WASHINGTON (CNN) - Senate Democratic leaders met Thursday night with White House officials to consider including a government-funded public health insurance option, along with a provision allowing states to opt out of it, in a health care overhaul bill.
Two senior Democratic Senate sources told CNN that Senate Majority Leader Harry Reid is leaning toward a public option with the state opt-out provision in the Senate health care bill that will reach the full chamber in coming weeks.
According to one source familiar with the White House meeting, the matter was discussed with President Barack Obama but no decisions were made.
Republicans and some moderate Democrats oppose a public option, threatening the chances for a bill that includes the provision to get the 60 votes necessary to overcome a Senate filibuster.
The state opt-out provision is considered a possible way to get moderate Democrats to support a bill with a public option. However, the spokesman for Democratic Sen. Ben Nelson of Nebraska, a key moderate, said Nelson opposes the idea of a national public option with an opt-out for the states.
In addition, the idea is opposed by Sen. Olympia Snowe of Maine, the only Republican to support any kind of health care proposal so far. Snowe's spokesman, John Gentzel, confirmed to CNN her opposition to the modified public option.
Obama and Democratic leaders say the non-profit public option will bring competition to the health insurance industry and lower costs while expanding access to Americans currently without coverage.
Republican opponents contend a public option would drive private insurers from the market and lead to an eventual government takeover of the health care system.
Of five health care bills approved so far by House and Senate committees, four include a public option. The other bill, from the Senate Finance Committee, includes non-profit cooperatives instead of a public option and is the proposal supported by Snowe.
In recent days, two administration officials have told CNN that the prevailing White House opinion is for the Senate health care bill to include a so-called "trigger" mechanism proposed by Snowe that would bring a public option in the future if thresholds for expanding coverage and lowering costs go unmet in coming years.
The source familiar with Thursday evening's meeting said Obama "pushed for a so-called trigger, because it's the more bipartisan way to go," due to Snowe's support for the concept. A critical White House goal in passing a health care bill is the ability to call it bipartisan, so Obama officials are wary of doing anything to alienate Snowe.
Also Thursday, 36 moderate House Democrats threatened to vote against the current health care bill the chamber's leaders are drafting because they don't believe it will sufficiently reduce long-term health care costs.
In a letter to House Speaker Nancy Pelosi, D-California, and House Majority Leader Steny Hoyer, D-Maryland, the fiscally conservative Democrats cited recent testimony by Congressional Budget Office Director Doug Elmendorf that indicated health care costs under the House legislation could rise after 10 years.
Elmendorf "has already indicated that the bill does nothing to rein in the costs of health care, and therefore may not be sustainable outside the 10-year budget window," the letter said.
"We will be unable to support any health care legislation that doesn't meet the president's goals of driving down and holding down the cost of health care, as determined by" the CBO, the letter concluded.
A Democratic leadership aide told CNN that final analysis from the Congressional Budget Office will be crucial to passing a bill in the House.
"If we do not get a reasonable sort of indication from CBO that we're going to bend it, that will be a problem," the aide said of lowering costs in the future.
House Democratic leaders learned earlier this week that the CBO projected their bill would cost $871 billion over 10 years and also reduce the deficit during that time. But the CBO was unable to assess what the impact would be in the next 10 years.
Moderate Democrats have asked leaders for details about the long-term costs from CBO, but no final analysis has yet been released.
Rep. John Barrow of Georgia, a leader of the fiscally conservative "Blue Dog" Democrats, initiated the letter because "the question of cost isn't one that should be swept under the rug," said Barrow's spokesperson, Jane Brodsky.
Updated: 9:25 p.m.
–CNN's Dana Bash and Deirdre Walsh contributed to this story.
This possibility would force senators from Southern states to save face but also feel the heat from their own constituents for siding with Big Insurance monopoly. Not a bad way to get the public option rolling.
GOOD! I hope the other democrats get the necessary spine replacement surgery and endorse a public option also.
