Pelosi Still Weighing Several Public Option Plans

(AP Photo/Harry Hamburg)
House Speaker Nancy Pelosi (D-Calif.) is still supporting a government health insurance plan, or "public option," tied to Medicare rates, but there is more room for flexibility, she told reporters today.

Following a report from Politico that Pelosi had determined that a "robust" public option could not pass in the House, Democratic leadership called a meeting of the entire caucus to count exactly how many supporters the plan had. The results showed that they are inching closer to getting 218 votes for the so-called "robust" plan, Rep. Lynn Woolsey (D-Calif.) said Friday.

Woolsey said many Democrats were not at the meeting and that a big group of Democrats are still undecided about the "robust" plan, which would pay medical providers the same rates as Medicare plus an additional 5 percent. Some Democrats are concerned that a public option tied to Medicare would not pay doctors in rural areas enough, since Medicare rates in those areas are below average. Rep. Charles Rangel (D-N.Y.) said they are in no rush to get to 218.

Pelosi continues to support that version of the public option, she said Friday at a press conference, though developments in the Senate have given the House more flexibility. The House health care bill will include a public option, the speaker said, but it may be a weaker version, such as one that would require the government to negotiate medical provider payment rates, to put it on competitive grounds with private industry.

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Initially, Pelosi was pressing harder for the more liberal public option, when it seemed as if the Senate would not include a public option in its own bill. Pelosi wanted to bring a strong public option to the negotiating table once the Senate and the House met to merge their two bills, in order to give the House more leverage.

Now, however, as it appears the Senate bill could also include a public option, there is more room for consideration of other options, she said.

"When we were dealing with the idea that the Senate had nothing, it was really important to go in with the most muscle for the middle class with a robust public option," Pelosi said. "So, this is about the end game now."

After coming under pressure from both liberal legislators and advocacy groups to include a public option in the Senate bill, reports now indicate Majority Leader Harry Reid (D-Nev.) is considering including in his health care bill a public option that states could opt out of.

Reid and other Senate leaders met with President Obama on Thursday to discuss health care. Some reports said the president expressed a preference for a so-called "trigger option," but the White House told that Mr. Obama did not express a preference in the meeting. A "trigger" plan would only establish a public option if private insurers failed to meet certain standards.

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The opt-out approach, which Reid is reportedly considering, may not have the support of all 60 Democratic senators. Sen. Ben Nelson (D-Neb.) criticized the plan, the Washington Post reports, and is urging Reid to drop the public option all together.

Sen. Olympia Snowe (R-Maine), the one Republican who may support any health care legislation, has made it clear she does not support the opt-out plan.

While much has been made of winning unanimous support for the final bill from Senate Democrats and possibly from Snowe, Senate leaders do not actually need 60 votes to pass the bill. Sixty senators simply need to agree they will not allow Republicans to filibuster the plan; alternatively, leadership is free to use a procedural maneuver called reconciliation, though they have said they would like to avoid that.

CBS News Capitol Hill Producers Evelyn Thomas and Jill Jackson contributed to this report.