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Public option drives health care reform debate

WASHINGTON — Democrats had little time to savor their weekend Senate health care victory, as two of the lawmakers who voted to move the debate forward Saturday night indicated Sunday they will not vote to pass the package if it includes a government-run insurance program.

Despite the success in the test vote, the fragile consensus in the Democratic caucus will face its greatest test yet as the debate moves to the Senate floor and Majority Leader Harry Reid, D-Nev., struggles to stave off internal schisms. The cracks in the 60-member caucus are most obvious over the public insurance option.

One member of the Democratic caucus, Sen. Joe Lieberman, an independent from Connecticut, reiterated he would oppose any bill that contained a public option. Appearing on NBC's Meet the Press, Lieberman called such a government-run plan "radical."

"We have a health care system that has real troubles, but we have an economic system that is in real crisis," he said. "And I don't want to fix the problems in our health care system in a way that creates more of an economic crisis."

Sen. Ben Nelson, D-Neb., another centrist who supported the move to continue debate but has made it clear he has many objections to the legislation as currently written, restated his opposition to a public plan. "I don't want a big-government, Washington-run operation that would undermine the private insurance that 200 million Americans now have," Nelson said on ABC's This Week.

Moderates Mary Landrieu, D-La., and Blanche Lincoln, D-Ark., also have misgivings about the Senate language — a public option with a state opt-out clause — and have expressed varying degrees of unhappiness about other approaches being considered.

Some liberals in the chamber were just as insistent that they would press to keep the bill largely intact. "I don't want four Democratic senators dictating to the other 56 of us and to the rest of the country — when the public option has this much support — that (a public option is) not going to be in it," Sen. Sherrod Brown, D-Ohio, said on CNN's State of the Union.

Reid announced after the vote that the Senate would begin deliberations on the $848 billion bill Nov. 30 and would consider amendments through most of December. What Democrats lack in consensus, they make up for in determination to pass a bill. Not for years has the Senate seen legislation as big as the health care measure — weighing in at more than 2,000 pages — move forward at such a steady, if plodding, pace.

"We know not all 60 senators in my caucus agree on every aspect of this bill," Reid told reporters after the vote. "But all Democrats do believe now is the time to make sure all Americans can access affordable health insurance."

And the deadline pressure is mounting. With less than a year until the 2010 midterm elections — and with Reid himself facing a potentially tough race at home in Nevada — senators are eager to vote on health care before Christmas and complete negotiations with the House no later than the end of January, so they can turn attention to legislation aimed at creating jobs.

"We have to finish it in the Senate or it's going to be maybe a long lunch break over Christmas," Assistant Majority Leader Richard Durbin, D-Ill., said on Meet the Press, suggesting that lawmakers may be forced to cut into their holiday recess to work on the health bill. "We've got to really focus, refocus our attention — all of our attention on getting people back to work."

Durbin argued for the public option but indicated a willingness to compromise to pass the bill.

For every member of the Democratic caucus Reid loses, he must gain the support of a Republican, and at the moment the number of potential converts adds up to no more than two. Sens. Olympia Snowe, R-Maine, and Susan Collins, R-Maine, are probably the only GOP senators Reid has any hope of attracting to the 60-vote bloc necessary to head off a filibuster.

Polls show that a public option — essentially a government-sponsored insurance plan that would be offered alongside private policies on exchanges created for people who do not have access to affordable employer coverage — remains popular with voters, although less so in more conservative states. But according to the Congressional Budget Office, a government plan as outlined in both the Senate and House bills would cost more than private coverage and, as a result, attract few customers.

The question is whether Reid and the many Democratic senators who are working to resolve the issue can identify an acceptable compromise. If not, some of Reid's Democratic colleagues think the only way liberals will relent is if Reid calls a vote on a Senate bill with a public option and the legislation fails.

Public option drives health care reform debate 11/22/09 [Last modified: Sunday, November 22, 2009 11:19pm]

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