Senate leaders close to including a version of public option in health bill

The New York Times: "In pushing to include a government-run health insurance plan in the health care bill, the Senate majority leader, Harry Reid, is taking a calculated gamble that the 60 members of his caucus could support the plan if it included a way for states to opt out."

"The Senate has long been seen as opposed to the federal government selling health insurance in competition with private industry, but now senior Senate Democrats and White House officials are strongly considering including such a measure in health care overhaul legislation, officials say." But moderates from both parties however, seized on the opportunity to ask Reid again to slow the bill down so Senators have a chance to analyze and consider it. They include Sens. Ben Nelson, D-Neb.; Olympia Snowe, R-Maine; and Susan Collins, R-Maine (Pear and Herszenhorn, 10/22).

The Associated Press reports that the provision to allow states to opt out could help to attract the votes of the moderates. "Several officials said no final decisions had been made, with one possibility that the idea was being circulated to see whether it could attract enough support to survive on the Senate floor. ... Democratic moderates are skeptical of allowing the government to sell insurance, concerned that it would mark an unwarranted federal intrusion into the private marketplace and potentially jeopardize payment rates to doctors, hospitals and other providers" (Espo, 10/23).

The Wall Street Journal: "Nelson, who has met twice this week with Mr. Reid, said it would be "very difficult" for him to support any proposal that creates a national plan -- even one that allows states to opt out." Similarly, Senate Budget Committee Chairman Sen. Kent Conrad of North Dakota said he has assurances that any plan "wouldn't be tied to Medicare" (Hitt and Adamy, 10/23).

CongressDaily: "Conrad, who authored the co-op system in the Finance Committee bill as an alternative to a public option, said Thursday states should have the choice to participate in a nonprofit" (Edney, 10/23).

Roll Call reports that "Snowe and Nelson noted that centrists want to make sure the underlying bill is acceptable to them before allowing it to come to the floor. They argued that once the measure is officially being debated, it will be difficult to secure the 60 votes necessary to strip key provisions — such as a public insurance option. Sixty votes are needed to overcome a filibuster of any amendment or bill" (Pierce, 10/22).

Bloomberg offers more insights into what Snowe is thinking: "'A public option at the forefront really does put the government in a disproportionate position with respect to the industry,' Snowe, the only Republican to vote for a health plan so far, said in an interview with Bloomberg Television's 'Political Capital With Al Hunt,' airing this weekend" (Litvan and Dodge, 10/23).

CNN: "In recent days, two administration officials have told CNN that the prevailing White House opinion is for the Senate health care bill to include a so-called 'trigger' mechanism proposed by Snowe that would bring a public option in the future if thresholds for expanding coverage and lowering costs go unmet in coming years. The source familiar with Thursday evening's meeting said Obama 'pushed for a so-called trigger, because it's the more bipartisan way to go,' due to Snowe's support for the concept" (Bash and Walsh, 10/22).

The Washington Independent has a scoreboard on how the public option might fare in the Senate with 14 on the fence, 47 likely supporters and 39 likely opponents (10/22).

Politico: "The pace of the negotiations is picking up. Sen. Chris Dodd (D-Conn.), who is representing the Senate Health, Education, Labor and Pensions Committee, said the merger group hopes to send a package to the Congressional Budget Office soon." Several senators have said it's imperative for a new CBO score on the bill before they will consider it (Budoff Brown, 10/23).

But The Hill reports on how some see the schedule unfolding as the process continues. "The healthcare reform debate will be pushed deep into December and possibly beyond by a lengthy floor debate, several senators predicted Thursday. Senate Majority Leader Harry Reid (D-Nev.) is under pressure from a group of centrist Republicans and Democrats who are demanding a go-slow approach" in order to have enough time "to review the legislative language and to give the Congressional Budget Office (CBO) a chance to provide a detailed cost estimate." That means the legislation "has no chance of being approved by Thanksgiving" (Bolton, 10/22).