Health Insurers plan to Merge. Rates to Rise. We Blew it with Healthcare

[Armstead]

Last edited Thu Aug 6, 2015, 06:06 AM - Edit history (1)

One of the big issues in the healthcare debate was whether BIG FUCKING INSURERS should continue to hold our healthcare system - and consumers - hostage to their rapacious greed.

Well in our infinite wisdom, we ultimately chose to allow it. And we chose to force everyone to buy their fucking health insurance.

Now the news is that a number of the big insurers are looking at merging, anfd reducing that Sacred Mantra of Choice and Competition.

And the are predictions that rates are going to rise sharply.

Well congratulations to the United States of America. We have managed to Screw the Pooch yet again on a major issue.

-------------
http://www.commondreams.org/news/2015/06/20/insurance-giants-proposed-merger-could-devastate-access-health-care
One of the largest health insurance giants in the country, Anthem, on Saturday proposed a $47 billion merger with its competitor Cigna, part of an industry-wide merger bonanza that analysts warn could have a devastating impact on health care cost and access nationwide.

The public proposal comes as the top five U.S. insurance companies—UnitedHealth Group Inc., Anthem Inc., Aetna Inc., Cigna Corp. and Humana Inc.—race to consolidate in what Bloomberg recently called a "five-way dating drama" and the Wall Street Journal referred to as an "oligopoly wave."

In a letter to the the Federal Trade Commission earlier this month, the American Association of Family Physicians expressed deep concerns "about the potential merger of any of the nation's largest health insurance companies and the impact such actions would have on access and affordability of health care for consumers across the nation." More

[Skittles]

1. yup

http://www.latimes.com/business/la-fi-lazarus-20150710-column.html

[pnwmom]

2. No, we didn't blow it. We took a significant step ahead, especially with the Medicaid expansion,

which helped many millions. And the the ACA has bent the cost curve significantly down, not up.

If private health insurers prove they can't handle the job, then there won't be any reason for anyone (except the insurers) to argue against Medicare for all.

And in the meantime, the states still have the right and obligation under the ACA to review and approve all requested rate increases. The insurers can ask for anything they want. The states don't have to give it to them. If the insurers don't like the rates they're offered, they can leave the business.

[TexasBushwhacker]

46. The more the insurance companies fuck up

the more chance we'll get single payer or at least a public option.

[TheKentuckian]

88. The "reform" 8s specifically designed to limit their fuck ups and putting the full faith and credit

of the United States behind them as the officially sanctioned gatekeeper of health care in the country.

The really sharp and able to see beyond the next quarter big wigs had sense enough to work a situation where they could come out of the coming death spiral while consolidating market share and increasing profits.

Stopping the insane growth as percentage of GDP is not a problem, the inflation is still too high but as the boomers came off and rates skyrocketing while benefits get slashed was setting up an adverse selection situation and I believe more than would ever be let on drawing the ire of the captains of other industry both from an expense and "the ocean called to tell you it is running out of shrimp" factor perspectives.

[Live and Learn]

4. Of course, a single payer would have been better but we must give credit to Obama

for getting anything through. And, if fact, it was pretty genius. If rates do begin to rise, which they haven't so far, people will be loathe to give up the safety features put in place already leaving only single payer as an option.

In addition, health care company mergers will bring to light the entire monopolization of industries that has been obviously occurring in recent years. Perhaps, people will finally demand more legislation regarding monopolies.

[Armstead]

25. I would hope so, but it doesn't seem to work that way -- We put up with abuse

No matter how high or awful rates become, if the history of the last 30 years is any indication, people will just take the abuse like lobsters in a pot of heating water, until the total damage is done and no one can afford it and the government is helpless to assist.

As for mergers in general -- I agree it's a problem, but we've allowed that to steadily get worse over the past few decades and the point of awful monopolization in many industries was passed long ago. And we're still allowing most of them to proceed without a whimper.

In order to really stem or correct it, we and our politicians and leaders have to wake up and start giving a damn. I hope that happens.

