Nebraska Sen. Ben Nelson has been in trouble with his constituents ever since he cast the crucial sixtieth vote to pass the Senate’s health reform bill. Apparently the water is so hot that that he has bought air time on Nebraska TV stations to explain the reasoning behind his vote. Last week he asked for an interview with the Fremont Tribune, which serves the state’s sixth largest city, population 25,576; the paper published a story in which the state’s Democratic senator talked about the bill.
His comments were illuminating, but could have been much more instructive and helpful had the paper surrounded them with context and perhaps even challenged some of what he said. The senator said that in order to secure his vote, the Senate had to dump the public plan and forbid the federal government from paying for abortions, and that both things had been accomplished. He was particularly vocal about the public plan:
The Senate bill ‘supports the private market 100 percent. There is no federal government insurance involved in this whatsoever.’… The public option ‘is dead. If it isn’t, then it dooms the entire bill.’
The paper also reported that Nelson said the public plan would not return when the House weighs in. “If there’s very much of [the House] bill in there, and if it’s got the public option in there, it loses not only my support, but perhaps a couple of others.” Nelson made clear to the Tribune.
If the Tribune asked Nelson what was so bad about a public plan or how it might help some of his constituents, it didn’t say. Nor did it bring up Nelson’s insurance industry bonafides, or indicate whether reporters asked about any relationship between his pre-Senate career and his strong opposition to the public plan—which the insurance industry (as well as the doctors and hospitals) also strongly opposed. It seems to Campaign Desk that some discussion of all this was necessary for readers to understand what they might gain (or lose) from a public plan. While polls have shown that the public generally liked the idea of a public option, the public didn’t exactly understand what it would do or how it might have helped them.
Nelson had a lot to say about abortions and was puzzled by the criticism he has taken over the language banning federally-funded abortions. He noted that there would be a tax credit intended to make adoptions more affordable. Adoptions more affordable? The paper could have skipped this one and instead asked Nelson about affordability of health insurance—you know, that elephant in the bill that the pols and the press don’t like to discuss—but should. Will Nebraskans really be able to afford health insurance?
Instead of going there, the paper let Nelson say that “there are about 127,000 Nebraskans that are going to be able to change from their expensive individual policies to a less costly private group plan.” Now even I had to stop for a moment to process what a “private group plan” is. Was it the Exchange—the government’s proposed shopping service that may or may not offer lower-priced coverage than people have now? Was it the latest offering from Nebraska Blue Cross? Tribune editors, take note: Your readers could have used some help on this one.
The senator did mention some positives for 220,000 of his constituents who cannot currently buy health coverage because of pre-existing health conditions. Well, yes, they might be able to get a policy. But at what price? A statement like that calls for some discussion of age rating, which means older people could pay more, or geographic rating, which means people in Omaha might pay more than those in Scottsbluff. Are such inequities okay with Nelson? If so, why?
As for the Cornhusker Kickback, that $100 million tucked in the bill to help the state cover its Medicaid expenses, Nelson said it was a way for individual states to “opt out of federal funds for Medicaid in the future.” Presumably he meant Nebraska. He pointed out that a “whole new group of individuals” would now qualify for Medicaid with the feds paying the whole tab at least until 2017. But what happens after that if states like Nebraska can opt out? Does that mean the Medicaid newbies will be kicked off the rolls because funding won’t be adequate if the states don’t pay their share? Context, please.