Senate Majority Leader Harry Reid announced today the health care reform bill the Senate will vote on in the next couple weeks will include a government managed option that allows individual states the option to opt out. The bill will also include a provision allowing the formation of nonprofit cooperatives that can negotiate directly with the private insurers for reduced rates.
"The public option is not a silver bullet, [but] I believe it's an important way to ensure competition and to level the playing field for patients with the insurance industry," Reid said. "Under this concept, states will be able to decide what works for them."
Congressional insiders say there are still not sufficient votes to shut down a Republican filibuster or actually pass the bill. Ezra Klein speculates Reid may be strategizing calling for the vote might push some of the fence sitters onto the public option side of the debate:
First, as (an) unnamed lobbyist points out, he can lose this vote but credibly claim that he went to bat for a pretty good compromise on the public option. Second, it creates consequences for those who want to vote against the public option. Rather than killing the proposal in a back room, moderates who won't vote for cloture will actually have to vote against cloture. That makes them a target in their next election, and ensures a lot of harassment from the left. Reid is, in other words, making it harder -- not impossible, but harder -- for them to oppose the public option. Procedurally, it's a big win for public option advocates.
And, as Klein also points out, the Senate bill has become a radically diluted version of a progressive health care reform measure:
For the real liberals, the public option was already a compromise from single-payer. For the slightly less radical folks, the public option that's barred from partnering with Medicare to maximize the government's buying power was a compromise down from a Medicare-like insurance plan. For the folks even less radical than that, the public option that states can reject is a compromise from the public option that would be available to Mississippi's residents and Vermont's residents alike. A liberal person in a conservative state will not be allowed to choose the insurance option they prefer, nor will an apolitical person who simply doesn't trust private insurers. Access to the public option will be a political question settled at the state level. It is not a settled matter of national policy.
It's something of a mystery how Democrats can control both houses of Congress and the Executive branch and fail to pass a robust health care reform bill. It became clear early on the bill would get no significant support from Congressional Republicans and rather than concentrating on developing a killer bill, Senate Democrats compromised the heck out of it, still knowing they wouldn't be getting any more than one Republican Senator's vote.
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