[LakeVermilion]

5. Haven't the profits for health care insurers been limited?

I thought that insurance companies were limited to 15 or 20% profits. Does anyone remember the rebates that were given when the ACA was initiated? Maybe those profit limits were phased out.

[Adrahil]

6. 80% of premiums must be paid back as benefits....

The remaining 20% can be for administration, profits, whatever.

[djean111]

11. As long as Pharma can keep charging outrageous prices, and providers and hospitals

can keep rising prices, insurance companies can keep raising rates. I believe they are all complicit.
Plus, I believe insurers were looking for ways to redefine what constitutes "health care".

With the TPP and other "trade" agreements, things will only get worse, as more entities will be put in the same position as Medicare - not allowed to negotiate drug prices. And time to generics pushed out to twelve years.

In fact, I wonder if "trade" agreements would eventually enable insurance companies to sue over something like single payer, especially single payer with negotiated drug prices. Can't interfere with profits, you know.

[Doctor_J]

36. They wouldn't have signed off on Heritage Care without the guaranteed profits

So the idea that they might be "reined in" is preposterous, since it was written to deliberately let them rob us blind. And of course the TPP will make this worse.

[Ilsa]

73. I've been squabbling with my insurer over 30 day Rx vs 90 day

From the insurer's pharmacy. I tried using the mail order pharmacy, but they screwed up my Rx once and left me hanging. So, I've been using a locally owned pharmacy.

Yes, it costs more, but my family meets its 5 million dollar deductible (slight hyperbole) by July, so why should I give a shit when I can keep some of the profit local?

The cost of several generic drugs used in this house is ridiculous. I told them they were doing a poor job of managing contracts with pharmaceutical companies.

[djean111]

75. You might want to call Costco, if there is one near you.

They can be astoundingly cheaper, and ask them about with and without insurance. No membership needed. I think they do mail order too.

[Ilsa]

79. I'll look into it. Thanks! nt

[Nuclear Unicorn]

15. Let's suppose there is a business that makes $100 million in revenue annually.

Traditionally they have made $30 million in "profit" but now the government passes a reg that says they can only realize 20% profit so the inattentive say, "Oh. I guess they'll have to put $10 million into production, research, etc."

Except the government also says the public must purchase the company's product and the government has restricted the number of producers able to provide that product, thus eliminating competition.

Suddenly the company raises prices to generate a revenue of $150 million. Well, they still get to take 20% and you aren't allowed to forgo purchasing their product so they're back to making $30 million in profit. Hell, they could raise prices even higher to generate more revenue and the consumers have no choice in the matter.

This was absolutely predictable and when I and others warned of it we were raked over the coals.

[cbdo2007]

44. Lol, it doesn't have anything to do with "revenue"

"Medical Loss Ratio / 80/20 Rule – Insurance companies have to spend at least 80 percent of premium dollars on claims and activities to improve health care quality. 85% in large group markets."

Premium dollars <> "revenue" lol

[Nuclear Unicorn]

45. So where do insurance company revenues come from?

[Doctor_J]

22. And I'm sure they'll all follow the law!

[still_one]

76. Yes

[KG]

7. who could have predicted that?

[Lint Head]

8. Example of a current merger.

Anthem Inc. agreed to buy Cigna Corp. for $48 billion, capping months of merger frenzy among top U.S. health insurers that is set to reshape the industry.

The deal, combining the second- and fifth-largest health insurers by revenue, would create a company with a huge footprint in commercial insurance, the type of coverage provided to employers and consumers.

http://www.wsj.com/articles/anthem-agrees-to-buy-cigna-for-48-billion-1437732331

[kelliekat44]

9. Example of a major talking point issue on the ACA in tonight's debate. Bet on it.

Just in time for more misinformation and bashing of "Obamacare." FOX will throw out the question on this with glee. Just remember the timing of these announcements and how the media has coordinated them.

