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Chairmen Insist on Public Plan for Health Care Bill

Blue Dogs Remain Opposed

House Democratic chairmen plan to disregard conservative Blue Dogs who are opposing a government-sponsored health insurance plan as part of a sweeping reform bill, in what is shaping up to be the biggest internal battle of President Barack Obama’s young agenda.

Just days after Blue Dogs insisted that no public option be included in the package — except as a possible fallback that could be “triggered— years from now — the powerful chairmen unveiled a draft bill that strongly backs a public option without such a trigger.

“There won’t be any consideration of the trigger,— Ways and Means Chairman Charlie Rangel (D-N.Y.) said. “We’re going to have a public plan and we’re not going to wait two, three, five years to see what happens and then trigger it. We’re going to have a plan.—

The liberal chairmen in charge of writing the bill — Rangel, Energy and Commerce Chairman Henry Waxman (D-Calif.) and Education and Labor Chairman George Miller (D-Calif.) — released a four-page outline of their bill Tuesday that includes a public health insurance plan.

Waxman said a trigger did not have broad support in the Democratic Caucus, although he noted that the chairmen’s draft incorporated other Blue Dog principles, including that any public option compete on a level playing field with private plans.

“The consumer should be able to make a choice, and that’s what we’re going to be pushing for,— Waxman said. “I don’t see why it should be objectionable to anybody for the consumer to have a choice.—

Waxman said each side is going to have to compromise.

“No one group could say they have to have it all their way,— Waxman said. “That was the problem in past efforts.—

Rep. Mike Ross (Ark.), chairman of the Blue Dog health care task force, warned leaders last week that they would lose his group’s votes if they push too hard on the public plan.

But Blue Dogs are facing mounting pressure to back down.

Obama came out strongly for a public option last week, arguing that a public competitor would provide a check on the private insurance market. His staff met with top Blue Dogs on Tuesday to discuss the matter.

And leaders in the Congressional Progressive Caucus warned again Tuesday that most of their members would vote against a bill if it did not include a robust public option, noting that most of them prefer the more liberal, single-payer government health system.

Advocates of the trigger idea argue that the threat of a future government-sponsored plan would be enough of an incentive for private insurance companies to act; some also expressed fear that the insurance industry would use its financial muscle to try to scuttle health care reform. Blue Dogs also worried that doctors and other providers could turn against the bill.

But some Blue Dogs said they were prepared to show some flexibility on the trigger if leaders don’t go too far in defining a public option.

“It all depends on the definition of a public plan,— said Rep. Jim Cooper (Tenn.), vice chairman of the Blue Dog health care task force.

Cooper said a co-op style health insurance plan floated by Senate Budget Chairman Kent Conrad (D-N.D.) would probably be acceptable to most in the fiscally conservative bloc and said he personally supports a public option as designed by Sen. Charles Schumer (D-N.Y.).

But a plan that looks like Medicare and forces doctors to accept low reimbursement rates “would spark a revolt of doctors across the country,— Cooper warned.

One Blue Dog aide also said the group is trying to avoid a situation where a public plan ultimately takes over the marketplace.

“The Blue Dogs want to make sure any public option truly creates competition and choice in the marketplace,— this aide said.

But others Blue Dogs rejected the call for a “trigger— outright.

Rep. Jane Harman (Calif.), a Blue Dog who serves on the Energy and Commerce Subcommittee on Health, said in a statement that the bill must include a public option and that she is “unwavering in my opposition to the so-called Blue Dog trigger.’—

With the details of the House health care package starting to take shape, some moderate Democrats — many of whom had complained about a lack of input in the process — said they were encouraged by improving outreach from leaders and chairmen.

Rep. Earl Pomeroy (N.D.), another Blue Dog, said sentiment in the coalition has shifted since 45 of the lawmakers fired off a letter last month to leaders complaining of being shut out of discussions.

“There has been much broader engagement across the Caucus,— he said, pointing to a Blue Dog huddle with White House senior adviser David Axelrod on Tuesday evening.

Rangel also said there were a lot of questions during a closed-door meeting among Democrats about what a public plan looked like but said Members seemed to support the idea after it was explained.

“They need more, more and more of the details so they can be the salesmen for the bill,— Rangel said.

Other Democrats also expressed concern that there be a stronger effort to sell the bill before it comes to the House floor. “We need to do a good job communicating to folks outside the Beltway,— Rep. Mike Doyle (Pa.) said.

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