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Senate healthcare bill to include public option, Reid says

Noam N. Levey

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1:34 PM PDT, October 26, 2009

Reporting from Washington

Fueling the push for a new government insurance plan, Senate Majority Leader Harry Reid (D-Nev.) said today that his chamber's healthcare bill would include a compromise that would create a nationwide public option but give states the right to opt out.

"The public option is not a silver bullet, [but] I believe it's an important way to ensure competition and to level the playing field for patients with the insurance industry," Reid said. "Under this concept, states will be able to decide what works for them."

Reid sent the proposal to the nonpartisan Congressional Budget Office to be analyzed today, a key step before he can bring a bill to the floor for debate.

His decision does not settle the debate roiling Democratic ranks over how to create a government plan that would give consumers who don't get coverage through their employers an alternative to plans offered by commercial insurers.

The "opt-out" compromise is still two votes shy of the 60 Reid needs to overcome a Republican filibuster, according to a senior Democratic aide on Capitol Hill who requested anonymity when discussing the plan.

And while Reid expresses a preference for the opt-out proposal, others continue to push for an alternative, known as a "trigger," that would establish local public options around the country only if commercial insurers did not provide affordable plans to consumers.

That scenario is being championed by Sen. Olympia J. Snowe of Maine, the only Republican to vote for the healthcare reform measure approved by the Senate Finance Committee.

With a 60-40 voting majority, which includes two independents who caucus with Democrats, Reid has to hold all his members or pick up Republicans to head off a filibuster.

Reid and House Speaker Nancy Pelosi (D- San Francisco) are advancing separate healthcare bills in the Senate and House, which would have to be reconciled later this year before they are sent to the White House for President Obama's signature.

But Pelosi indicated Friday that the opt-out alternative could be included in a reconciled bill.

For now, House Democrats are poised to pass a bill that would create a nationwide government plan, although there is still disagreement about how much such a plan should pay doctors, hospitals and other medical providers.

Liberals, including Pelosi, favor a proposal that would link those payments to the existing Medicare program, which often pays providers less than commercial insurers. Proponents believe such an arrangement would save money and help drive down costs.

But many conservative Democrats, particularly from rural areas where Medicare typically pays less, want the government plan to negotiate its rates with providers, as commercial insurers do.

Pelosi hopes to settle those differences in time to unveil a bill later this week, according to her office.

noam.levey@latimes.com

www.latimes.com/news/nationworld/nation/la-naw-healthcare-reid27-2009oct27,0,7399934,print.story