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Does The Health Care Bill Have A Chance?

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Does The Health Care Bill Have A Chance?

Health Care

Does The Health Care Bill Have A Chance?

Does The Health Care Bill Have A Chance?

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  • Transcript

GUESTS:
Joe Neel, science editor, NPR
Christopher Hayes, Washington editor for The Nation
Matthew Continetti, associate editor, The Weekly Standard

Senate Finance Chairman Max Baucus (D-MT) has released a healthcare overhaul bill. So far, it has received no support from the GOP, and a tepid response from many Democrats. Guests discuss what the bill would mean for you, and whether it will get enough votes to pass.

NEAL CONAN, host:

This is TALK OF THE NATION. I'm Neal Conan in Washington.

While several House and Senate committees have approved various proposals to overhaul health care, the most closely watched legislation emerged yesterday from Senate Finance Committee chairman Max Baucus. He's been working for months with the so-called Gang of Six, three Republicans and three Democrats, to produce a bill that can win support from both sides of the aisle. So far, reviews are mixed.

Some Democrats fume the measure does not include what's known as the public option, a government-run insurance provider to compete with private companies. It would extend coverage but not to everybody, and while at $856 billion over 10 years, it's priced well below other proposals, that's still too much money and too much government control to win the support of even one Republican, at least so far. But many analysts also believe this bill has, by far, the best chance to actually get to President Obama's desk.

Later in the hour, first comes the bad behavior, then comes the apology. Ask Amy's Amy Dickinson on the recent spate of public incivility and the lost art of the apology.

But first, the health care bill. If you have questions about the bill or how it might make it through Congress, give us a call, 800-989-8255. Email us, talk@npr.org. You can also join the conversation on our Web site. Go to npr.org. Click on TALK OF THE NATION.

We'll get to the politics of this bill in a bit, but first, NPR science editor Joe Neel joins us here in Studio 3A to help us parse what's in it and what isn't. Nice to have you with us.

JOE NEEL: Always glad to be here, Neal.

CONAN: And why don't we begin by asking, well, how it would affect most of us, or in fact all of us, the patients.

NEEL: Well, it would affect all of us, or almost all of us, by requiring that we have health insurance. The only exceptions would be for very poor people and for undocumented immigrants. If you don't have insurance, you would have to pay a penalty. The penalties run from anywhere from about $750 for a single person in the lowest income category up to about $3,800 for a family of four in a sort of a - at the border of the middle class, about $66,000 for a family of four. Those are a lot of numbers. In about six years, this is thought to cut the number of people without insurance about in half, from the 46 million we have now to about 24 million.

CONAN: And you say people would have to pay a penalty. At what point, when they try to get health care?

NEEL: Taxes.

CONAN: Taxes, taxes. So the IRS would know whether you're participating or not.

NEEL: Right.

CONAN: And when you say undocumented aliens, there was a lot of questions about verification. How would somebody know that you're undocumented?

NEEL: Well, that's right. There was an effort earlier in this decade to try to require all people seeking health care or people - I'm sorry, all people applying for federal Medicaid and other programs to show documentation to prove that they were citizens, and as you've probably heard in the rhetoric, quite a bit of money was spent and only uncovered eight people who were fraudulently applying. Meanwhile, several hundred or even more U.S. citizens who couldn't prove that they were citizens were unable to get the Medicaid that they needed.

Some people don't have birth certificates, older African-Americans, for example. At a time when there were segregated hospitals, birth certificates weren't handed out. So that's a barrier. And of course, when you're really poor, you just have difficulty keeping up with all the requirements, the paperwork requirements. So people were being denied care, and it sort of fell by the wayside.

CONAN: All right, well, more details to follow on that.

NEEL: Right.

CONAN: Those are patients. How would this affect businesses?

NEEL: Businesses would not be required to give their employees health insurance, but if a business has more than 50 employees, they would be required to pay the federal government a share of the cost that the federal government is paying to cover those people because workers who don't have coverage would be able to buy health insurance through something called an exchange, where there would be many plans offered. You could pick and choose the best benefits at what cost you can afford, and the federal subsidies would be circulated through there.

