20 Questions for Bill Killers

1. Over the medium term, how many other opportunities will exist to provide in excess of $100 billion per year in public subsidies to poor and sick people? 2. Would a bill that contained$50 billion in additional subsidies for people making less than 250% of poverty be acceptable?

3. Where is the evidence that the plan, as constructed, would substantially increase insurance industry profit margins, particularly when it is funded in part via a tax on insurers?

4. Why are some of the same people who are criticizing the bill’s lack of cost control also criticizing the inclusion of the excise tax, which is one of the few cost control mechanisms to have survived the process?

5. Why are some of the same people who are criticizing the bill’s lack of cost control also criticizing the inclusion of the individual mandate, which is key to controlling premiums in the individual market?

6. Would concerns about the political downside to the individual mandate in fact substantially be altered if a public plan were included among the choices? Might not the Republican talking point become: “forcing you to buy government-run insurance?”

7. Roughly how many people would in fact meet ALL of the following criteria: (i) in the individual insurance market, and not eligible for Medicaid or Medicare; (ii) consider the insurance to be a bad deal, even after substantial government subsidies; (iii) are not knowingly gaming the system by waiting to buy insurance until they become sick; (iv) are not exempt from the individual mandate penalty because of low income status or other exemptions carved out by the bill?

8. How many years is it likely to be before Democrats again have (i) at least as many non-Blue Dog seats in the Congress as they do now, and (ii) a President in the White House who would not veto an ambitious health care bill?

9. If the idea is to wait for a complete meltdown of the health care system, how likely is it that our country will respond to such a crisis in a rational fashion? How have we tended to respond to such crises in the past?

10. Where is the evidence that the public option is particularly important to base voters and/or swing voters (rather than activists), as compared with other aspects of health care reform?

11. Would base voters be less likely to turn out in 2010 if no health care plan is passed at all, rather than a reasonable plan without a public option?

12. What is the approximate likelihood that a plan passed through reconciliation would be better, on balance, from a policy perspective, than a bill passed through regular order but without a public option?

13. What is the likely extent of political fallout that might result from an attempt to use the reconciliation process?

14. How certain is it that a plan passed through reconciliation would in fact receive 51 votes (when some Democrats would might have objections to the use of the process)?

15. Are there any compromises or concessions not having to do with the provision of publicly-run health programs that could still be achieved through progressive pressure?

16. What are the chances that improvements can be made around the margins of the plan — possibly including a public option — between 2011 and the bill’s implementation in 2014?

17. What are the potential upsides and downsides to using the 2010 midterms as a referendum on the public option, with the goal of achieving a ‘mandate’ for a public option that could be inserted via reconciliation?

18. Was the public option ever an attainable near-term political goal?

19. How many of the arguments that you might be making against the bill would you still be making if a public option were included (but in fact have little to do with the public option)?

20. How many of the arguments that you might be making against the bill are being made out of anger, frustration, or a desire to ring Joe Lieberman by his scruffy, no-good, backstabbing neck?

Nate Silver is the founder and editor in chief of FiveThirtyEight.

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