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Public Option Gains Momentum

The House of Representatives may unveil a unified health care bill as early as next week, and new cost estimates give moderates in the House a stronger argument for the type of government-run health insurance plan, or "public option," that they favor.

Democrats in the House are considering a number of different ways to fashion a public option for their health care bill. Last week they submitted a few ideas to the nonpartisan Congressional Budget Office (CBO) to find out how much they would cost.

The CBO is reporting that the public option favored by moderates would cost less than the option favored by liberals, the Washington Post reports.

The liberal public plan would give doctors and medical providers the same payment rates they receive from Medicare, plus an additional five percent; this plan had initially been expected to be the most cost-effective, since Medicare rates are cheaper than the rates private insurers pay. But it didn't turn out that way: A health care bill with this plan would reportedly cost $905 billion, according to the CBO.

Moderates prefer a government-run plan to negotiate payment rates directly with medical providers, so the government would be on a "level playing field" with the private industry. This structure, they argued, would make sure doctors are not short-changed.

It was expected that this plan would cost the government more, however, so the House submitted this proposal along with a plan to expand Medicaid eligibility to 150 percent of the poverty line, a strategy believed to be cheaper than giving more low-income people tax credits to buy their own insurance. The strategy worked: the CBO came back with a price tag of $859 billion for the bill with the moderate public option and expanded Medicaid.

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On Thursday, House Speaker Nancy Pelosi (D-Calif.) once again emphatically stressed the need for a public option, Politico reports, saying, "If you are going to mandate that people must buy insurance, why would you throw them into the lion's den of the insurance industry without some leverage with a public option?"

Pelosi reportedly said she wants to unveil the finished House health care bill as early as next week.

Even one of the most high-profile Democratic opponents to the public option in the House was reportedly suggesting new public option plans this week.

Rep. Mike Ross (D-Ark.) suggested to colleagues the idea of opening up Medicare to those under 65 who are uninsured, according to the Hill newspaper.

Opening up Medicare -- a government plan people are familiar with and like -- could be simpler than starting a new public plan. However, that idea has already been largely written off as too liberal since it is perceived as a precursor to a single-payer health care system.

Ross reportedly said he merely suggested the idea, though he does not endorse it. Ross voted in favor of a public option compromise in a House committee, but he later came out in opposition to it.

Public option supporters are also speaking up in the Senate, according to reports.

"At a luncheon behind closed doors, Democrats said, liberals made impassioned pleas for a new government insurance plan, and they challenged the chairman of the Senate Finance Committee, Max Baucus, Democrat of Montana, to defend his bill, which has no such public option," the New York Times reported. "Among the outspoken champions of the public plan were Senators Sherrod Brown, Democrat of Ohio; Tom Harkin, Democrat of Iowa; and Bernard Sanders of Vermont, an independent who caucuses with the Democrats."

Meanwhile, the liberal reform group Health Care for America Now launches a new television ad today, shown above, that argues a public option is necessary because of the current lack of competition in the health insurance market.