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The public option: Very alive or totally dead?

The public option letter in the Senate has more than 40 signatories now. That would seem to push it well beyond the point of viability. But with Nancy Pelosi saying that the Senate doesn't have the votes and "it's not in the reconciliation," it's not exhibiting many signs of life.

As far as I can tell, the story of the public option's resurgence has been a mixture of smart organizing and Senate cowardice. Few senators wanted to stand against the thing. But nor did they want to bring it back into play. So a number of them signed the letter under pressure, waiting and hoping that someone else -- maybe the leadership or the White House -- would figure this out for them. The White House and Pelosi have attempted a version of that. They're not coming out against the public option push; they're just saying the votes don't exist. And maybe they don''t. The letter has 41 senators signed on, which is still fewer than 50.

But the proper way to decide this is with a vote. Sen. Bernard Sanders has promised to bring the public option up in an amendment to the reconciliation package. Good. And if it passes, then Republicans can take a good, long look in the mirror and ask themselves if forcing the Democrats to use a reconciliation strategy rather than compromising to make the bill friendlier to conservative insights was really such a good idea. I don't think it would be the worst thing in the world if relentless obstruction imposed policy costs on Republicans.

By Ezra Klein  |  March 12, 2010; 11:46 AM ET
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Next: What sort of guarantee does the House want from the Senate?


This is good information. I'll be asking one of my Senators, Kay Hagan the wishy-washy non-committal Dem, to vote for the amendment.

Posted by: Jenn2 | March 12, 2010 12:19 PM | Report abuse

"the public option"

"The"? Which one?

Posted by: ostap666 | March 12, 2010 12:22 PM | Report abuse

My concern is that any headway Pelosi makes with Blue Dogs in the House who voted no on the original House Bill will be put into jeopardy if it looks like the public option could resurrect itself in reconciliation.

Isn't her leverage with those Blue Dogs centered around the Senate bill being more to their tastes?

It just adds an extra dimension to this chess game, one that I personally am not confident they can properly triangulate on.

Posted by: cbaratta | March 12, 2010 12:26 PM | Report abuse

This post is similar to an idea I had a couple of days ago. Should the number of signatories rise to the level of a simple majority, tactically speaking, the President should be permitted to make one last pass at the GOP leadership--offer up the public option as a sacrificial lamb to the GOP leadership: for GOP support of healthcare reform the public option would be jettisoned. This move would force the GOP to put its money where its mouth is. The GOP would, in all likelihood, still say no, and, after giving it the keys of the public option car and having it reject such an opportunity, this failure would provide an albatross to throw around its neck come the midterm. Its constituents hate this "government takeover of healthcare" more than anything, yet the GOP failed to deliver. Meanwhile, with independents, the slapping of this sizeable olive branch would add legitimacy to the public option. Nobody would think rejecting such an offer would be reasonable negotiations and, therefore, the rejection would, once and for all, demonstrate that the GOP is not in the business of negotiating, governing, with the majority.

Posted by: rawlsian | March 12, 2010 12:28 PM | Report abuse

Even better would be to have a stand alone vote on something like Rep. Grayson's bill (assuming it has majority support). Let the GOP obstruct it in the Senate then make it a central issue in the fall campaign.

Posted by: redwards95 | March 12, 2010 12:30 PM | Report abuse

Wouldn't be the worst thing ever that's for sure. Seems a little sneaky and your know Repubs/Fox News would be all over an amendment during reconciliation. I know, I know. Amendment is perfectly legal. But we aren't dealing with sane people

Posted by: Chris-TheFold | March 12, 2010 12:40 PM | Report abuse

Here's what I think is going on here: The number of public option supporters in the Senate is at least 50, but far short of 60 -- Tom Harkin once said he thought there were 52 or 53 votes for the public option in the Senate (though since then the Dems are down 1 vote). So the House passed a bill with a weak public option last fall, but that was doomed in the Senate. Now, with reconciliation, theoretically, a public option could (probably barely) pass.

HOWEVER, the new problem is with the House. There were barely enough votes to pass a bill with a weak public option in the fall. Since then, some "yes vote" people have gotten cold feet due to the Massachusetts election, others are concerned about provisions in the Senate bill (abortion, excise tax, immigration, etc.), and as a result, Pelosi is fishing for 10 or 12 conservative "no" votes from the last bill to get her over the top. These folks are almost certainly not public option fans.

This is why Durbin said today, essentially "look, if what the House sends us has a public option, beautiful. We'll fight for it. But I'm not going to try to add the public option after the fact and bounce it back to the House where the whole bill will die because it's short of the votes." And that's the problem -- not that there aren't 50 votes for the public option in the Senate. The problem is that there aren't 216 House votes for the Senate bill + what can be fixed in reconciliation + a public option. If it comes to a vote in the Senate (Sanders amendment), you may see some stalwart public option supporters vote no not because they've "caved", but because they realize the legislative reality that a yes vote to add something major to what the House already passed is a mortal blow to the bill. (Jay Rockefeller has already said this.)

I hope I'm wrong and that with just a little "guts" and "armtwisting" the House can pass a bill with a public option despite the loss of weak kneed conservative Dems and Stupak block pro-lifers. But I don't think I'm wrong.

That said, I can see why public option diehards see this as a giant conspiracy against the public option (always being "just short of the votes"), but I think the scenario above is a reasonable explanation.

Posted by: vvf2 | March 12, 2010 12:47 PM | Report abuse

vvf2 is spot on.