So the employers with over 50 workers would have to pay a penalty if they did not provide insurance.

CONAN: And again, tax time is when the penalty would be (unintelligible)…

NEEL: That would be it.

CONAN: Okay. Now the system, how would the system change? You know, most of us, you and me, for example, we work for a big company that offers us health care coverage.

NEEL: Yeah, most people - patients won't really see much of a change. It'll all be behind the scenes, where the government's trying to encourage a lot more efficiency and collaboration to eliminate all the duplication. You know, you've got to take your x-ray from one doctor to another, and you took a test here, and they don't have the results over there. One way to do that is with the electronic medical record, though that may not save the government very much money.

There is some restructuring going on in Medicare, the big - well, mainly Medicare, the big federal government program for seniors and the disabled, and that - they're trying - they want to re-jigger in this bill, they want to re-jigger the payment system so that doctors aren't rewarded and hospitals aren't paid for every single service and test that they order, but rather the payments are more for a diagnosis or for the results that are obtained.

CONAN: Okay, so that would reform the system from that end, but…

NEEL: From that end.

CONAN: from the consumer end…

NEEL: From the consumer, you may not see that much.

CONAN: Okay, now again, the cost: $856 billion. That's quite a bit.

NEEL: Well, that's what the Senate Finance Committee says the price of their bill is. The Congressional Budget Office actually came out with a lower number: $774 billion over 10 years.

CONAN: And there had been estimates that if we were going to do this, that would be $1 trillion over 10 years.

NEEL: Yeah, there are other proposals that do go over a trillion.

CONAN: So where does that money come from? This is supposed to be deficit neutral.

NEEL: Well, it is - it actually, according to the Congressional Budget Office, it actually will cut the deficit by - I've got to look at my paper - by $49 billion, and that's because of the savings that they get from restructuring the system, as I explained. I mean, there are many more things than we can go into here that are done, and by covering everyone, you eliminate a lot of the duplication and waste that's in the system.

CONAN: Well, who's going to pay for it?

NEEL: Well, there are three basic sources. There will be an excise tax on so-called Cadillac plans. These are insurance plans that have premiums of over $20,000 a year. I believe in this bill, it's $21,000 is the limit. These would be plans that some unions have negotiated with, you know, major manufacturers. Sometimes it's people in the individual market who have to buy their own policy, and they pay a lot.

So there was an early proposal to tax individuals who had these plans, but the plan here is to actually tax the insurance companies. There are fees on drug makers. There are fees on medical-device makers, and there are fees on clinical laboratories, and that adds up to $20, $30 billion, just off the top of my head.

CONAN: Okay, now we have to concede that radio may not be the best medium for such a detail-rich analysis. You may want to go to npr.org to find out a little bit more. If you want to immerse yourself in details in terms of the budget analysis, go to cbo.org…

NEEL: That's cbo.gov.

CONAN: …cbo.gov, excuse me on that. But finally, we've mentioned the public option was left out, but there is something else in its place.

NEEL: Yes, that's co-ops. These are insurance companies that are run by the premium-holders themselves. The experience has been in a few limited places, Minnesota's the one that comes to my mind, because they're run by the premium-holders, they're able to keep - they have been able to keep the cost of the premiums somewhat lower than other places. But the Congressional Budget Office, which you mentioned, doesn't think much of these and doesn't think they'll save any money at all.

CONAN: Here's an email question from Anthony(ph) in San Francisco. I heard yesterday the Baucus plan does not deal with the pre-existing condition problem until 2013. Is this true? If so, it seems like one of the most important problems with health insurance now is being shuffled off until later.

NEEL: Well, I can look through the paper here. I'm not sure there are so many dates, and it's true that much of this does not kick in for four or five or even six years. I will look that up as we sit here and get a better answer.

CONAN: We'll get a better answer. Of course, 2013, somebody would point out, would be after the next election. So that's an interesting part.

NEEL: That's right.

