Senate Dems Seek Viable Public Option
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.