House Speaker Nancy Pelosi sent the strongest signal yet Friday that she is willing to accept a more moderate version of the “public” health insurance option amid signs that Senate Democratic leaders are leaning toward including the provision in their bill.
“The atmosphere has changed,” Mrs. Pelosi told reporters. “When we were dealing with the idea that the Senate would have [no public option], it was really important to go in with the muscle for the middle class with the robust public option.”
Mrs. Pelosi has vowed to include a government-backed public insurance plan in the House version of the bill, but has to gauge support among House Democrats for various strong and scaled-backed versions of the concept.
But now that Senate Majority Leader Harry Reid has told other lawmakers he is considering a reform bill with a government-run insurance plan and the chance for states to opt out, House leaders feel like their negotiating hand has improved.
Democratic leaders in both the House and Senate are trying to draft health care reform bills that can pass their respective chambers, but they’re also focused on the next step - merging the House and Senate bills - in a final compromise measure.
For weeks, conventional thinking was that the Senate may not have a public option in its bill. Now that the tide is shifting, it appears House leaders are becoming less demanding that their bill include what’s considered the most liberal public option structure.
Mrs. Pelosi and her allies are considering a few different versions. A plan that reimburses doctors based on Medicare rates plus 5 percent is backed by House liberal members, but could also be the hardest to pass. Mrs. Pelosi and liberal Democrats have argued that this version, called the “robust public option,” is best because it would be the cheapest to implement.
Another public option proposal under consideration would allow the Department of Health and Human Services to negotiate rates with providers. That version likely has wider support in the House.
A third option with support in the Senate would create a “trigger” for a public option, setting up the government plan only if private insurers failed to control costs and increase coverage in the coming years.
Democrats calculate they must supply all the votes for passage, however, as House Republican leaders Friday again vowed to vote down any government insurance plan.
“None of the legislative proposals Mrs. Pelosi is discussing can be called reform,” House Minority Leader John A. Boehner of Ohio said.
“Whether you call it a public option, trigger or a co-op, the fact is all of these proposals put us on the path to government-run health care. Forcing Americans off of their current health coverage and onto a government-run plan isn’t the answer, but that’s exactly what the Democrats’ plan would do.”
Mrs. Pelosi said earlier this week that she has the votes to pass some form of a public option, but she hasn’t said which version. The final House bill - being assembled from drafts approved by three House committees - may come down to which plan House leaders think will give them the strongest hand during the conference with the Senate.
“I have to again discuss with my colleagues what’s the best approach to [the] conference,” Mrs. Pelosi told reporters, adding, “This is about the endgame now.”
Liberal Democrats who support the “robust” plan say they have not given up.
“We’re pulling together. We don’t have a bill yet,” said Rep. Lynn Woolsey, California Democrat and co-chairman of the Congressional Progressive Caucus. When they do, “I would want it to have a robust plan and then we can go to the undecideds and say, ’Are you for health care reform or not?’ ”
In the Senate, Mr. Reid continued meeting with individual senators about the health bill he is putting together from two Senate committee drafts. Centrist Democrats in the Senate have been skeptical of the plan to include a government-run insurance plan in his bill.
But Sen. Mary L. Landrieu of Louisiana, a moderate Democrat, said Friday she is hopeful that a compromise can be reached.
“I conveyed to [Mr. Reid] that a number of moderates still were extremely concerned about a government-run, taxpayer-funded, national public plan,” Ms. Landrieu said after another meeting to discuss the plan Friday. “However, I am encouraged that the conversations taking place over the past week among senators who back different versions of a public option could potentially lead to a compromise.”
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