CONAN: In the meantime, let's see if we can get a caller on the line, and this is John(ph), John with us from Media in Pennsylvania.

JOHN (Caller): Hi, how are you?

CONAN: Very well, thanks.

JOHN: That's great. I have a question, two questions sort of, two small questions. I'm self-employed, I've been self-employed for 20 years. A family of four in Media, real quickly, for full coverage is $26,000 a year through a nonprofit. If I'm making $100,000 a year, that's 26 percent of my income. I can't afford that. If I'm going to be penalized for not having health insurance, how does your bill make it so that, say, I can get full health insurance for something that's less of a chunk out of my income.

CONAN: John, let me point out it's not my bill, nor is it Joe Neel's bill. It's Max Baucus's…

NEEL: Senator Max Baucus's…

(Soundbite of laughter)

JOHN: My question - yeah, I'm just curious. How are they figuring that that's going to actually help the problem?

NEEL: Well, for people who make up to about $66,000 a year, a family of four, there would be subsidies, especially when the cost is over 13 percent of your income. For someone in your situation, I think that you may be above the threshold being considered here for getting any federal help with your premium, although clearly your premium is a big chunk of your income.

CONAN: He would, though, be able to shop for - across state lines. There might be somebody in another state, another company that might offer him a better deal.

NEEL: Well, that's been one proposal that Republicans have been behind. That remains to be seen exactly how that would work. The exchanges may offer you another alternative…

JOHN: Well, the exchange, you know, I've been doing this for 20 years, and every two years, I have to find basically a new exchange. That's how I get my - I go through co-ops. So I've joined the co-op of unemployed. I've joined chambers of commerces. They were supposed to lower the premiums, but they don't lower the premiums at all, and in fact, in some cases, the co-ops have higher premiums.

NEEL: Well, that's certainly been - you're absolutely right. That's been the experience. It remains to be seen whether the exchange that they're proposing now will actually work.

CONAN: Well, John, thanks very much, and good luck.

JOHN: Thanks. Talk to you later.

CONAN: Bye-bye.

NEEL: And I have an answer to the earlier question. You're right, the pre-existing conditions clause does not take effect until 2013, but there are new high-risk pools that you could sign up for until then if you have a pre-existing disease like diabetes or cancer, and that might give you a lower premium.

CONAN: All right, Joe Neel, thank you very much for being with us today.

NEEL: Sure, as always.

CONAN: And that's a broad outline of what's in and what is not in the Baucus bill. Again, this is produced by the chairman of the Senate Finance Committee yesterday, and it's believed by most analysts to be the version of health care overhaul that has the best option of getting it through the United States Congress.

When we return, we'll be talking about how that process will work and how the politics of that may play out. Thus far, some Democrats are upset with the bill because it does not include a public option, and well, thus far, no Republicans have endorsed it whatsoever.

We'll talk with Christopher Hayes of The Nation and Matthew Continetti, associate editor of The Weekly Standard. If you'd like to join the conversation, give us a call, 800-989-8255. Email is talk@npr.org. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

(Soundbite of music)

CONAN: This is TALK OF THE NATION. I'm Neal Conan in Washington. The health care bill, unveiled yesterday by Senate Finance Committee chairman Max Baucus, widely viewed as having the best shot to actually reach President Obama's desk, but it's a long way between here and there. No Republicans support the measure thus far. Even many Democrats are tepid at best.

So where does it go from here? Does it have any chance to actually be enacted? If you have questions about how this measure might make it through Congress, our phone number is 800-989-8255. Email is talk@npr.org. You can also join the conversation on our Web site. That's at npr.org. Click on TALK OF THE NATION.

Joining us now, Matthew Continetti, associate editor for The Weekly Standard. He's with us here in studio 3A. Nice to have you back with us.

Mr. MATTHEW CONTINETTI (Associate Editor, The Weekly Standard): Thanks for having me.

CONAN: And Christopher Hayes, Washington editor for The Nation, with us from his office here in Washington. It's nice of you to join us today.

Mr. CHRISTOPHER HAYES (Washington Editor, The Nation): Thanks for having me.

