Senate Dems Seek Viable Public Option

Negotiators Work with Obama to Find Government Insurance Option Palatable to Whole Party

(CBS/AP)  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.

The provision would permit individual states to drop out of the system, a design that could make it more palatable to moderates who have opposed the "public option."

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The government provides health care to the elderly and indigent, but the rest of Americans must rely on private insurance, and most receive coverage through their employers. Nearly 50 million don't have any insurance at all.

Liberals in Congress view a public option as an essential ingredient to overhaul the U.S. health care system, and President Obama has said frequently he favors it. But he has also made clear it is not essential to the legislation he seeks, a gesture to Democratic moderates who have opposed it.

Democratic Sens. Ben Nelson and Kent Conrad said in separate interviews they had been told the plan was drawing interest in private negotiations led by Senate Majority Leader Harry Reid, also a Democrat, who is merging health bills passed by two separate committees into a final package to bring to the floor.

"What I'm hearing is that this is the direction of the conversation," said Conrad, who supports an alternative approach under which non-profit co-ops would compete with private industry.

Nelson said he'd also heard the plan was drawing favor, adding he thought that was unfortunate.

The White House declined to comment. Reid's office did likewise, and he left a meeting at the White House with other Democrats late Thursday without talking to reporters.

Reid is under intense pressure - not just from moderate Democrats weary of a public option, but also from an array of decidedly liberal groups which, CBSNews.com political reporter Stephanie Condon reports, could have significant influence on his chances at reelection in 2010.

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.

If not, it surely would be jettisoned beforehand, with liberals urged to accept something less or risk defeat of health care legislation. There is little margin for error among Mr. Obama's allies in the Senate as they confront nearly unanimous Republican opposition.

Democrats hold a 60-40 majority in the Senate, counting two independents, precisely the number needed to overcome threatened Republican delaying tactics.

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.

Mr. Obama's health care reform ambitions also face potential challenges from several pivotal Senate Democrats who are more concerned about their next election or feel they have little to lose by opposing their party's hierarchy.

Legislation taking shape in the House of Representatives is also expected to include a public option, although it is unlikely states would be allowed to opt out.

After months of struggle, both chambers of Congress are expected to vote in the next few weeks on sweeping legislation that expands coverage to millions of Americans who lack it and bans industry practices such as denial of coverage for pre-existing medical conditions.

The House and Senate measures aim to expand coverage to about 95 per cent of the population, and include federal subsidies to help lower-income families afford coverage and permit small businesses to provide it for their employees.

The two bills differ at many points, although both are paid for through a combination of cuts in future Medicare spending and higher taxes.

House Speaker Nancy Pelosi said at a news conference she and her leadership were entering the "final stages" of assembling a health care bill to be voted on this fall. Officials have said the measure would cost $871 billion over a decade, but that total excluded a handful of items not directly related to expanded coverage that would push the total to well over $1 trillion.

Meanwhile, House Democrats are at an impasse over whether their proposal would effectively allow federal funding of abortion.

At least two dozen anti-abortion Democrats believe it would, and while their opposition is unlikely to stall the legislation in the end, they are at odds with Democratic leaders just weeks ahead of anticipated floor action on the bill.

Abortion has been legal in the country since a 1973 U.S. Supreme Court ruling, but it remains a politically sensitive issue in the country.

[mjlewis6]

Republicans in the Senate and the House want the Democrats to take this issue and make it law...Their only token resistance is to make a good show. That way they have credibility to those industries to keep sending campaign funds their way....and can blame Democrats for any foulups.

Besides, if Healthcare Reform should work....there is the benefit of having this issue out from in front of them so they can work behind the scenes to protect other facets of their corporate's interests.

Hey, you don't see them screaming 'Stay the Course' for Bush's failed policies on Rebuilding New Orleans....attracting allies in the war on Terror with renditions and torture....billions to Pakistan for the corrupt regime to fight for its own survivial....and WMD's....to say nothing of the Social Security Intitiative to divert the fund into Wall Street ventures....HAHAHAHAHAHA

[stuart-johns2]

Now see, this is how a political party is supposed to act. Because the dems are an "inclusive" party, they have varied profiles and yet they all come together and work out their differences. What a refreshing and beneficial way of governing.

Now in contrast, the republican extremist party is ridgid and hence they are in the pits they are in. They have tremendous infighting among their ranks and refuse to compromise on anything. Why do you think some have walked out on that pathetic party and converted to either the democratic party or are now independents?

The republicans are getting a teachable moment here. But they won't take advantage of it. They are stupidly stubborn and just negative.

[actornaught]

by BeckieBest October 23, 2009 11:06 AM EDT

Even after a Public Option is put into place, health costs will go up, just less so. But then the foxrush Yappers will be trained to bark about any increase being the fault of the PO.

And a means test for it is so lame, it will doom the fake-PO to under-funded failure.

Any 'pub input should be viewed as sabotage.

So with that, we should just forge ahead with a full Single Payer system.

Not gonna hold my breath....

[BeckieBest]

Health care prices have doubled in the last 10 years.

