Pelosi Uses New Cost Projections To Argue for ‘Robust’ Public Plan

House Speaker Nancy Pelosi (D-Calif.) plans to include a "robust" public option in the chamber's final health care reform bill after a Congressional Budget Office score released Tuesday shows that the robust option would cost about $871 billion over the next 10 years, meeting President Obama's target of $900 billion for overhaul legislation, the AP/MSNBC reports.

The robust plan also would provide insurance coverage to 96% of uninsured U.S. residents who qualify (AP/MSNBC, 10/20).

A preliminary CBO score given to House leaders last week had pegged the cost of the robust option at $905 billion (California Healthline, 10/19).

Pelosi told her caucus that she anticipates receiving more exact cost estimates for the House's legislation from CBO later this week (Wayne, CQ Today, 10/20).

Other Options on the Table

Pelosi has been reviewing three different versions of a public option that could appear in the House's final bill (O'Connor, Politico, 10/20).

The robust plan, favored by liberals, would reimburse physicians at Medicare rates plus 5% (Soraghan, The Hill, 10/20).

Moderates prefer two alternative plans: Both options would require the federal government to negotiate rates directly with providers, but one stipulates that a Medicare-plus-5% plan would take effect if negotiated rates failed to generate enough savings (Politico, 10/20).

Some moderate Democrats, particularly those from rural states, say that Medicare rates already fail to adequately reimburse physicians and that using Medicare rates for a public option could further exacerbate regional disparities in spending. Others fear that a public option would drive private insurers from the marketplace (The Hill, 10/20).

Pelosi still is waiting on final CBO projections for the cost of the negotiated rate plans (Politico, 10/20).

Aides Assert Lower Costs for More Robust Option

The new CBO score of the robust plan shows that it would cost less than the two alternatives, senior Democratic aides said (CQ Today, 10/20).

Another Democratic aide noted that the new score's low cost projections for the robust option could assuage concerns of some members of the fiscally conservative Blue Dog Coalition, which opposes the robust option.

Pelosi said, "The preliminary estimates that were received from the CBO enable us to make our choices knowing that whatever choice we make will reduce the deficit ... not only under 10 years, the life of the bill, but over 20 years" (Hunt, CongressDaily, 10/21).

Pelosi Asks Whip To Gauge Support for Robust Plan

House Majority Whip James Clyburn (D-S.C.) will begin surveying Democrats in the chamber to determine whether the robust plan can achieve the 218 votes needed for passage (CQ Today, 10/20).

During a meeting with Democrats Tuesday night, Pelosi told her colleagues that she has 200 votes for the robust public option and that she will "see if we can find the remaining votes."

Although Pelosi left open the possibility of using one of the alternative proposals if she lacks 218 votes for the robust plan, she said, "There's no question that the robust public option always scores better" (Politico, 10/20).

House Democrats might schedule another caucus meeting today to discuss the CBO scores. Democratic leaders plan to unveil the final version of their bill and hope to vote on it by the first week in November (The Hill, 10/20).

Pelosi Looks Ahead to Negotiations With Senate

During Tuesday's meeting with Democrats, Pelosi said that including a robust option would give her a stronger bargaining position when merging the House bill with the Senate's legislation, according to a Democratic aide.

The Senate Finance Committee bill (S 1796) lacks a public option (Politico, 10/20).