CONAN: And first of all, why don't we begin with you, Chris Hayes. As I understand it, this has some heavy lifting to get through the Senate Finance Committee, much less the Senate.

Mr. HAYES: Well, it does. I mean, part of the reason it does is because you're already starting with a base, it looks like, of zero Republican votes. And Jay Rockefeller said yesterday that he would not vote the bill out of committee. Now, that's a senator from West Virginia. He's not necessary known, I think, or has a reputation in Washington as a stark ideologue, but there's two issues.

One is that, I think at the personal level, he was very frustrated, as were many Democrats on the committee, from being excluded from the Gang of Six negotiations. So there's some frustration there. And two, Rockefeller has been a pretty strong advocate of the public option, which isn't in this bill.

So you're down to a very razor-thin committee vote without Rockefeller. I think they still have a margin of one without him, but the president talked to Rockefeller yesterday, and we'll see if they can hold the line and get it out of committee.

CONAN: Matt Continetti, no Republican support? There's been months of negotiations here to try to bring Republicans on board.

Mr. CONTINETTI: That's right. And I guess when you ask the question how much is too much, $774 billion is too much for the Republicans, even though the CBO, as was pointed out previously, says this might actually cut the deficit if it were passed.

In terms of that Senate Rockefeller and whether this will get out of committee, two words: Rahm Emanuel. And I think the White House chief of staff sees this bill, the Baucus bill, as the bill most likely to be, you know, to resemble most closely the final legislation that might come out for the president's signature.

CONAN: And as we compare this to what the president had to say to the joint session of Congress last week, these accord pretty closely.

Mr. CONTINETTI: Yeah, it seems remarkably similar. The mandate is there. You have the exchange there. You have the insurance reforms in terms of pre-existing conditions and the so-called rescission. And then of course, again I'd say the most important figure is that CBO figure, which says this would be deficit neutral or better if - of course, the CBO also stipulated, they said if it's followed to a T, and our experience with government is that often the government doesn't follow things to a T.

CONAN: Well this may die eventually a death of 1,000 amendments, but in any case, Christopher Hayes, that's the Senate Finance Committee and maybe the United States Senate. There are an awful lots of Democrats in the House of Representatives who will be unhappy with this measure, too.

Mr. HAYES: Yeah, in fact, today I was just reading about - the president was in College Park, Maryland, discussing health care reform, and when he raised the Baucus bill and mentioned it, the crowd booed. This is crowd that's made up of sort of liberal Democrats, progressives, the base if you will, and the reason is because of a few of the things that Matt mentioned. I mean, the lack of a public option has gotten the most attention, but also the subsidies.

There's quite a big difference between the House version of the bill in terms of the generosity of the subsidies and the Senate version. And the irony is, you know, there's a sort of stereotype of liberals -constantly, you know, the bleeding-heart liberal throwing things at the poor, but actually, it's the middle class that's cut out of the Baucus and included in the subsidy level in the House bill. So there's a pool of House progressives who said they're not going to vote for a bill without a public option, and the White House has to take that threat seriously, I think.

CONAN: And Matt Continetti, they do have to take that threat seriously, but you mentioned the name Rahm Emanuel, the White House chief of staff, former member of the House of Representatives, of course, and formerly on Bill Clinton's staff, familiar with what happened when the Democrats failed to get health reform through during the Clinton administration.

Mr. CONTINETTI: Exactly. And you know, you look at the president's popularity. In a Pew Center poll out today, he's at 55 percent. And even though the public is relatively split on the merits of the plan, and I know there's five different plans now out there, but let's call it the platonic ideal of the plan, the public is split on support of it. I think the more important number is that 55 percent.

Look, the bill, whatever bill is voted on in the House, will pass unless 40 Democrats defect from Nancy Pelosi. And then, of course, if there's no vote in the Senate by October 15, it looks like they're going to go for a reconciliation vote, in which you only need 51 Democrats. And you know, I think Republicans might be shaking their head more in sorrow than in anger when they - I think the chances of that happening are pretty likely.

