Lieberman riles many with role in health debate
Mischaracterization of public option alleged

By Lois Romano and Alec MacGillis
Tuesday, December 8, 2009

Sen. Joseph I. Lieberman (Conn.) has once again inserted himself into the middle of an inflamed partisan debate, raising questions about his motives, his ego and his fickle allegiance to the Democratic Party, which forgave him after he supported Sen. John McCain (R-Ariz.) for president.

Lieberman, a Democrat-turned-independent who caucuses with his former party, says he is feeling "relevant" as he threatens to withhold his vote -- potentially the decisive 60th -- on health-care reform legislation if it includes a government-run insurance plan. And it is hard to dispute that as Capitol Hill moves farther from the "public option," to the consternation of liberals.

"There is no question he's taken pleasure in this role," said Jacob S. Hacker, a Yale political scientist who helped craft the initial proposal for the public option.

Lieberman has assumed such a central role despite what health-policy experts say have been serial misstatements about reform proposals. But, Hacker laments, "No one's called him on anything."

Lieberman has helped push the debate far from the public option, which was conceived as a way to force competition. Over the weekend, attention turned to a new alternative, a network of national, nonprofit insurance plans similar to the Federal Employee Health Benefits Plan. Skeptics say this falls far short of the original goal of a government-run plan. Lieberman says he is open to the idea.

Although he has been more in line with Republicans on national security issues, Lieberman has tended to stick with Democrats on domestic politics. So it has been startling for even his detractors to hear the four-term senator vowing to join a Republican filibuster against any bill with a government-run plan.

A number of senators are privately furious, Senate sources said. But they added that it is unlikely the Democratic caucus would take punitive action, such as stripping his chairmanship of the Homeland Security and Governmental Affairs Committee -- at least not in this Congress.

Beyond the Hill, liberals have stepped up attacks, with one advocacy airing ads in Connecticut and on national cable that accuse Lieberman of acting in self-interest. John Mertens, who is challenging Sen. Christopher J. Dodd (D-Conn.) as a third-party candidate next year, narrates a 30-second spot: "Joe never forgets who he ran to represent: Himself. It's not about you. It's all about Joe." The League of Women Voters is also launching radio spots to pressure him.

Hundreds of protesters representing an interfaith organization showed up at Lieberman's home in Stamford and at his office in Hartford, to plead (and pray) for him to support the bill. Among them was Rabbi Ron Fish, of Congregation Beth El in Norwalk, Conn., who was so supportive of Lieberman's 2006 reelection bid that he rushed through John F. Kennedy International Airport in search of a mailbox in which to send his absentee ballot before boarding a flight to Israel.

"I was very upset when I heard him say it was a matter of conscience for him to vote against the bill," Fish said. "His conscience bothers him about the cost of a government insurance option? What about his conscience for the millions of people living in real fear, suffering without insurance?"

More than a few liberal blogs have accused Lieberman of being beholden to the insurance industry in his state. According to the Center for Responsive Politics, he has received more than $1 million from insurance interests since 1990. Last month, protesters were arrested in his Washington office, shouting, "Represent Connecticut, not Aetna!"

Some believe he is being driven by a potential reelection bid in 2012, when he will need strong GOP support. Lieberman switched his affiliation to independent in 2006 after being defeated in the Democratic primary by antiwar businessman Ned Lamont. Lieberman won the general election by knitting together a coalition that included 70 percent of the Republican vote and only 33 percent of the Democratic vote.

Lieberman scoffs at the theories of his motives. "I listen, but I tell them respectfully that they're as wrong about me as they are in reading my position," he said in an interview. "I was elected as an independent, and I'm going to do what I believe is the most sensible and the best. And as I see it, wherever that puts me, that's where it will be."

Lieberman says the public option is a sop to supporters of full government-run health insurance. He argues that the proposal lacks public support, although polls show a majority favor the concept. He says the government has no place in providing health insurance, despite its role in overseeing Medicare and Medicaid.

Most of all, he insists that a public option would drive the country further into debt. But this argument muddles how the new system will function and is at odds with independent assessments.

Under the Senate and House bills, those without employer-provided coverage would get income-based government subsidies to help buy coverage in a new insurance marketplace. The case for the public option is to reduce the cost of those subsidies by forgoing profits and reimbursing providers at lower rates, and by driving private insurers' rates lower via competition. A strong public option would lower the bill's cost by tens of billions of dollars, the Congressional Budget Office found.

But Lieberman has maintained that the public option alone represents a cost to the government. "He keeps saying over and over that we can't afford the public option, but the question is whether we can afford the subsidies," said John Holahan of the Urban Institute.

Confronted with the cost-saving assessments of a strong public option, Lieberman concedes the point, but he says an aggressive government-run plan would put undue pressures on medical providers and force them to shift costs to private insurers. Put simply, he opposes the public option in any form, regardless of whether it reduces costs. "If they really wanted to do something to deal with my concerns, they would take it out altogether," he said.

That is where the debate is heading. The latest alternative is a collection of private, nonprofit plans overseen by the Office of Personnel Management that would essentially mirror what is already in the proposed new insurance marketplace.

Critics say the new plans' nonprofit status would offer minimal savings -- many insurers today are nonprofit. The plans would have less leverage in holding down provider prices than would a strong public option. The rates for federal employee plans rose almost 9 percent this year. But Lieberman is interested, and in the current debate that is key.

"If it's private, and there's no federal government financial exposure, and the government's not creating an insurance company, that's a long way toward what I've been concerned about," he said.

© 2009 The Washington Post Company