Nobody on the left is happy about that. And a private co-op plan would almost surely cause revolt. But a trigger–particularly, as Speaker Pelosi suggested today, a trigger affixed to a Medicare-like public option–might allow them to vote for the legislation with a clear conscience.
Today, House Majority Leader Steny Hoyer and House Whip James Clyburn both said a trigger might be the way to go. And deputy whip Debbie Wasserman-Schultz said that while “now’s not the time” for triggers, she’s also not willing to play “my way or the highway politics” with health care reform.
It’s far from a sure thing. But as Josh suggests here, it’s the one way forward that doesn’t seem destined to get the axe from either progressives or centrists, or that doesn’t carry with it all of the procedural problems the reconciliation option poses.
It also doesn’t scare off the insurance companies in quite the same way that a regular public option would. All of which probably explains why White House Chief of Staff Rahm Emanuel has been floating the idea for a long time now.