CONAN: Here's an email from Jennifer(ph) in Massachusetts. I'm confused by Neal's suggestion the Baucus bill is considered the one most likely to get through Congress. It seems to me everyone except for Baucus is against it, including the rest of the so-called Gang of Six. Chris Hayes?

Mr. HAYES: Yeah, that's a good point. I mean, I think the reason that the conventional wisdom is centered around the Baucus bill is because it was going to be the one with the bipartisan support. I mean, that was the reason that it was going to be the one that was going to be the bill that was going to be the blueprint, and that was it's kind of trump card.

Now that it doesn't have that, the question is if they're going to pass it with reconciliation, why would you alienate this massive part of your base for a bill that was modified in all these ways to gain Republican support when that Republican support isn't actually there? I mean, I don't even mean this on a substantive level, although I think the House bill is substantively better, but just at a basic political level, it's unclear what the benefit accrues in going with something like the Baucus bill if you're not getting the reward of this bipartisan support.

CONAN: And by reconciliation, he means the parliamentary maneuver the Democrats could invoke, whereby they could gain passage of the bill or much of the bill, anyway, with just a simple majority, 51 votes, not the 60 they would need to avoid a Republican filibuster. And Matt Continetti, if that's the option they take, well, Chris Hayes has a point. If the Democrats are going to pass this without Republican votes, why don't they pass the bill they'd like to pass anyway?

Mr. CONTINETTI: I think from the White House's perspective, and here I'm kind of engaging in psychic powers or whatever, but if you're the White House, you see the liberal base of the Democratic Party. They're going to be with you pretty - you're calculating, anyway, they're going to be with you no matter what, much like conservatives, as much as they whined and moaned about certain elements of the Bush administration - always fell in line with Bush.

Now, you look at the Republicans, if you're Obama and Rahm Emanuel, and you know the Republicans are going to be against you, too. So you go for that middle of the country, the independents, 43 percent of the electorate, the people who are with Obama, who got him elected in '08 but are now moving in the opposite direction. These voters are concerned about things like the deficit, which the Baucus bill addresses, and they're also concerned about high prices of premiums, which the Baucus bill tries to address. I personally don't think it will work, but anyway, politically, you can make that case to the independent voter.

CONAN: Let's get some callers in on the conversation, Pat(ph) with us from Prescott, Arizona.

PAT (Caller): Yeah, hi. As I see it, the Republicans seem to be against the public option, and they want things like tort reform and also the ability to buy insurance policies across state lines. And I'm - you know, why couldn't there be like sort of a federalist sort of a bipartisanship where you said, okay, well, let states opt out of the public option, and as far as states buying - or buying insurance from different states, why couldn't states do that now? Like, I live in Arizona. Why couldn't Arizona pass a law that says hey, we're willing to accept all the rules, you know, or the insurance policies written for Mississippi. And then you can take Republicans at their word that they want to keep the federal government out of our lives. And you could say hey, the states can decide whether or not they're going to accept policies from, say, California or Mississippi or whatever, you know?

CONAN: Well, states have gone ahead with tort…

PAT: (Unintelligible) tort reform.

CONAN: Tort reform, states have gone ahead on their own. Texas, for example, has enacted tort reform on its own.

PAT: Yeah, (unintelligible)…

CONAN: Well, let's get some - hey.

PAT: (Unintelligible)…

CONAN: Pat, Pat, Pat, Pat, let's get some answers all right? Christopher Hayes, is there a federalist option here?

Mr. HAYES: You know, the federalist option is not being discussed in terms of a public option, although I've heard it floated. I've read some people suggest that on the Internet. It's sort of an interesting thing to conceive of.

In terms of the - you know, I mean, if you had a public option in California, for instance, that's a very large risk pool, and if it functioned well, that might work in the kind of laboratory-of-democracy sense to prove to other people that it's not the sort of first step down the slippery slope to socialism.

