Both Sides Hit Landrieu on Healthcare

Sen. Mary Landrieu plans to host a town-hall meeting on healthcare reform later this month somewhere in the river parishes. Bring a helmet.

That would be the advice of Democratic congressmen around the country who have been booed, heckled, shouted down and threatened while trying to explain and/or defend their positions on health insurance legislation, particularly the 1,017-page bill that will be on the House floor when lawmakers return from August recess.

Republican operatives and conservative talk show hosts have been blamed for or credited with whipping up the masses, but they didn't wholly manufacture the genuine anger, fear and confusion over an omnibus bill that people felt was being jammed down on them.

Even before the facilitators got involved, one of the first such outbursts of public wrath took place in Reserve, La., last month, when a national rural listening tour of federal Cabinet secretaries, particularly Health Secretary Kathleen Sebelius, received a hostile earful from a loud and angry crowd. The prospect of walking into another raucous town-square shout-out doesn't seem to rattle Landrieu, who has been attacked already over national healthcare--not by conservatives but by liberals in her own party.

Last month, advocacy groups MoveOn.org and Change Congress ran radio and TV ads, respectively, that painted Landrieu as a toady for the insurance industry because she opposed a government-run health insurance option. She was urged to get in line with other Democrats supporting the government plan that would compete with private insurance.

One month later, the worm it is a-turning. Even before the town-hall riots of August, the notion of a federally-run insurance program, the centerpiece of the House bill, was starting to founder in the Senate.

There, negotiations over an elusive bipartisan bill have been moving away from the government option toward coverage offered by a network of non-profit member-owned cooperatives, which would be subsidized by the feds but run by the states. Though the bipartisan Senate bill has not taken full shape, it alone among the major bills under consideration would rein in the growth of federal healthcare spending over ten years, according to the Congressional Budget Office.

The notion of more local control diminishes fear of Big Brother with a needle. Yet critics point out that under a subsidized co-op plan, like with a government plan, cheaper rates would lure many businesses who now offer insurance to employees to drop their private plans for the public model. So when the president says that if you like your insurance policy you can keep it, he should add, "unless your boss chooses the government option or co-op for you."

Landrieu has similar reservations about the government and employers determining the coverage for workers. She and 11 colleagues--six Democrats, six Republicans--have co-sponsored the Healthy Americans Act, which would grant individuals, instead of employers, substantial tax deductions to use to purchase insurance in the marketplace.

Everyone would be required to have insurance, but the government would subsidize those with low incomes. Employers would be required to increase wages to replace what they were spending on health insurance. And insurers could not deny coverage based on pre-existing conditions. It sounds too reasonable and straightforward to be taken seriously in Congress, and it hasn't been yet.

A large number of Democrats will not let go of the government option, while many Republicans still oppose required coverage and more government rules. Frustrated Democrats, angered by the mobbish disruptions in the heartland, might urge the president to pass a bill without any GOP votes.

They would do so at their peril, for passing a law is only the first step. Making that much change work, at what cost, and getting the people to like it, will be how healthcare reform is won, or lost. Sen. Landrieu, meanwhile, seems comfortable on the middle ground she has staked out, though she is scorned on the left and distrusted on the right.

Yet the longer she stays there, the closer the debate seems to move toward her. Down home later this month, armed only with her centrist plan, she will stride into the valley of the town-hall meeting, where, who knows, both sides might stop shouting long enough to listen.