Public Option Re-Emerges In Senate Discussions; Continues To Play Role In House

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Senate Majority Leader Harry Reid's efforts to merge the two Senate health care reform bills is being complicated by question of whether to include a public plan and how it might fit with vote counting, the president's agenda and the more liberal version sure to come out of the House.

The New York Times reports that the White House has "looked favorably" on a proposal from Sen. Olympia Snowe - what lawmakers call a "trigger" - that would create a government-run public plan for health insurance only if insurers can't contain costs. "But liberal Democrats were maneuvering against it Wednesday, arguing that Ms. Snowe, the lone Republican to vote in favor of the Finance Committee's bill, was gaining undue influence over the talks."

The fight is over the role of government and how much intervention is too much in light of the bank bailout and the stimulus package, experts say. In the meantime, Reid "has said he likes Ms. Snowe's trigger proposal - 'a pretty doggone good idea,' he called it in a recent conference call with Nevada voters" (Stolberg, 10/14).

The Associated Press: "Business groups and conservatives remain steadfastly opposed to government insurance - formidable political opposition that shows no sign of weakening. So advocates are getting creative, trying to reformulate the 'public option' in a way that can gain the 60 votes needed to clear the Senate." These options include allowing states to offer their own public plan or the option to opt out of a public plan or allowing public coverage only in places where there is just one insurer in the market.

"Reid is giving no hints. Asked Wednesday if he thought it was likely there would be a public plan in his merged bill, he responded: 'I'm not betting on health care. "Likely" is in a game of craps'" (Alonso-Zaldivar, 10/14).

Meanwhile, in the House, the public option continues to have powerful advocates.

CongressDaily reports that House leaders are considering increasing hospital payments under a public option in the push for a Medicare-like government insurance plan. "House Speaker [Nancy] Pelosi met with members Wednesday to discuss the public option, and sources said she indicated the House would likely vote on a bill with one based on Medicare rates. 'They are very close to including this,' a lobbying source said" (Hunt, 10/15).

Pelosi is trying to win liberal votes with inclusion of a public option, Roll Call reports. To satisfy moderate Democrats, Pelosi has created a compromise to bump the payments to hospitals to Medicare rates plus 5 percent (Newmyer, 10/15).

The Hill: Pelosi "said that if House Democrats pass the public option liberals support, they could ultimately have the more centrist version of the provision when the final bill is hashed out in conference with senators, according to some of those in attendance" (Soraghan, 10/14).

NPR lets Rep. Henry Waxman, of California, sound off on reform in both the Senate and House and a public option: "In the House we stand strongly behind a public option from the beginning. … We would encourage the Senate to come along with us." Waxman said that people all should have a responsibility to carry insurance (10/14).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.