Senate, House Leaders Stare Down Options for Government-Run Plan
As Senate Majority Leader Harry Reid (D-Nev.) and House Speaker Nancy Pelosi (D-Calif.) each work to merge their chamber's health reform bills, the debate over a government-run insurance plan stands as one of the key points of the debate, the New York Times reports.
Two of the House bills include a robust public option with provider payment rates tied to Medicare, while the third House bill's public option proposal would have the government negotiate provider payment rates.
The Senate Finance Committee's bill does not include a public option but would set aside money to encourage the creation of private insurance cooperatives. The Senate Health, Education, Labor and Pensions Committee's health reform bill (S 1679) calls for a public option with negotiable provider rates (Stolberg, New York Times, 10/15).
Alternative Plans in the Senate
Another option on the table is the "trigger" plan, which as proposed by Sen. Olympia Snowe (R-Maine) would set up a government-run plan in states where at least 5% of residents did not have access to affordable health insurance.
Two senior Obama administration officials said the White House "looked favorably" on the trigger proposal, while Reid also has called Snowe's trigger plan a good idea (New York Times, 10/15).
On Wednesday, however, Reid would not say whether a public option would "likely" be included in the merged bill. "I'm not betting on health care. 'Likely' is in a game of craps," Reid said (AP/Atlanta Journal-Constitution, 10/15).
Sen. Tom Carper (D-Del.) also has proposed allowing states to set up public option plans individually, and Carper and Sen. Charles Schumer (D-N.Y.) reportedly are discussing how to create a federal public option that would give states the choice of participating (New York Times, 10/15).
Pelosi Seeks To Build Consensus
On the House side, Pelosi proposed paying hospitals at rates 5% above Medicare rates, in an attempt to appease legislators split on whether to support a public option that pays providers Medicare rates or negotiated rates, Roll Call reports.
The move is meant to ease pressure on rural hospitals, which some say receive unfairly low reimbursements from Medicare (Newmyer, Roll Call, 10/15).
The move also aims to attract more moderate Democrats to support a robust public option, as Pelosi attempts to push the House bill "to the left in order to improve the House's bargaining position in conference," according to The Hill.
Pelosi reportedly has told centrist Democrats that a more modest public option could result from the House-Senate negotiations on a final bill, The Hill reports (Soraghan, The Hill, 10/14).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.