Group of Senate Democrats Eye Public Health Plan Alternative

Ten Senate Democrats -- five liberals and five moderates -- have started working on an alternative to a public health insurance plan for the chamber's health reform bill (HR 3590), indicating that Democrats are feeling "pressure" to resolve their differences by the self-imposed Christmas deadline, the New York Times reports (Pear/Herszenhorn, New York Times, 12/7).

Moderate Sen. Tom Carper (D-Del.) on Friday called the public option "the principal impediment right now to finding a way to muster the votes to pass a bill," adding, "I just feel we can't let health care reform go down because of our differences on this one issue" (Wayne, CQ Today, 12/6).

The leading proposal the group is considering calls for the federal Office of Personnel Management to negotiate the terms of a public plan with private insurers and contract with not-for-profit groups to run the program (Hitt/Adamy, Wall Street Journal, 12/7). OPM currently arranges health care benefits for federal employees, including members of Congress (New York Times, 12/7).

The plan would replace Senate Majority Leader Harry Reid's (D-Nev.) proposal that would allow states to opt out of a public plan. According to Sen. Ben Nelson (D-Neb.), Reid's plan "is no longer being talked about" (Budoff Brown, Politico, 12/6).

The five liberal Democrats in the negotiating group are:

• Sen. Sherrod Brown (Ohio);
• Sen. Russ Feingold (Wis.);
• Sen. Tom Harkin (Iowa);
• Sen. Jay Rockefeller (W.Va.); and
• Sen. Charles Schumer (N.Y.).

The moderate Democrats involved in the negotiations are:

• Carper;
• Nelson;
• Sen. Mary Landrieu (La.);
• Sen. Blanche Lincoln (Ark.); and
• Sen. Mark Pryor (Ark.) (Budoff Brown, Politico, 12/5).

Sen. Joseph Lieberman (I-Conn.), a vocal opponent of a public plan, is not participating in the meetings, but members of Lieberman's staff are attending, according to Politico.

Schumer, who is acting as the intermediary between the moderates and the liberals, said that the senators "are making a real effort to come together," adding that "people have strong views and we'll have to see where people end up" (Politico, 12/6).

According to the Wall Street Journal, supporters of the new proposal say that it could appeal to liberals, who can claim that they created a nationally available health plan that improves competition and choice, while also appealing to moderates, who can stress that it would be run by the private sector (Wall Street Journal, 12/7).

Lincoln, an opponent of a public plan who faces a tough re-election in 2010, said that the new proposal "bodes well for being able to do what we want to do, which is to create greater choice and options in the marketplace but also have a downward pressure on premiums [and] cost" (Politico, 12/5).

The Times reports that by "trying to minimize the role of government in any public plan" to attract moderates, Democratic leaders "risk alienating liberal Democrats," like Brown (New York Times, 12/7).

Of the new proposal, Brown said, "I don't think much of it, frankly, compared to a public option," adding, "I'm willing to talk to anybody about anything but they haven't sold it yet" (Politico, 12/5).

Some Elusive Votes

The public option is one of the many issues that Democrats have to resolve as they try to reach the 60 votes necessary for final passage, but it is proving to be the critical issue for Lieberman, who has said that he cannot see himself voting for a bill with a public plan.

Carper said that Lieberman is "not alone in that concern," adding that "our challenge is to make sure at the end of the day that we address that concern in a way that's acceptable to him and, frankly, to a number of others in our caucus" (CQ Today, 12/6).

Meanwhile, Democratic leaders continue to court Sen. Olympia Snowe (R-Maine), who opposes many versions of a public option but supports a trigger option, in which a public plan would be instituted only if private-sector reforms failed to lower costs and expand coverage.

On Saturday, Snowe met privately with President Obama. She called the new proposal "a positive development" (Wall Street Journal, 12/7). She added that there are "too many major loose ends here that need to be addressed, and I went through that -- extensively -- with the president" (CQ Today, 12/6).