Senate Majority Leader Puts Public Option in Chamber's Health Reform Bill

Senate Majority Leader Harry Reid said the health care reform bill he'll put on the Senate floor includes a version of the public option that the insurance industry opposes. Reid, who is sending the legislation to the Congressional Budget Office for an analysis of what it might cost, detailed his Senate compromise bill, which includes a somewhat weaker version of government-run insurance because it allows states to opt out of the national plan. "The best way to move forward is to include a pubic option with the opt-out provision for states," Reid said at a press conference announcing his decision. "I think it's the fairest way to go." Though he also said the public option is "not a silver bullet."

The Democrat from Nevada said he believed the rest of his Democratic caucus would support the idea once it reaches a vote. If all 60 lawmakers in that caucus vote yes, the bill can bypass a filibuster threat.

Reid was asked repeatedly why he chose to include the public option. "It's something I believe in," he said. "All the national polls show a wide majority of Americans support the public option."

The insurance industry is among the most vocal critics of the idea. "A new government-run plan would underpay doctors and hospitals rather than driving real reforms that bring down costs and improve quality," said Karen Ignagni, president and chief executive officer of America's Health Insurance Plans, in a statement responding to Reid's announcement. "The American people want health care reform that will reduce costs and this plan doesn't do that."

As soon as the congressional analysts return with a cost report, the majority leader indicated the bill will move toward a debate on the Senate floor.

With the House of Representatives expected to debate and vote on a reform bill that will also include the government-sponsored insurer, Reid's announcement has swung the months-long argument back toward the public option, even though the bill that recently passed the Senate Finance Committee with great fanfare didn't have it. As majority leader, Reid had the responsibility of merging the two versions of the bill in the Senate. The Health, Education, Labor and Pensions Committee's bill -- authored by Sen. Edward Kennedy before his death -- was more influenced by Democrats' ideas, including few bipartisan compromises. That Democratic bill -- the first to pass a congressional committee -- included a public option with few limitations, though it also was projected to cost significantly more than subsequent versions.

Reid said he has been working "countless hours" with senior senators and the White House and is taking advantage of the "momentum that now exists" for a public option. In this version, he said, "states will be able to determine whether the public option works well for them and will have the ability to opt out if they choose. ... They'll have until 2014."

Reid had decided not to include the "trigger" provision favored by some moderates, including Republican Sen. Olympia Snowe of Vermont, that would have left the public option dormant unless the private insurance market failed to meet requirements for competition and cost. But the merged bill does include another compromise plan straight from the Finance Committee's bill: nonprofit health cooperatives initially funded by government money.

Sen. Max Baucus, D-Mont., chairman of the Finance Committee, had offered the co-ops in his committee's bill as a compromise for leaving out the public option. Baucus had worked for months to come up with a health care bill that earned at least one Republican supporter -- Snowe (BestWire, Oct. 13, 2009).

About whether he is now leaving Snowe's vote behind, Reid said, "At this stage, she does not like a public option of any kind. ... We hope that Olympia will come back."

Republicans have consistently argued against this proposal for the government to sell insurance, but a number of Democrats have said they won't vote for a bill that doesn't include it.

"The divisive debate about a government-run plan is a roadblock to reform," Ignagni said.

A statement from Tom McMahon, acting executive director of progressive group Americans United for Change, congratulated Reid. "Senator Reid's announcement that the Senate health care bill will include a public health insurance option, shows that he has refused to buckle in the face of withering pressure from the big insurance companies and sided instead with everyday health care consumers."

Speaker of the House Nancy Pelosi hasn't yet unveiled the House's compromise bill, which will combine three versions of reform legislation that passed through three committees. She has said it will include a public option.