Senate Democrats remain divided over Majority Leader Harry Reid’s plan to establish a national health insurance program run by the government, signaling that Capitol Hill leaders could have a difficult time scraping together enough votes for passage.
Sen. Joe Lieberman of Connecticut, an independent who typically votes with Democrats, became the first to declare that he would join a Republican filibuster to block passage of a bill that enacts a national public option. But he left room for negotiation, saying he doesn’t oppose state-based programs or cooperatives.
Other moderate Democrats in both the House and Senate remain skeptical of plans to establish a government insurance program over concern that it would add to the federal deficit and increase private insurance rates, but didn’t go so far as promise to block it. Many are waiting to see the details in the text of the bill, which hasn’t been released yet.
Mr. Reid’s announcement Monday that he would pursue a public option in his health care reform bill re-energized liberal Democrats, who say the plan is the only way to drive down costs and truly reform the nation’s health care system.
But all 40 Senate Republicans are expected to vote against the bill and any procedural votes required, meaning Democrats would need to keep all 60 of their members within the fold to overcome a filibuster.
Mr. Reid, Nevada Democrat, told reporters he thinks Mr. Lieberman and other Democrats will come around.
“There are a lot of senators, Democrat and Republicans, who don’t like part of what’s in this bill,” Mr. Reid said. “We’re going to see what the final product is. We’re not there yet.”
In the House, conservative “Blue Dog” Democrats have been skeptical of the plan’s cost and another group of 40 pro-life Democrats say they will block the bill from getting to the floor unless they are promised a chance to debate their proposal to ban government funding of abortions.
House leaders are trying to determine whether they have support for a “robust” public option, which is favored by liberals and reimburses doctors based on Medicare rates, plus 5 percent. There is wider support for a public option that negotiates its own rates with health providers, but it saves less money.
House Speaker Nancy Pelosi of California encouraged Democrats to come together to support the bill in a caucus meeting Tuesday and told members she expects the bill to be released this week, with floor debate beginning next week.
In the Senate, Democrats are already crafting alternatives in case their proposal to allow states to “opt out” of the public plan doesn’t do enough to generate moderate support. Sen. Thomas R. Carper of Delaware is floating an “opt-in and opt-out” alternative that would only establish the public plan in states with expensive insurance rates or little competition and later allow other states to join or leave the program.
“There’s some senators, Democrats, who aren’t going to vote for a public option in all 50 states,” he said, calling the opt-in and out-out plan, “more acceptable to some of our centrists.”
Republicans have pledged to vote against the reform plans if they include a public option, arguing that the proposals would drive up costs for people who already have health insurance and lead to a government takeover of the health care system.
“We know that it will include a half a trillion dollars in Medicare cuts,” Senate Minority Leader Mitch McConnell of Kentucky said of the pending legislation. “We know it will include $400 billion in new taxes. And we know that independent - independent groups taking a look at the effect on the insurance market have indicated that insurance for the 85 percent of Americans who have insurance - health insurance is going to go up.”