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A New Alternative to the Public Option Emerges

The Senate could be on the verge of abandoning the "public option," as originally envisioned, but are senators any closer to a compromise?

As reported in's Health Care Progress Report this morning, a group of liberal and moderate senators discussed over the weekend a new plan that could potentially replace Senate Majority Leader Harry Reid's proposal to establish a government-run health insurance option for a limited number of people.

This group of 10 Democrats is considering a plan to establish national health insurance options, which would be administered by the Office of Personnel Management (OPM) but operated by private, nonprofit insurers. In essence, this plan would expand the options now given to federal employees to the rest of the country, since the OPM already runs the Federal Employees Health Benefit Program (FEHBP).

The new proposal is billed as a "public option" compromise, but it would, in fact, take the "public" out of the public option. That could appeal to the most conservative Democrats, like Sen. Ben Nelson (D-Neb.).

"Seems to me it would be in lieu of the public option," Nelson said of the plan, according to Politico. He reportedly said Majority Leader Harry Reid's version of the public option, which would allow states to opt out of the national, government plan, "is no longer being talked about."

Nelson reportedly took part in the weekend discussions about the new plan, along with moderate Democrats Mary Landrieu (La.), Blanche Lincoln (Ark.), Tom Carper (Del.) and Mark Pryor (Ark.). The liberal senators in attendance were Russ Feingold (Wisc.), Tom Harkin (Iowa), Sherrod Brown (Ohio) and John Rockefeller (W.V.).

The Democrats' entire health care overhaul could be put in peril if the Senate bill is not altered to the liking of moderate holdouts like Nelson. Progressives are hardly ready to give up the fight, however, for the public option, which they call essential for providing marketplace competition and driving down insurance costs.

"We have compromised four times on the public option," said Brown, according to the New York Times. He explained how liberals went from supporting "single payer" health care -- or "Medicare for all" -- to finally agreeing to a public option that negotiates its own payment rates and allows states to opt out. Special Report: Health Care

"We have moved three or four or five times on this and those days are over," Brown reportedly said. "Why should four people decide that they don't like the public option the way it is, when 50 plus of us like the public option the way it is?"

For Democratic leaders who cannot afford to let the health care overhaul fail, the new alternative could prove to be tempting because it could even possibly win over one or two Republicans. Republican Sen. Olympia Snowe (Maine) called the new idea "a very novel and innovative idea," according to the Washington Post.

At least two senators, however -- Bernie Sanders (I-Vt.) and Roland Burris (D-Ill.) -- have said they will only vote for a bill that includes a truly "public" option. Meanwhile, the experts behind the original public option idea are vehemently opposed to the new compromise.

The 'middle-ground' ideas that are currently flying around aren't in the middle at all," Yale political science professor Jacob Hacker wrote Sunday in the New Republic. "They represent abandonment of the public plan idea altogether."

And while the new plan was proposed as a way to smooth over one of the most contentious reform issues among senators (it is not so contentious among the general public, where the public option sees strong support), it could possibly complicate things more, health policy consultant Linda Bergthold writes at Huffington Post.

"It would be difficult to include abortion coverage [in the new insurance options], because the current FEHBP plans offer very limited abortion coverage to federal employees," Bergthold writes. "This could truly complicate the debate by conflating the two most contentious issues -- abortion and public option -- into one big mess of a concept."

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