[Armstead]

27. This has been floating around for a while. I think they don't care about the politics of it

[Scuba]

10. A public option would have helped immensely. Wish POTUS had fought for one like he does the TPP.

[Vinca]

12. A public option is exactly what was needed to prevent this problem.

[City Lights]

30. I, too, wish he had fought for a public option like he fights for the TPP. nt

[pnwmom]

50. There is nothing to prevent one TODAY except for the will of Congress.

Obama pushed for as much as was possible. After Ted Kennedy died and we lost the super-majority in Congress, we couldn't push a public option through.

This wasn't Obama's fault. The only solution is to change Congress.

[Nuclear Unicorn]

13. As soon as the health insurance corps became the central feature of the ACA

their profitability and "vigor" became paramount. There is even a corporate profit slush fund. Moreover, the mandate obliterated anti-trust legislation for their industry.

The only people who couldn't see this happening were those who didn't want to see it happening.

[Martin Eden]

14. President Sanders will use this to rally public support

for a Single Payer system.

[Blue_Adept]

16. And once they all merge

Just nationalize it and acquire it. Easier to take out one than a dozen?

[Armstead]

28. Yeah, that's gonna happen

I wish, but...

[Doctor_J]

37. So now monopolies are good!

Ah, the mental contortions of the corporatists. Could make up an entire university psych course.

[deutsey]

17. The invisible hand of the market is spanking us yet again

and all most Americans can say is: "Thank you, sir! May I have another!"

[raouldukelives]

18. Well, we've always needed health care.

Sometimes it feels like the battle for health insurance wasted so much of the good work people did and the suffering people were exposed to. Like Michael Moore's film Sicko and the nurses and doctors on the front lines screaming for help.

Health care as a right was a movement, a wave, and it was ridden right into the hands of Wall St.

We still need health care. Our veterans need health care. We could provide both in fell swoop. There is no reason not to have it, other than greed of course. The reason we have nothing is that so many invest and labor for those taking it from us.

[Hoyt]

19. I actually think it will be better with just a few large insurers. First, providers are combining

into larger units to bargain for higher payments. Second, it's easier to regulate a few large insurers than thousands of independents. Third, providers will have to enroll in the large insurers' plans, a bunch of smaller insurers have a harder time developing big networks. With a few larger plans, it will be easier to determine which is best for you.

Provider groups -- like the one in the article -- are concerned that they can't get higher payments as easily from a few large insurers.

Most importantly, it will be easier to ratchet down the medical loss ratio and eventually absorb them into a single payer or at least a few quasi-public plans. I do think a public option would be nice, but I don't think it will necessarily be a lot cheaper. In any event, government needs to step up the regulation.

[nc4bo]

20. Thanks for the view on the other side.

It makes sense. It's just when you see big companies making strategic moves like mergers, it's usually the consumer that takes the hit the hardest.

I hope you're right or at least mostly right about this one. If not, there will be pain.

[Doctor_J]

23. Hoyt is a dedicated corporatist who believes in the innate benevolence of

Billionaires and CEO. He also loves TPP. So you might want to take his outlook with a pound of salt.

[Hoyt]

24. I'd rather regulate a few greedy insurance CEOs than hundreds of them, which is what we have now.

I do think TPP -- with some modifications -- is good for our future, much better than trying to make it trading among ourselves thinking that we can provide all the things people want in a declining economic environment. Personally, I'm fine with living on a dirt farm, but I don't think most folks are.

So how do you feel about doctors and hospitals banning together in large groups to extract higher payments from insurers and government?

Do you work for a corporation?

[Armstead]

31. I it;s gonna be a business, I'd rather there be a diverse and competative marketplace

I think the banding together we'll see are the hospital monopolists and the insurance monopolists forming their own healthcare system, and we're all the captive market.

[nc4bo]

26. Admittingly on 1st read, I lost it.

Then read this post and saw another side.

But in order for this to work, there needs to be strong oversight to protect the insured and as things stand, there isn't much oversight, strong regs or sufficient punishments if there is abuse.

Hey, I'm in the single payer camp but since this is the hand we're dealt, etc........