The "trigger" is so totally inappropriate. It is Lucy asking Charlie Brown one more time to try to kick the football that she's holding, all to make him look like an idiot again. Americans don't trust any monopolies, insurance monopolies, ANY monopolies. Sen. Snowe, what part of "no monopoly" can you not spell?
I hope the Republicans stop Obama's health care in it's tracks. The fact of the matter is that no one knows what additional financial burdens this will put on all of us because Obama needs to satisfy his ego. The insurance companies will always have the upper hand – always.
Except that it would cost us a lot of money to field all the lawsuits to have all this mess overturned (as it is ALL unconstitutional anyway and won't stand the challenge) – I almost wish they would play the public option card... it would guarantee even more of these idiot senators and congressmen get tossed out on their ear in 2010 for not doing the people's will.
They are trying to cram too much in. They should start on what they do agree on – try just cutting costs first. Open up insurance companies to compete across state lines.
"the question of cost isn't one that should be swept under the rug,"
So far the Democrats have shown no plan that reduces health care costs. There are 2 reasons why they ignore this core problem with health care. For one, it is difficult. It's a challenge. It is easier to say," Let's treat the symptoms ( like less than 100% coverage )." than to solve the main problem. Just throw money at it and raise taxes! That's the easy way out.
The second reason is that Obama came out and defined a high cost way to address the issue and gave no leadership to a real solution to the real problem of cost. Calling the target he defined as 'reform' is a misuse of the word. It's more like Health Care Band-Aid than Health Care Reform.
I say send them back to come up with meaningful reform, something that does not cost $900 billion and something that actually addresses the cost of health care. Republicans will support this kind of a plan and then it will pass, but not before then.
Opt-out provision! So they basically want to give it with one hand and take it away with the other! so why even bother? What a bunch of jokers!
Let the Dems add it in. That'll just give us more and more excuse to vote them out in 2010.
It couldn't come sooner!
I need a public option about as much as I need a 3 month wait to see a specialist...
If people will stop being so negative and start thinking postive maybe we can get somewhere, You have a job you complain you dont have one but yet you are still making it, evidently so you still have a computer to post your comment but yet you still complain the President give extended unemployement benefits you complain about that at least whether you have a job or not you have life and that you cannot beat so Thank GOD for what you do have.I gurantee you when this healthcare package is passed with a public option somebody somewhere will still complain. The president spend you complain if he dont spend especiall the way you want you complain so i just PRAY for President Obama to just do whats right for the country no matter if people like his policies or not1
I am unclear what the Dems are missing when the majority of polls reflect that the majority of Americans do not want big government/public option in their healthcare! Well, typical – all their good ideas will go away come 2010! Too bad.
And two important, effective ways to help fund meaningful health care reform (including a robust public option and eliminating pre-existing condition exclusions) are:
1. Eliminate the FICA tax cap on income above $90,000. This would generate a huge source of funds. (Right now, no FICA is paid on individual income above $90,000.)
2. Change the top tax rate to what it was under Ronald Reagan: 39%. Right now, the top rate is 36%; people making higher incomes can afford to pay an additional 3%.
Are these "taxes on the rich?" Yes, they are. And the wealthy of this country can well afford it. After all, it's the least they can do for this country that has given them the opportunity to create
What reason does any Senator have to oppose an OPTIONAL public option for health care except to protect their precious, precious insurance industry contributions?
Add public option to your healthcare boondoggle - and be swept out of office in 2010!!!!!!!!!!!!! Bank on it !!!!!!!!!!!
If those so-called moderate/conservative Democrats think that their democratic constituents are going to vote for their re-election if they don't vote for a health care reform bill with a public option, they're crazy. And if they think republicans are going to vote to put them back in office, no matter how they vote on the health care reform bill, they're crazy. Either way they're out in 2010. Maybe they'll feel good sitting on the sidelines with their insurance industry payoff.