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Road Map: Reid, Obama Weigh Fate of Public Option

Is the public insurance option alive or dead?

It kind of depends on whom you talk to these days. Some Senators say they can’t vote for any bill without it. Just as many say they can’t vote for anything with it.

[IMGCAP(1)]And somewhere in between, President Barack Obama and Senate Majority Leader Harry Reid (D-Nev.) are trying to figure out a plan to have it both ways.

Even though a public insurance option sailed through on largely party-line votes in four Congressional committees — one Senate and three House panels — the fact that it will likely fall short in the Senate Finance Committee today could be a significant factor in whether liberals realize their dream of having the government control a powerful competitor to private health insurers.

Proponents of creating a public insurance option, such as Sens. Charles Schumer (D-N.Y.) and Jay Rockefeller (D-W.Va.), have said the Finance vote is the first real test for the option, and they insist the vote will help them build momentum for it.

“There’s no doubt that, of all the committees, the public plan faces the steepest climb in the Finance Committee,— Schumer said last week. “This is the starting gate, and we know it will get better and better as we go on.—

But the fate of the public insurance option is not as simple as whether there are enough votes in the Finance Committee today to kill Chairman Max Baucus’ (D-Mont.) plan to create nonprofit health insurance cooperatives.

After all, Reid has said a public insurance option is in the eye of the beholder, and Obama has said he wants one, but that it’s not the “silver bullet.— Obviously, a public insurance option that mimics Medicare is the purest form and the one liberals have been clamoring for. However, some argue that co-ops are a kind of public insurance option, and others say liberal Members could still declare victory by agreeing to set up a “trigger— mechanism by which a public option kicks in only if private insurers can’t lower costs and increase coverage.

So, as one senior Senate Democratic aide explained, “How it goes down is as important as whether it goes down— in the Finance panel.

As they head into their second week of markup on Baucus’ health care plan, what Democrats and one Republican — Sen. Olympia Snowe (Maine) — say about why they’re opposing the public insurance option could make a difference when Reid and Obama pick the winners and losers during the high-stakes merger of the Finance measure and a bill passed by the Health, Education, Labor and Pensions Committee in July. The HELP bill includes the public insurance option.

“Even people who oppose the amendments may still signal a general desire to find a result that still brings competition to the insurance industry,— another senior Democratic aide said. This aide added: “A month ago, it looked like the Senate bill was going to be co-ops. … Now, moderates are clearly trying to find something else that provides sufficient cover.—

Indeed, Baucus may have crafted the co-op model with Democratic centrists and Republicans in mind, but few have warmed to the idea. Instead, Snowe’s proposal to create a trigger seems to be the model that has attracted the most moderates. The trick will be in persuading liberals to go along with it, Senate Democratic aides said.

Reid’s calculation is twofold. First, he is mindful that a pure public insurance option cannot get a filibuster-proof 60 votes on the Senate floor, and he also knows that the House will likely keep the public option alive when the two chambers go to conference committee on any health care bill.

So on the one hand, “There are not the votes in the Senate Finance Committee to include a public option … [and] the Senate Finance Committee bill is the only bill that is going to come close to being bipartisan,— one Senate Democratic leadership aide said. On the other, “We’ll have a chance to revisit all of this once it gets to conference,— the aide added.

Of course, Reid has long insisted that all of this will be sorted out on the Senate floor, with votes on every option — public or otherwise — that people can think of. However, it’s unclear whether the public insurance option, or something else, will get a leg up by being anointed the preferred choice in the bill that hits the floor. And that question remains unanswered as Reid and Obama wait to see how the rest of the Finance markup this week shakes out.

“No decisions have been made,— the leadership aide said.

That’s right, folks. Despite wanting to bring up a merged Finance-HELP bill in as little as two weeks, Reid and Obama are still trying to game out the best strategy.

“I’m not sure we can see the shape of the plan that’s going to be on the table,— the first senior Senate Democratic aide said of the upcoming floor debate. “The field is wide open.—

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