In terms of selling insurance across state lines, I mean, just to be clear, you know, insurance companies do this. The issue is whether they abide by the local state's regulation in the market in which they're participating. And the fear about this selling across state lines is that you essentially create a regulatory race to the bottom. You end up with some state that is to health insurance what Delaware is to credit cards and corporate governance. That is to say a state that is the most lax, the least regulated, and all the health care companies, you know, incorporate and opt to use those regulations. And then you've sort of gutted a lot of the regulatory provisions you're trying to put in the bill.

CONAN: Matt Continetti?

Mr. CONTINETTI: Well, for better or worse, I mean, people love their credit cards, and it's pretty easy to get one. And so I think if you transform that metaphor to health insurance, that may actually be a remark in its favor.

I hate to sound like a cynic, though, but I think the problem with federalist solutions is that federal politicians don't get any credit, and so they're less willing to entertain the things that might let these states be laboratories of democracy.

CONAN: Pat, thanks for the call. Let's go next to Frederick(ph). Frederick with us from Calistoga in California.

FREDERICK (Caller): Good morning, gentlemen. This conversation is a clear example why we need a single-payer option like Western Europe has and the rest of the industrial world. My question is to Chris: How is the Democratic Party going to reconcile this overwhelming support of the base of the party, the base of America wanting true health care reform which is exhibited by the House version, isn't it, with what has come out by this insurance-dominated plan that was written by Baucus? How is the party going to do that?

Mr. HAYES: Well, that's a - that is the big unanswered question. I think it's a real challenge, and I think that they run tremendous political risk in abandoning the base. I mean, you know, there's going to be some choice and there's going to be some compromise that gets hammered out, the details of which are going to pitch towards one poll or the other. I should be clear that substantively I agree with you about single-payer. That would be the system that I would endorse and have written favorably about. None of the five bills that are currently being entertained would enact that. And, you know, the - I agree there is a large risk, particularly when you think about midterm elections which tend to be dominated by the activist-base because of their low turnout. There is a big risk of sort of blowing off the progressive base of the party heading into the midterms in terms of what actually - bill ends up coming out.

CONAN: Well, Chris Hayes, I - excuse me just a second, Frederick. Chris Hayes, there's also a large group in the Democratic Party, the so-called Blue Dogs, who are elected from much closer districts, who say we're going to lose our seats. We're not going to vote for anything with a public option in it.

Mr. HAYES: Yeah. That's true, although in some ways that's less of a concern in the Senate because there's a lot of room for maneuver in terms of what the majority that Pelosi is working with in the House, right? So, as Matt said, what is it, 40 votes that she can…

CONAN: She has to play with, yeah.

Mr. HAYES: Right, that she has to play with. So, you can do - you know, I mean, Tom DeLay, of course, was the master at this. You know, it's something that they used to call catch and release in the day, which you line up, you know, your caucus and then you sort of allow these dispensations to people that feel that they're particularly vulnerable -and I'm sure that's going to be done. But the issue is much more in the Senate. I mean, that's where the problem is and that's where the kind of center of gravity around something more Baucus-like is. Because Pelosi is going to deliver the votes in the House to essentially pass on the floor the version of the bill, the tri-committee bill that exists now.

CONAN: We're talking about the politics of health care reform with Christopher Hayes, Washington editor of The Nation, and Matthew Continetti, associate editor of the Weekly Standard. You're listening to TALK OF THE NATION from NPR News.

And let's try Guy(ph). Guy with us from Akron - excuse me - Akon(ph) in South Carolina.

GUY (Caller): That's Aiken, South Carolina…

CONAN: Go ahead, please.

GUY: …Joe Wilson's district.

CONAN: Yes.

GUY: Leave it to somebody from Joe Wilson's district, I guess, to bring up something political and cynical here, but the reason that there's going to be some support - there's all the support for the Baucus bill in my mind is because it's the one that gives at least some superficial cover to the White House and to Democrats behind this thing because it does have at least the superficial bipartisan, you know, input with the gang of six. I don't think anybody has brought that up yet, but it's…

CONAN: So, Republicans can't say they weren't consulted, they weren't talked to, that they weren't listened to. And Matt Continetti, there's a lot of…

GUY: A lot of buy-in, right. There's buy-in.

