Senate Finance Panel Rejects Amendments for a Public Option

On Tuesday, the Senate Finance Committee voted to reject a pair of amendments that would have added a public insurance plan option to the committee's health reform legislation, Roll Call reports.

The committee voted 10-13 against an amendment by Sen. Charles Schumer (D-N.Y.) (Drucker, Roll Call, 9/29).

A similar amendment by Sen. Jay Rockefeller (D-W.Va.) was voted down, 8-15.

All 10 of the committee's Republican members voted against the two amendments, along with committee Chair Max Baucus (D-Mont.) and Sens. Kent Conrad (D-N.D.) and Blanche Lincoln (D-Ark.).

Sens. Tom Carper (D-Del.) and Bill Nelson (D-Fla.) voted against the Rockefeller amendment but voted in support of the Schumer amendment (Haberkorn, Washington Times, 9/30).

The current version of the bill would establish a network of private not-for-profit health cooperatives, which Conrad proposed as a compromise amid strong opposition from the committee's Republicans and moderate Democrats to a public plan (CQ Politics, 9/29).

Amendment Details

Rockefeller's amendment would have made insurance available to all individuals and businesses through a national exchange and would have required Medicare providers to participate in the public plan for the first two years (Norman, CQ HealthBeat, 9/29).

Schumer's proposal called for the public plan to pay providers above Medicare rates but under those paid by insurers, the Wall Street Journal reports (Hitt/Adamy, Wall Street Journal, 9/30).

Opposition

Opponents of a public option said that it would not adequately reimburse providers, prompting them to pass down the added costs to consumers with private insurance and then force the insurers out of business.

Committee ranking member Chuck Grassley (R-Iowa) said that a public plan would be "a slow walk toward government-controlled, single-payer health care" (Washington Times, 9/30).

Conrad, chair of the Senate Budget Committee, said, "Every hospital in my state goes broke" under Rockefeller's amendment, adding, "I can't possibly support an amendment that does that" (Murray/Montgomery, Washington Post, 9/30).

After the vote, Baucus said that he voted against the amendments because he did not think the bill would pass if it included a public plan. He said, "My job is to put together a bill that will become law," adding, "I can count, and no one shows me how to get to 60 votes with a public option" (Hook, Los Angeles Times, 9/30). He added, "I fear if this provision is in this bill as it goes out of this committee, it will jeopardize real meaningful health reform" (Budoff Brown, Politico, 9/29).

Prospects for a Public Plan

Despite the votes, Schumer expressed optimism that a public option in a final reform bill is still possible. He said, "This vote will be a good test so the American people know there is significant support in this committee," adding, "This is not the first word on the public insurance option and it won't be the last" (Los Angeles Times, 9/30).

Democrats who favor including a public plan in reform legislation might have several options at their disposal to include the option, according to Politico.

One such option might be to involve President Obama in the proceedings as "the final arbiter" on whether a public plan should be included in the bill that advances to the Senate floor.

However, calling on the president is not the only option for including a public plan within reform legislation, Politico reports. Senate Majority Leader Harry Reid (D-Nev.) -- who will be in charge of merging the Finance Committee's bill with the Senate Health, Education, Labor and Pensions Committee's bill (S 1679) -- could decide whether to insert a public plan in the bill (Politico, 9/29).

On Tuesday, aides to Reid said that he has not yet made that decision (Washington Post, 9/30).

Furthermore, some observers have noted that the final bill that comes out of a House-Senate conference could include a public plan, Politico reports (Politico, 9/29).

Proponents of a public plan can propose amendments to insert it on the Senate floor or in the House, where House Speaker Nancy Pelosi (D-Calif.) remains a strong advocate, the Washington Post reports (Washington Post, 9/30).

Democrats also could consider asking the 60 Senate Democrats to vote to override a Republican filibuster, before allowing them to vote as they wish on final adoption of a public plan, which requires a simple 51-vote majority to pass (Politico, 9/29).

Harkin Says Public Option Can Pass Senate

On Tuesday, Senate HELP Committee Chair Tom Harkin (D-Iowa) said that there are enough votes in the Senate to pass a reform bill that includes a public plan, The Hill's "Blog Briefing Room" reports.

In an interview on "The Bill Press Show," Harkin said, "I have polled senators, and the vast majority of Democrats -- maybe approaching 50 -- support a public option" (O'Brien, "Blog Briefing Room," The Hill, 9/29).

Compromises to a Public Plan Also Are Available

Democrats also could choose to adopt one of the several compromise plans that have been offered and are being debated among senators, the AP/San Francisco Chronicle reports.

One of the more notable compromises is the "trigger option" by Sen. Olympia Snowe (R-Maine), whom many Democrats see as the only likely Republican vote for a reform bill.

Snowe's proposal would make the public option active only in states where private insurers are not providing affordable coverage alternatives to consumers.

According to the AP/Chronicle, Snowe on Tuesday said that she is discussing her compromise proposal with Finance Committee Democrats. However, she has not made a decision on how to move forward, according to the AP/Chronicle (Werner, AP/San Francisco Chronicle, 9/30).

In addition, Carper last week began circulating a one-page document among the Senate Democratic leadership that details another alternative to a public plan and co-ops, Politico's "Live Pulse" reports.

The compromise is a variation of Snowe's proposal of the trigger, under which state officials would have the option of creating a competitor to private insurers. States could opt for the public plan, the network of co-ops or a large purchasing pool similar to the Federal Employees Health Benefits Plan.