WASHINGTON (By
Robert Pear and David M. Herszenhorn,
NYT) October 26, 2009
― The Senate majority leader,
Harry Reid, announced Monday he would
include a government-run insurance plan
in the major health care legislation he
plans to take to the Senate floor within
a few weeks, but in a new effort at
compromise he proposed states be allowed
to “opt out” of the public plan.
Mr. Reid’s decision, made after two
weeks of deliberations and under intense
pressure by his party’s liberals,
assures a public insurance option
will be included in bills brought to the
floor in both houses of Congress.
“The best way to move forward is to
include a public option with the opt-out
provision for states,” Mr. Reid, of
Nevada, said at a news conference. “I
believe a public option can achieve the
goal of bringing meaningful reform to
our broken system.
It is not clear Mr. Reid has the 60
votes he would need just to bring the
bill to the Senate floor if it includes
the public insurance plan. Senate aides
said Monday Mr. Reid was several votes
short of that goal.
And with his latest move, he lost the
one Republican who had given the
Democratic efforts a hint of
bipartisanship, Senator Olympia J. Snowe
of Maine, who had supported the Senate
Finance Committee’s version of the bill,
which did not include a public plan.
“I am deeply disappointed with the
majority leader’s decision to include a
public option as the focus of the
legislation,” Ms. Snowe said in a
statement, and she said Mr. Reid had
missed a chance to keep her on board.
“I still believe a fallback safety net
plan, to be triggered and available
immediately in states where insurance
companies fail to offer plans that meet
the standards of affordability, could
have been the road toward achieving a
broader bipartisan consensus in the
Senate,” Ms. Snowe said.
But Mr. Reid instantly achieved one of
his goals, as his decision was acclaimed
by liberal organizations like MoveOn,
Families USA and Health Care for America
Now, a coalition that includes labor
unions and civil rights groups.
Such praise was expected to lift his
political prospects back home in Nevada
where he is up for re-election next
year.
Pressed on whether Senate Democrats
would unite to advance the bill, Mr.
Reid said he believed they would. “I
believe we clearly will have the support
of my caucus to move to this bill and
start legislating,” he said.
A Democrat on Capitol Hill who supports
the public option said “there is a lot
of concern” Mr. Reid had made his
decision without having nailed down the
votes to get the bill approved on the
Senate floor.
The White House press secretary, Robert
Gibbs, said President Obama was pleased
with Mr. Reid’s decision. “He supports
the public option because it has the
potential to play an essential role in
holding insurance companies accountable
through choice and competition,” Mr.
Gibbs said of the president.
Republicans and insurance companies
assailed the decision. “No matter what
you call it or how you dress it up, the
Democrats’ proposal is government-run
insurance,” said Senator Jon Kyl of
Arizona, the No. 2 Republican.
Liberal senators have urged Mr. Reid to
include the public insurance plan in the
bill that he has been putting together,
working with versions approved by two
Senate committees.
Mr. Reid’s aides provided few details
about how the opt-out provision would
work. They said the public plan would be
national in scope and that it would be
available on the first day the major
provisions of the health care
legislation go into effect, which is now
expected to be July. 1, 2013.
The government plan would be required to
negotiate payment rates with doctors,
hospitals and other providers. Some
liberal Democrats have pressed for a
public plan using rates tied to
Medicare, which could generate more
costs savings for the government and for
consumers.
Mr. Reid said he was submitting a number
of proposals related to the health care
legislation to the Congressional Budget
Office for cost analysis. Senators in
both parties have demanded to see a full
cost estimate before being asked to vote
on bringing the bill to the floor.
For the moment, Senate Democratic
leaders are taking an aggressive
approach, defying Republicans and
ignoring the concerns of moderate
Democrats who are apprehensive about a
public plan.
But Mr. Reid’s decision will not be the
last word. The Senate will probably
spend weeks on the health care bill and
could vote on dozens of amendments,
including several to alter or eliminate
his version of a public plan.
In the House, Speaker Nancy Pelosi faces
a slightly different challenge. She says
she is certain the House will pass a
health care bill with a public plan. The
only question, she says, is what form it
will take. On that question, House
Democrats are split.
The Senate and House bills would require
most Americans to carry health
insurance. Supporters of a public plan
say it would hold down costs by forcing
competition with private insurers,
which, under the legislation, could get
20 million to 30 million new customers.
Opponents say the public plan would have
unfair advantages and could eventually
drive private insurers from the market.
Without a public option, said Senator
Richard J. Durbin of Illinois, the
Democratic whip, “health insurance
companies have virtually no restrictions
on what they can charge us.”
Christina D. Romer, chairwoman of the
president’s Council of Economic
Advisers, weighed in to the debate
Monday, supporting creation of a public
plan.
“A public health insurance option would
be a credible entrant in concentrated
markets, and would serve as a
competitive, alternative choice,
constraining the ability of insurers to
raise premiums, and thus containing the
growth rate of costs,” Ms. Romer said.