CONAN: Yeah. There's buy-in there. And a lot of people think that at the end of the day they will pick off one or two Republicans in the Senate.

Mr. CONTINETTI: Possible. Yeah, possible. You know, when I look at this debate, I see just the replay of the stimulus debate, right? Right there, you had…

GUY: Absolutely.

Mr. CONTINETTI: …the eventual stimulus plan that was enacted, got criticism from the left. They said that the plan was too small. It got criticism from the right. They said it was too big. All this focus was then on the Senate. But twisting the arms of a few, you know - then he was a Republican, Arlen Specter and the two ladies from Maine, and everyone was unhappy with the final product but that's the product we got. I think something very similar will happen here with health care.

CONAN: And is the real battle, do you think, Christopher Hayes, going to be in reconciliation? That's going to be when the House passes its measure and the Senate passes its measure, and then they try to marry the two in a single committee to present a bill to both houses that would then go to President Obama.

Mr. HAYES: Right. So, just so that the listeners aren't confused, conference committee, reconciliation is the - you mean, reconciliation in sort of the general sense of reconciling the two…

CONAN: In reconciling the two bills, yes.

Mr. HAYES: Right. Yes. Yes. So, in conference committee, that is where the, you know, the real - the issue I was just discussing with the previous caller about towards which end of the pole does - do things go. I mean, I know - and Matt's absolutely right. The contours of this are identical to the contours over the Recovery Act. And in that case, you know, the House is able to put in some things that have been taken out by the Senate but largely the bill that came out of conference was tipped towards the Senate. And the reason was to try to keep those three Republican votes.

One of the questions is, you know, can they get - is - if they're going to do with the reconciliation in which they only need 51 votes, then the center of the gravity, I think, shifts a little bit towards the House. And so, that's going to play a role into what kind of compromise comes out of conference.

CONAN: And let me ask you both about timing, both in the short term. Everybody says if this bill is going to pass it's going to pass this fall. Matt Continetti, do you agree?

Mr. CONTINETTI: At the moment, that's where the political landscape looks like. I mean, we had a very tumultuous summer. I think the president was able to calm down some of the tea party movement in terms of creating a public opposition to this bill. Right now, the numbers have basically settled. The public is evenly divided, some polls show a little bit more in favor, some other ones show a little bit more opposed. So, it seems to me, from a conservative standpoint, you know, sadly - but from - if you're the Obama White House yeah, things look, at the moment, pretty good for passage this fall.

CONAN: Would you agree, Christopher Hayes?

Mr. HAYES: Yeah. I think if I was - if I were a betting man, I would bet that a health care bill is passed out of both houses and signed this year. I think that the question is: Is it a good bill?

(Soundbite of laughter)

Mr. HAYES: And I think that that question is not - you know, in the short term, the White House and the Democratic Party need a political victory. In the long term, it won't be a political victory for long unless it's not a bill that people like, that provides people with health insurance and end some of the worst kind of insurance industry practices and slows the growth of health care inflation.

So, in the short term, it could be a pyrrhic victory if they pass something this fall and get the bump from that and the bill itself doesn't end up delivering on its promise.

CONAN: Well, it's going to take - even it is passed, it's going to take some years before a lot of the measures take effect, as we were hearing on the - some of the measures in the bill, at least in the Baucus bill -I think in everybody's bill - don't take effect until after the next presidential election, possibly no coincidence.

Mr. HAYES: Convenience. Yeah.

CONAN: Yes. Yeah. Anyway, gentlemen, thank you so much. We appreciate your time today. Christopher Hayes, the Washington editor of The Nation, joined us from that newspaper's offices here in Washington, D.C. Thanks very much.

Mr. HAYES: Thank you.

CONAN: And Matthew Continetti, associate editor of the Weekly Standard, was with us here in studio 3A. As always, we appreciate your time.

Mr. CONTINETTI: Thank you, Neal.

CONAN: Coming up, Kanye, Serena - whatever happened to the art of civility and the art of apology? Ask Amy's Amy Dickinson joins us next. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

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