[Armstead]

33. There will be NO oversight -- It will be a true monopoly controlled by the oligarchs

I realize that's a bit of overheated rhetoric, but looking at history of the last 30 years, any assertion of regulating this rotten system is not gonna happen. The Oligarchs will just enslave us to a system they create and run -- and there will be no alternative to letting them kill us -- literally and/or financially.

[Hoyt]

49. Tell you what, call up a doctor's office and tell them you will be paying cash since you are

chose not to deal with health insurance companies. Don't tell them you are broke, just say you are paying cash. See what that doctor's office charges you vs. what they will accept when an insurance company is involved. You'll be paying 2 to 3 times as much as an insured patient, in most cases, maybe even more depending on what you need.

Now you might be able to negotiate with the doctor, hospital, pharmacy, etc., but how many people are going to do that.

Point is, you want to get screwed even worse, go uninsured and get sick.

I don't like insurance companies, utilities, grocery stores, auto makers, TV networks, internet cable companies, banks, mortgage companies, etc., it even ticks me off when I can't buy a really nice guitar for just $100 etc.

But it ain't gonna change any time soon, here or anywhere else.

[Armstead]

29. I disagree

If there were actually meaningful regulation...maybe.

But there is little appetite for that. So we'll jusr sit back and let these defacto monopolies screw us worse.

And health care systems and hospitls have been going through the same process of consolidation.

Pretty soon we'll have Single Payer System -- but it will be run by and for shadowy Corporate Oligarchs, instead of the public interest.

[Nuclear Unicorn]

89. There's a reason we have anti-trust laws.

[Hoyt]

90. And don't use them for utilities and the like, and get by with a few auto companies, etc.

Some things aren't best/cheapest with hundreds of little operators. How much do you think electricity, water, or postal service, etc., would cost with hundreds of competitors stringing lines, building pipelines, delivering packages, etc.

[Nuclear Unicorn]

91. Citing public utilities as the shining example of good monopolies wouldn't fly in

my neck of the woods. People constantly grouse about the cronyism between the state capital and the PUC.

[Hoyt]

92. Nuclear, people grouse about everything -- "the rent is too high," medical care costs to much,

everything cost too much or should be free, my neighbors are Aholes, the street is too bumpy, my butt hurts, your voice grates, . . . . . . .

I suspect you grouse about a lot of stuff, hence "Nuclear." Not being critical, because I'm that way too.

But no matter how much we grouse, things could be a lot worse. Grousing is hardly a defense of your position.

I'm saying there are some things that would not be as cheap as they are if there were hundreds of competitors having to invest the huge upfront money to produce a product or service.

I think healthcare will be of higher quality and less expense, with fewer insurers and health plans. Of course, that assumes rigorous government regulation and oversight. Would single payer be better? Maybe, but there would have to be some big changes to make traditional Medicare better in a lot of cases.

And you know what, if we had Medicare for all -- within a year or two, there would be a lot of grousing, from you guys too.

[Nuclear Unicorn]

93. No, they're grousing because fees are being collected for alt energy development only

we have no alt energy assets. They're being given permission to raise prices 65% despite a $100 million bond to build a high-efficiency plant. In other words, we're paying more for broken promises. They have us over a barrel because they are a monopoly and they have bought the pols who live outside our state districts.

[Doctor_J]

21. yup. had to be a thundering idiot not to see this coming

Or, I guess, so deeply in love with one person that your personal feelings made you incapable of rational thought.

With respect to duers, I think that more succumbed to lust than to idiocy.

[mythology]

39. Saying with respect to DUers before then insulting doesn't

Exactly negate the insult.

But let's turn your insult around and say that some DUers lusted over a political impossibility (single payer or a private option) that they lost became incapable of rational thought.

But hey go ahead and explain how you would have gotten either passed with the Congress that was elected. Explain which additional senators you can specifically have gotten to change their vote. I haven't heard any specific examples in the years since ACA was passed.

[Armstead]

43. THere were possible manipulations. Remember the All Powerful Joe Liberman...

left Congress shortly after that.