They will double again in the next 7 without serious reform and a public OPTION.

No insurance company ever brought a country quality, affordable health care.

The government has always had to step in and offer a public OPTION.

[RNurse6]

As a Registered Nurse working with Children with Cancer and also for Santa Clara County at the Children's Shelter Clinic, I am very concerned with the direction of Health Care in this country. Big Insurance and Big Pharmaceutical Companies are running the show. Even if you have coverage, the insurance companies make it almost impossible to get paid. When people are sick with Cancer and other health problems, it is the worse time to try and get money back from the insurance companies. They seem to know this and throw every road block in the way to keep from paying their share. Please let there be an OPTION to have public health insurance. People are not getting good health care in the United States. We can do better than this. Don't let a few talking heads confuse the issue, only Insurance companies and Pharmaceutical companies have something to lose if we have public option. There are so many people who need insurance coverage that is fair and works.

[element51]

I commend you for your work and am thankful that we have compassionate people like you in the system. Saddly though, the big insurance companies and big pharma are not going to allow anything that will put as much as one penny on the line. There is an old joke that says that we have the best government money can buy. This is certainly true when it comes to health care reform. I'm sorry but it just ain't gonna happen. The House and Senate are nothing more than paid mouth pieces for big business and the rich and that isn't going to change. Keep fighting the good fight and do whatever you can to help the poor folks who are in such desperate need.

[element51]

It makes perfect sense to stand up for the big insurance companies who will continue to reap major profits than it does to support any kind of health care reform. The republicans can drag this out for years until many of us who stand to benefit will be dead. As long as the big insurance companies have the support of the republicans there will be no changes made. It hasn't been that long ago that the insurance industry told the President that they would back him in any way they could. Now they are running fear adds to turn senior citizens against any change. It seems now that noble ideas are a haven for the foolish. The republicans will have their way and even if something is passed it will only be with the blessing of big insurance. We live in a time when there is an all out assault on the middle class and it will not stop until we are destroyed. This is what the super rich want and we all know that they always get what they want. So don't get all upset...accept what is to come. Becoming a third world country might by bearable after all. I wonder if the Mexicans will have to build a fence to keep Americans out of Mexico? Talk about a wild turn around.

[aheadace]

Republicans are the problem with this country

[sjc_1]

I don't see the wrong wing supporting insurance companies so much as supporting "free enterprise" and rejecting "big government". If Medicare Plus type program can be designed for people under 65 that do not now have insurance, then it might be acceptable. The "slippery slope" to single payer is an objection, so the law should be written to address that issue as well.

[BeckieBest]

44,000 Americans die every year because they don't have health insurance.

Nearly 1 million Americans go bankrupt every year under because of skyrocketing health care costs.

No other nation in the industrialized world allows this to happen to it's citizens.

[BeckieBest]

Americans pay twice what any other country for health care and yet we have fallen below Costa Rica in quality of care.

Republicans and there Big Insurance Company masters are fighting for your right to pay more and get less.

It's time for a public OPTION!

[BeckieBest]

No corporation has ever brough quality affordable health care to any nation on the planet.

It's always taken a government to do that.

If we don't have a public option, prices will continue to skyrocket leaving millions more without affordable coverage.

Every other industrialized nation in the world has a public option.

It's time we did too.

[melchg07]

Want to save money?

Increase your deductibles and co-pays. When I looked at the price difference...unless I had to pay up to the deductible amount every two years, it pays for itself and then some.

IE: I raised my deductible to $1000 and save $500 per year on premiums. I may get hit hard when I get sick, but will be more than able to make that money up.

Truth is that most americans are using health insurance in a way we shouldn't.

Insurance is supposed to be for something CATESTROPHIC.....ie: something you couldn't save up and pay out of pocket for.

Now we have people using it to buy things like Viagra........this type of practice is the MAIN force in the high healthcare costs. People aren't forced to think about the choices they are making. They simply think "my insurance will take care of it"......when you have an entire nation doing that.....it drives up costs because people aren't looking for the best deals and aren't asking themselves "do I really need this".....

If we treated auto insurance this way it would be like having us use auto insurance for repairs.....everyone wouldn't hesitate to get repairs where-ever, no matter the price since "my insurance will get it", thus prices would shoot up...along with your auto insurance premiums.

[helloall34]

You couldn't be more wrong! It is much, much more cost effective to use preventative care then to wait for a catastrophe and it also makes a much better quality of life. No one should have to think about if they can afford to go to the doctor because they don't have the $20 deductible or worse, because the there is $500 left on the deductible. Health care is a basic human need that should be met by any civilized community. There can really be no argument about this. We will always complain about the cost, but the price will be paid one way or another. To put it in your terms, if I don't perform maintenance on my airplane there is going to be a costly accident.

[txlakeside]

The US is the only industrialized country in the entire world without Universal Health Care for all its citizens. Vote any Dem or republiCON out that fights this! Every citizen should have equal health care benefits that are just as good as the do nothing politicians that are fighting against Universal Health Care. If they fight this they will be voted out in 2010!