Posted by: Bethesdangit | March 12, 2010 12:59 PM | Report abuse

What vvf2 said: the problem is in the House, and it all comes down to what Pelosi can get 216 votes for in the House. Pelosi's clearly going to need a few votes that she doesn't yet have, and they're going to have to come from Blue Dogs. A public option might well sink the bill.

Let's pass the damn bill, then push for Grayson's Medicare buy-in proposal. That would be even better than a public option.

Posted by: rt42 | March 12, 2010 1:22 PM | Report abuse

I also agree with vvf2 and, also, rt42.

I'll add that it appears like the ping-pong strategy is for the House to not only pass the Senate bill unamended, but for the Senate to pass the House's reconciliation bill unamended. It appears the leadership is trying to limit the number of votes the House has to take to the very minimum. If the Senate changes ANYTHING about the reconciliation bill - adds ANY amendments, gets anything stripped by the Byrd Rule - the House has to vote on it again.

It appears that Pelosi et al. want very much for the House to simply take ONE vote for everything: pass the Senate bill with a self-executing rule on the reconciliation bill, and have the Senate pass the reconciliation bill as is.

Posted by: Isa8686 | March 12, 2010 1:27 PM | Report abuse

Well, if the House has to pass the Senate bill first, before any sidecar can be considered, then all the better. Pass the Senate bill and get it into law. Then pass a sidecar with tweaks like getting rid of the Nebraska deal, changing subsidies, etc. Then, if possible, pass another sidecar with the public option and let people vote however they like.

Posted by: MosBen | March 12, 2010 1:50 PM | Report abuse

MosBen, from what I understand reconciliation can only be used once each fiscal year. That's why they're looking to fold SAFRA (the student loan reform bill) into the health care fix, because otherwise they couldn't do it until the next budget resolution is passed, which wouldn't be until the summer. And then there probably won't be time for it before the midterm, and who knows what kinds of majorities Democrats have in Congress, if they have them at all.

Posted by: Isa8686 | March 12, 2010 1:58 PM | Report abuse

"I don't think it would be the worst thing in the world if relentless obstruction imposed policy costs on Republicans."

I would argue that it is imperative. The policy of No has cost the country dearly, it cannot be permitted to be a dominant strategy for both political and policy advancement.

Posted by: adamiani | March 12, 2010 2:01 PM | Report abuse

vvf2 is right - 'The problem is that there aren't 216 House votes for the Senate bill + what can be fixed in reconciliation + a public option.'

So regardless how much Ezra likes this, it is still a reality that Public Option is a way to kill any Health Care Reform. Any talk of PO is still killing HCR.

I do not agree with Ezra when he says GOP will may be upset if PO indeed passes because they pushed Dems on the edge. On the contrary, GOP will have clear 'villain' in hand - PO - as the 'socialization of Medicine' and they will try to get votes on that basis. They may succeed too.

Probably WH has to take the leadership here and all the heat from 'FireDogLake', 'DailyKos' and 'HuffingtonPost' and declare that PO is off the table in this iteration.

Posted by: umesh409 | March 12, 2010 2:36 PM | Report abuse

The truth is it looks like Obama and many Sen Dems talk a good game about the public option but when it comes right down to it they want the money from the ins companies more than helping the people they serve.

Why else would they be trying so hard to keep the most popular part of reform out of the bill.

I'm lobbying hard for a public option. I want Bernie Sanders to Introduce Public Option Amendment because then we will know where senetors really stand.

I know it would derail this bill but a gift to the insurance companies is not reform. At the rate health ins. is increasing it won't take long for all of the country to demand universal health care.

Posted by: joejoe2000 | March 12, 2010 7:21 PM | Report abuse

Where there's a will there's a way. I doubt adding a weak public option that has already passed the House would jeopardize passage of a bill that the health industry desperately needs. But you could add a Medicare buy-in or state single payer instead if you were afraid. Remember, the Senate could have just passed the House bill. It's just a matter of leadership.

Posted by: bmull | March 12, 2010 8:47 PM | Report abuse

Let's stop playing all the second guessing games on what the political ramifications might be if the bill is passed. Medicare was passed without Republican support and I'm sure much consternation by some Dems.
Let's look at what is best for the PEOPLE and accomplish that.
Without a 'robust public option' (not the House's PO) the bill is worse than nothing at all; so most of the handwringing about the 'PO' is a mental exercise. Without the 'robust public option' this is just one huge handout to the insurance industry no matter how they try to sugar coat it; and we should let the bill be defeated and start over!

Posted by: medicare444all | March 13, 2010 8:10 AM | Report abuse

No Public Option then no Dems in 2010 for this voter. I do not wish to be sold out to the Big private insurers.

Posted by: drtodd1977 | March 13, 2010 8:27 AM | Report abuse

Obama made a deal with the for-profit hospital industry to not sign a law with the public option. Copy-paste-Google these article titles: (Huffington Post) "The Real Reason Obama's Plan Doesn't Include a Public Option" and "Obama, Durbin and Pelosi All Point Fingers at Someone Else for Killing Public Option" ---- (New York Times) "Obama Is Taking an Active Role in Talks on Health Care Plan" ---- From the NY Times article: "Several hospital lobbyists involved in the White House deals said it was understood as a condition of their support that the final legislation would not include a government-run health plan........"We have an agreement with the White House that I'm very confident will be seen all the way through conference," one of the industry lobbyists, Chip Kahn, director of the Federation of American Hospitals, told a Capitol Hill newsletter." ---- Why is the mainstream media other than the New York Times and Huffington Post not reporting this? Where are the real journalists?

Posted by: Keefanda | March 15, 2010 4:45 AM | Report abuse

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