If the political climate of the moment made it impossible, then I;d have rather seen them hold off rather than do further damage.

IMO if the Demos had pushed for the better things in the ACA (like pre-existing conditions) wthout the destruictive crap, they cold have gotten it through.

[Doctor_J]

47. I don't think that those who hold such views consider it insulting

Their stance is that the president is to be worshipped regardless of his positions. So when I write that their dedication to him overrode what should be common sense for members of the party I've belonged to for my entire life, they agree, and think that's what everyone should do.

As for me, my principles don't change when the occupancy of the white house changes. Trying to convince a 60 year old that having the worst healthcare in the world, together with the highest prices, is a good thing, is a battle you will lose.

[Skittles]

72. excellent response, Doctor_J

[Erich Bloodaxe BSN]

55. I don't think he meant 'respect' in that sense of the word.

I think he meant it in the sense of 'As regards DUers'. When you say 'With respect to the stock market fall today,' you aren't saying you 'respect' the fall, you're just announcing your next statements will be related to it.

[pnwmom]

51. Someone would have to be a thundering idiot to not see that CONGRESS had to approve this law,

not Obama, and that after Ted Kennedy died, we didn't have the super-majority available to pass it over their filibusters.

And someone would have to be a thundering idiot not to see that the fact that we have many millions more covered under Medicaid now, thanks to the ACA, and that that represents a significant advance in another kind of public option.

[tularetom]

32. When one shark gobbles up all the others

Single payer is here and there is no longer any reason for the government not to step in and assume responsibility for the entire program.

[RadiationTherapy]

34. I think this is a necessary step, though it disgusts me deeply.

Since so many disgusting, grubby pigs refuse to contribute to a socialized healthcare model, we must wait and watch as the capitalists eat one another and destroy likely thousands of lives and families in the meantime. When they have ruined enough people, socialized healthcare can emerge via the will of the people.

[Armstead]

41. Been hearing that for a looooong time

and the porcine keep getting fatter and happier and we let them get ever closer to literally having us for dinner.

[Doctor_J]

48. Yes, 2109 promises to be a great year!

[RadiationTherapy]

68. Hahaaha. It's so discouraging.

[closeupready]

35. Strengthen Anti-Trust laws, in response.

Because what they are doing is eliminating their competition, leading to rising prices - precisely what trusts DO.

[arcane1]

38. That " Choice and Competition" nonsense was a bold-faced lie from our current president n/t

[Doctor_J]

40. "American Association of Family Physicians expressed deep concerns"

What a bunch of commies who don't understand civics and triangles. Like they know more about healthcare than the president and the insurance CEOs!



Let it be said that some of us knew, and stated, what was going to happen. When my annuals went from $500 to $8350 I was not the least bit surprised. Still others, like Krugman, lost their way due to their devotion to the president. This health "care" plan sucked when Heritage wrote it, it sucked when Gingrinch proposed it, and it still sucks.

[pnwmom]

54. If your "annual" before was $500, as a 60 year old, you had a junk policy.

But maybe you didn't care because you are an actual doctor and planned on getting "professional courtesy." For the rest of us, we need something beyond junk policies.

[Doctor_J]

57. Actually it was quite a good policy. Thanks for inquiring

I work for a small business, and my employer takes care of a nice chunk of it. I pay, as I did before, $200/month for self and spouse. Before Heritage Care was enacted, my deductibles and co-pays maxed out at $500. After Heritage Care, the insurance companies gave the employers a choice between high-premium or high-deductible plans. My employer chose the latter. Small business employees are shouldering most of the new astronomical insurance profits that are built in to the ACA.

Before Gingrichcare - Good policy
With Gingrichcare - Junk policy

BTW the $8500 is more than 1/5th of my take-home pay. For new people at my employer, it's more than 1/4th.

FInally, if the president was not going to include a public, non-profit option, he should not have lied during the camaign.

[pnwmom]

63. The ACA created a marketplace for individual policies. The changes your EMPLOYER decided

to make for his GROUP policies were not required by the ACA -- and employers have always been free to change insurance policies.