[Marc_1986]

@txlakeside

So just because everyone else is jumping off the cliff we should follow suit? I'm not saying we don't need healthcare reform, but to say we need UHC 'just because everyone else does it' is moronic.

[bobbyduck1]

by Marc_1986 October 23, 2009 8:50 AM EDT

Everyone else didn't "jump off the cliff", they got smart and cut the profit-driven, unethical insurance types out of the game.

Insurance does not provide any health care, it simply takes profits off the top of the money that we spend. If their profits are low this month, they deny a larger number of perfectly valid claims or cancel a larger number of policies because the policy holders have actually become ill and will now cause the companies to pay out. So they just cancel and see if you can afford to (and live long enough) to sue them.

Their only commitment is to the bottom line.

The system we have, and any other system that doesn't provide government funded, not-for-profit health care, is barbaric and should be illegal. Hopefully we will grow up like the rest of the civilised world did years ago.

[rightbehind]

Get rid of the parasitic republican created HMOs and save another 300 billion. They eat up 1 of every 3 dollars spent on health care and provide no service to the patient at all. Freedom is not having to line a HMO ceo pocket. Freedom = Very Strong Public Option / Single Payer!

[rightbehind]

by TamsinBlight October 23, 2009 8:03 AM EDT
The dems need to give themselves a break. We are not going to live under government health care control. PERIOD! They've beaten that dead horse enough!

You might want to consider moving. Question is will it be a good plan designed to get rid of the worthless republican created HMOs.

[Marc_1986]

@rightbehind

You're completely delusional if you think Single Payer = Freedom.

And if you want it so bad, move to Europe.

[pubsrtoast]

Whats the matter Rowdy, is the reality that you lose yet again starting to sink in?

[pubsrtoast]

Marc, sorry to say, we still live in a Democratic Republic. When enough of us reach a consensus on where we want the country to go, and we can find a representative that can actually fulfill his obligation to the people instead of the higher calling of special interest dollars, then that is the direction the country takes. Asking the majority to move because you don't agree is simply un-American.

[slownewsday_5]

Rowdy is back.

[slownewsday_5]

Finally we'll have some entertainment again ;)

[rightbehind]

Bring a very strong public option bill to vote. I would rather a good bill fail than have a bad bill pass. Pass the bill in the house. I bet it's a good one or a good start at least.

[rightbehind]

Forget that! The yellow dogs have stalled long enough. They need to step aside now and get out of the way. The voters will be removing some of them anyway in 2010. They will be done as they come up for reelection. If they act like republicans we don't want them.

[BlueDogDem]

I think you're referring to us "Blue Dogs", not the yellow dogs.

[LLOYDJ45]

I agree with the concerns of the elderly. They have worked and fought for this country only to suffer inadequate health care and social security benefits. The healthy forget that this country may not be here if not for them. Yet you reward them by turning your back and down playing their importance in our society. This country has too much take from the poor and infirm attitude. How about these people thats voted into office take some cuts ? How about they relinquish the right to take six month vacations at the publics expense ? How about they get a $1.00 pay raise for a couple of years ? How about they, and the rich, pay their fair share in taxes instead of having these exuberant tax breaks ? You want to take it out on someone, take from those that made the decisions that got us into this mess in the first place. and this comment about the dems voting along party lines. who's been more infamous of this than the republicans? Who voted to give larger tax breaks to the rich while raising taxes on the lower classes? The same classes that have to work 2.5 jobs to make ends meet. Other countries have a government health care package. Why is this country always putting more money into the pockets of those that have money ?

[stryker54]

how about they just let us plain ol folks decide if we want to buy health coverage or not.
Make cuts in medicare and raise taxes. come on.

[stuart-johns2]

The government provides health care to the elderly and indigent, but the rest of Americans must rely on private insurance, and most receive coverage through their employers.

--------------------

Just who will be indigent? If someone works for a company that does'nt offer healthcare insurance but also does'nt make enough money to afford private insurance, are they indigent?

I don't believe employers should be required to offer insurance.

I am concerned that States have the right to drop out. Who will decide? The State or the people of the State. I think a referendum of 2/3 of the population should be required to allow a State to drop out.
Let the people decide not the politicians.

I think abortion should be covered if it's determined that the mother's life WILL be endangered by having the baby and a ceasarian section won't remedy the danger. But there is already a law banning the use of federal funds for abortion. Are they saying they are going to repeal that law?

Otherwise, let these woman who use abortion as a means of birth control learn to refrain from unprotected sex. I am for abortion as a emergency medical procedure ONLY.

I am not worried about democrats being at odds with themselves. I have always said they would vote their party line when push came to shove. The political fallout in not doing so is too great and they all know it. Let's not repeat history. The democrats are notorious for being their own worst enemy.

We have a rapidly aging society. I am concerned about the future cuts to Medicare spending. What exactly are they intending on cutting?

Many, many questions here.

[huegorgan]

So if my state opts out, do I have to move to a different state?

[rightbehind]

You have to watch your state politicians. Some will cling to a failed ideology purely out of spite and claim to speak for the entire state when it's actually otherwise. Now's the time to keep throwing the republicans out at all levels of government.