KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Democrats Ready To Battle Amongst Themselves Over Public Plan

Democrats are set to spar - among themselves - on inclusion of a government-run public option for health insurance coverage during Finance Committee action today.

The Associated Press: "A public option is the top goal for liberals, but it has no Republican support and moderate Democrats say the Senate will never go along. So Tuesday's debate is expected to pit Democratic liberals against moderates. Although the public plan isn't expected to get a majority of the panel, supporters say at least they'll know where everybody stands. … Senators will have at least two Democratic alternatives to choose from -- and maybe a compromise from a moderate Republican who is keeping all her options open. Sen. Jay Rockefeller, D-W.Va., is proposing a public plan modeled on Medicare. ... Sen. Chuck Schumer, D-N.Y., is proposing a government plan that looks more like a private insurance company and negotiates payment rates with providers." Many say the possible compromise proposal being considered by Sen. Olympia Snowe, R-Maine, could be the ultimate choice. "Aides say she's considering offering a compromise that would use the public option as a threat, to be deployed only if private insurers fail to keep premiums in check after a reasonable period of time" (Alonso-Zaldivar, 9/29).

The New York Times: "The prospects for passage" of a public plan in the Finance Committee "appear dim, but supporters hope they can build momentum by debating the issue now and holding a roll-call vote of committee members under the gaze of Democratic constituencies like labor unions, which strongly support the public option. The supporters plan to continue pushing when Democratic leaders reconcile the Finance Committee's bill with one from the more liberal health committee, which already includes a public option, and when the resulting legislation goes to the Senate floor" (Seelye, 9/28).

The Hill reports that the public option has had no greater champion than Schumer: "Schumer has become the Senate's most outspoken advocate for a government-run health insurance plan, investing significant political capital in the proposal. While that may have seemed a losing bet a month ago, the political odds have shifted in recent weeks" (Bolton, 9/29).

Politico: "Still, there are signs everywhere that it remains an uphill fight. Senate Majority Leader Harry Reid's office scrambled Monday to deny a report in The New York Times that the merged Senate bill - with competing versions from the Senate Finance and Health, Education, Labor and Pensions committees - would not include the public health option. The White House has said it doesn't consider the public option a crucial part of health reform but also has sent mixed signals of late" (Budoff Brown and O'Connor, 9/29).

The Los Angeles Times: "A recent New York Times/CBS News poll found that nearly two-thirds of those surveyed supported the creation of a public insurance plan. The case for a government option is based on concern that the overhaul bill requires almost every American to have insurance but includes no direct controls over the premiums private companies can charge.

"The result, some fear, is that families of modest means will be required to buy policies they cannot afford. A government option, the argument goes, will guarantee at least one affordable policy and put competitive pressure on private companies to control prices. But critics say the public option will drive most private insurers out of business because it will always be able to under-price them -- the first step on the path to government domination, if not total control, of the health insurance market" (Hook, 9/29).

Meanwhile, Politico reports in a second story that Republicans are struggling to explain how their proposals would spur competition amongst insurance companies. "Republicans have maligned the Democrats' public option as a government takeover of the health care system, but it's proving to be a more straightforward answer to the competitiveness question than anything the Republicans have offered." 

"Democrats, by pushing an optional, self-sustaining, government-run insurer to keep private insurers honest, may be offering a more clear-cut proposal for increasing competition than their free-market counterparts on the other side of the aisle. Whereas the Democrats' plan would operate in the existing marketplace, many Republicans would like to revamp that marketplace completely - something that makes most Americans queasy. Ideas range from dismantling Medicaid to upending the system of employer-provided health care so that insurers cater to the people they cover, rather than the companies that pay for that coverage" (O'Connor, 9/29).

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