Your employer and his insurance company is just using the ACA as an excuse for doing what they wanted to do anyway.

The President didn't lie during the campaign; his detractors are lying now. President Obama couldn't get the public option through Congress after Ted Kennedy died. The President couldn't wave a magic wand and defeat the filibuster in the Senate.

[Doctor_J]

65. He stated, "I will insist on a public option"

That was a lie, since he gave it away before the negotiations (kabuki theatre) began.

As for my situation, Big Insurance is raking in historic, obscene, disgusting profits. Who do you think is paying for that? Do you think it's a good thing that more money than ever is going towards non health care? If so, why do you claim to support actual healthcare? If not, why do you consider heritage care so great, and how would you fix it? And why do you believe Americans deserve the worst, most expensive healthcare in the world?

[pnwmom]

66. Link please. I don't believe Obama said that because no President can force

Congress to do anything.

Your anger is entirely misplaced. Blame the Rethugs in Congress, not the President who got the best deal he could, or the Democrats in Congress who managed to pass a bill that helped millions get on Medicaid and millions of others get individual policies through the state exchanges.

Your not liking your employer-based group policy is a separate issue. Yeah, Medicare for all would be great. But we need the votes in Congress for that. The President couldn't do it alone.

[nationalize the fed]

70. Here

Sep 9, 2009: President Barack Obama told Congress Wednesday the public option would be part of an insurance exchange for last-resort coverage. Obama said the Congressional Budget Office estimates that less than 5 percent of Americans would sign up


Harry Reid

Uploaded on Oct 26, 2009

Majority Leader Harry Reid says health care legislation headed to the Senate floor will include an option for government-run insurance.

The health insurance mandate in the 2010 Patient Protection and Affordable Care Act, also known as Obamacare, is an idea hatched in 1989 by Stuart M. Butler at The Heritage Foundation in a publication titled "Assuring Affordable Health Care for All Americans". This was also the model for Mitt Romney's health care plan in Massachusetts.
https://en.wikipedia.org/wiki/The_Heritage_Foundation#Policy_influence

[pnwmom]

71. The sound doesn't work on my old computer. So I'll take your word.

But Obama didn't lie. He just didn't realize yet that Ted Kennedy, in the safely liberal state of MA, would be replaced by a Rethug, and that that would change everything.

[dreamnightwind]

85. He also campaigned against mandated purchasing - eom

[pnwmom]

86. He shouldn't have done that because there was no way they could make it affordable

for everyone, and not exclude people for pre-existing conditions or drop them when they got sick, unless they required everyone to enroll.

New York State was the test case for that and it failed. Rates skyrocketed because most people waited to enroll till they got sick or old.

[dreamnightwind]

87. But he did

I could live with the mandate if it wasn't a corporate mandate.

[Hoyt]

59. +1

[GoneFishin]

42. "Will they screw us?" is exactly the same question as "Can they can screw us?". When the Public

Option was traded away for magic beans by the President behind closed doors, this result became inevitable.

[PoliticAverse]

52. Consider it one step closer to a "single payer"... n/t

[Erich Bloodaxe BSN]

53. Who's this 'we'?

As I recall, single payer advocates were arrested and escorted out of the room. They never got a seat at the table, and the President gave a halfhearted shrug to losing the public option.

A giveaway to the insurance companies was ALWAYS central to the retread 30 year old Heritage Foundation plan the president dusted off and handed to Congress.

The centrists assured us it was the only deal possible, and would only get better over time.

[pnwmom]

56. Bernie Sanders was part of the "we" who supported it, after Ted Kennedy died and it became clear

that there were not enough votes in Congress to override the Rethugs filibusters. So the death of Ted Kennedy was the death of the public option, until we get another super-majority in the Senate and a majority in the House.

[Doctor_J]

60. Actually Sanders has called it a "great Republican solution" and disdained it until the very end

And you will notice that part of his platform is SP or a public option, while Clinton plans to lock in the profit model in perpetuity.

