Healthcare reform 'public option' still alive in Senate?

Although one key committee bill excludes it, a public option is favored by most Democratic senators - not to mention the House, where support among majority Dems is strong.

Jonathan Ernst/Reuters
U.S. Senator Tom Harkin (D-IA) gestures during an interview in his office on Capitol Hill in Washington September 21, 2009. The veteran liberal lawmaker has succeeded Edward Kennedy as chairman of the Senate health committee.

Is the public option still alive?

Sen. Tom Harkin insists that it is. The Iowa Democrat, chairman of the Senate health committee, told reporters Friday that his chamber’s final version of health reform legislation will include a government-run insurance plan intended to compete with private insurers – the so-called “public option.”

“All the polls show a huge majority of the American people want a public option,” said Senator Harkin in a conference call.

Prior to its recent (possible) revival, the public option’s future had appeared bleak. President Obama declined to insist that a public option per se be part of any health reform bill, saying only that legislation needed to accomplish the purpose of trying to keep private insurers honest.

Plus, the Senate Finance Committee approved a bill without a public option. Republicans, and some Democrats, see a public option as an opening that could lead to greater and greater government control in the healthcare marketplace.

But it’s possible the reports of the public option’s demise were exaggerated. It has strong support among liberals, particularly in the House.

House Speaker Nancy Pelosi said Oct. 15 that a final House version of healthcare reform inevitably will include a public option. The House would not be daunted by opposition to the move in the Senate, she said.

“The need for a public option is very clear,” said Speaker Pelosi at her weekly news conference.

Supporters of a public plan have been galvanized by an industry-funded study that said insurance premiums would rise under the Senate Finance Committee’s version of health legislation. The study was released just prior to the panel’s vote.

"Anyone who had any doubts about the need for [a public option] need only look at the behavior of the health insurance industry this week," said Pelosi.

The key will be the Senate. Right now, Senate Democratic leaders are melding two versions of health legislation passed by chamber committees. One – the Senate health panel’s version – contains a public option. The other – from Senate Finance – doesn’t.

Harkin insists that the politics of the Senate supports a public option. Opposition to the move among Democrats is centered in the relatively conservative Finance panel. The vast majority of Senate Democrats favor a public option, according to Harkin. Five Senate Democrats are opposed, he said Friday.

“Should those five come on board? Or should the majority give in to the minority?” he asked.

Harkin did indicate that he might be amenable to an opt-out clause that would allow states to have nonprofit cooperatives as an alternative to a full public option.

“That co-op idea seems to be persistent, though I’m not seeing any data on how it could work,” said Harkin.


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