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Public Option Debate May Derail Healthcare Reform Bills
As we continue to focus this editorial series on healthcare reform, the hottest topic of debate for the nation and the healthcare industry, the public option seems to be on the way out of any government healthcare reform plan. In last month’s edition of The Communiqué, we noted that the public option did not seem to have much support among anyone but the most liberal Democrats. Since that writing, the Senate finance committee voted against including any public option in a healthcare reform bill. This week House Speaker Nancy Pelosi noted she did not have votes to pass a “robust public option.”
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The Obama Administration may have to now compromise on a public option. In a meeting on October 22, President Obama told Democrats that we would prefer a plan supported by Senator Olympia Snowe (R-Maine) that would allow a public plan to kick in if private insurers do not expand coverage.
Meanwhile, Senate Majority Leader Harry Reid supports a plan that would include a different type of public option; this plan that would create a national public plan but allow states to “opt-out.” Reid thinks he has enough votes in the Senate to pass such a bill.
However, any public option would probably be blocked in the House of Representatives, where Pelosi does not have enough votes to support it. Democratic leaders in the House have privately commented that a public option push by the most liberal House members ignores the power of moderate Democrats.
In the House, a weaker version of the bill may emerge and may include a public option where doctors and hospitals negotiate rates for a public plan with Medicare.
Pelosi and other liberals are not giving up on the public option plan. According to Nadeam Elshami, deputy communications director and senior adviser to Pelosi: "Speculation that a final decision has been made about the public option are not accurate. We continue to work with all the members of the caucus to build consensus."
Meanwhile, House Democrats contend that the votes have not yet been counted, and the public option may still be viable.
Pelosi and House liberals are now trying to finalize the bill that they plan to present to for consideration on the House floor in light of the lack of support for the public option in the house.
Meanwhile, Christine A. Varney, the head of the Justice Department's antitrust division, testified before Congress noting that the Obama administration "generally supports the idea of repealing antitrust exemptions. However, we take no position as to how and when Congress should address this issue."
Without a clear direction from the administration, it is unclear how this statement will affect the healthcare industry. However, repeal of current exemptions may allow for greater competition in the health insurance markets.
In the Senate, negotiations are proceeding with “unusual secrecy,” among Reid, Senator Max Baucus, D-Mont., and Senator Christopher Dodd, D-Conn., and a group of administration officials led by White House Chief of Staff Rahm Emanuel.
The role of such a group is to merge bills cleared earlier by Senate committees, but it seems they are drafting legislation that Reid will introduce into the Senate.
While Congress continues to work on a healthcare reform as mandated by the Obama administration, we are all still wondering what will ultimately come out of all of these healthcare reform proposals.
The Democrats hold a 60% majority in the Senate (including two independents). This is the exact number of votes needed to stop a Republican filibuster. Senator Snowe voted for the health care bill that cleared the Senate Finance Committee and may vote with the Democrats in the future. However, Snowe opposes the public option, as do some moderate Democrats. These dissenting votes would cut the 60% Democratic majority in the Senate and completely slow down the debate and legislative process.
While the Obama administration continues to announce that healthcare reform will happen this year, the reality is any reform to the healthcare system has barely begun. |