[pnwmom]

62. He voted for it at the end because he knew nothing better could get passed without a supermajority.

I don't know anyone here who thought it was the optimal solution, and neither Obama nor Clinton did. But it was the best that was achievable at the time, given the political circumstances.

So Bernie, to his credit, voted for it.

[dmosh42]

58. Remember when we all thought Obama was about the "public option"? That would have prevented this...

monopoly activity. An administration which isn't kissing the ass of big business can stop these plans to block competition, but Obama & Republicans never oppose big business! Bernie will put an end to this shit!

[pnwmom]

64. Remember when Ted Kennedy was alive? He would have provided the essential vote for

overcoming the Rethug filibuster against the bill. When he died, and was replaced by Rethug Scott Brown, so did the public option.

[questionseverything]

82. we had a decent bill from the house that included a public option

you are correct it could not overcome the 60 vote hurdle but as i remember it as soon as liberals started talking about the nuclear option being used...a 51 vote threshold (perfectly legal as healthcare certainly deals with finances) the repubs and the conservative dems in the senate came up with the aca (crap bill that expects citizens to have 30% of their income to dedicate to healthcare)

i am glad for every1 the aca helps but it was foolish to try and reign in medical costs without first addressing containing costs....the pharmaceutical companies and the insurance companies are all owned by the same 1%ers...so the 80/20 rule is not working out

/////////////////


Tuesday, September 22, 2009

Senate Majority Leader Harry Reid threatened on Tuesday to use a procedural maneuver to steamroll opponents of health care reform, even as a Senate panel began delicate negotiations over a package that could have the best chance at passing.

The Nevada Democrat, who has issued similar threats before, spoke as the Senate Finance Committee began debate over Chairman Max Baucus' reform plan. Reid threatened to use a budgetary tool called reconciliation -- also known as the "nuclear option" -- that would allow Democrats to pass key parts of the legislation with a simple majority, as opposed to the 60 votes needed to avoid a Republican filibuster.

"If we can't work this out to do something within the committee structure, then we'll be forced to do the reconciliation," Reid said, adding that he views that as a "last resort."

"It remains to be seen as to whether we will have to do reconciliation. I am confident and hopeful we won't have to do that, but time will only tell," Reid said.

Republican Sen. Richard Burr, N.C., said reconciliation would be a "grave mistake," and that Reid underestimates the public concerns over the bill.

"I don't think it's a threat. I think that's what Harry Reid intends to do," Burr told FOX News.

But the Senate Finance Committee pushed through tense and intensive talks Tuesday to reach common ground on the Baucus plan. Senators have filed 564 amendments, and on Tuesday afternoon Baucus released a slew of changes.

Among them, Baucus agreed to cut in half the penalty attached to a government-mandated requirement to buy health insurance. Under the changes, families could be charged a maximum of $1,900 for failing to meet the requirement -- as opposed to $3,800.

[Hiraeth]

61. It was off to a rocky start, granted but, I fully expect Bernie to hammer it home.

[Rex]

67. But but but...we already have single payer...er...okay for people 65 and older.

Some of the garbage I read here makes me SMH and wonder why people post RWing talking points as if they are Democratic ideas.

[hifiguy]

74. Two things have never come from mega-mergers

and never will: lower costs and greater efficiency. Never in human history. But they are alway cited as justification/excuse for allowing them to proceed.

What the FUCK ever happened to antitrust law?

[Armstead]

77. Government failed to do its job as a restraint in monopoly power...

..and We the people allowed it to happen.

We still are, obviously.

[ibegurpard]

81. And yet somehow

It's going to step up and do it if mega-merging insurance companies get too far out of line...

[Agony]

78. merge 'em all together and then nationalize the beast!

one step away from single payer universal

[ibegurpard]

80. People are claiming RIGHT IN THIS THREAD

that if insurance companies get too big we can just regulate them or take them over... at the same time they're claiming there's no way we could get a single payer option passed... can you believe this shit?

[Armstead]

83. That ol' Catch 22 in action

[Zorra]

84. Elect Bernie Sanders 2016. nt