WASHINGTON (CNN) - House Speaker Nancy Pelosi signaled her willingness Thursday to consider a health care bill that lacks a government-run public health insurance option.
Pelosi has previously insisted the public option was necessary for House approval of a health care bill. Last month, the House passed its version of the sweeping health care measure that includes the public option.
However, Senate Democrats agreed this week on a tentative deal to drop the public option from their health care bill in order to ensure the measure can pass the chamber.
Under a proposed alternative, the Senate bill would permit private insurers to offer non-profit coverage overseen by the government and expand the Medicare program for senior citizens to allow people as young as 55 to buy in.
Pelosi, D-California, at her weekly news conference said she wants to get the Congressional Budget Office analysis of the Senate alternative before judging it, but she opened the door to a final bill without the public option.
"We in the House believe that the public option is the best way to keep insurance companies honest and also to increase competition," Pelosi said, adding: "If you have a better way, put it on the table."
With President Barack Obama supporting the Senate alternative, Pelosi's openness to consider it represents a potential major step toward eventual passage of a health care bill by Congress.
If the Senate eventually passes a health care bill, it would be merged with the House version by a conference committee. Both chambers would have to approve the final bill before it could be sent to Obama to be signed into law.
The House and Senate bills are "probably 75 percent compatible," Pelosi said, adding that a final merged bill could win approval from both chambers before Christmas if the Senate completes its work by the end of next week and a conference committee can meet over the weekend of December 19-20.
Liberal Democrats call the public option the only way to truly reform the health care system by ensuring people have access to affordable coverage and providing low-cost competition to private insurers.
Republicans and some moderate Democrats consider the public option an unnecessary federal intrusion in health care that could lead to an eventual government takeover of the system.
The House narrowly passed its health care bill last month, and the Senate is in the second week of debate on its version. Senate Democrats need all 60 votes in their caucus to overcome a Republican filibuster to pass the bill, and some senators in the Democratic caucus have rejected the public option.
Democratic sources said the Senate deal reached Tuesday night includes proposals to replace the public option by creating a not-for-profit private insurance option overseen by the Office of Personnel Management, much like the current health plan for federal workers, along with the Medicare expansion.
A Democratic source with knowledge of the deal said the alternative also includes a "trigger" mechanism that would create a public option in the future if the non-profit private alternatives fail to effectively expand coverage and bring down costs. However, the source said the trigger provision was tentative for now, based on whether moderates opposed to a public option would accept it.
Pelosi said he had yet to see details of the Senate plan. She listed essential elements for passing a health care bill, including making coverage more affordable for middle-class Americans, sustaining the solvency of the Medicare program for senior citizens while eliminating a gap in their prescription drug coverage, no deficit increase and holding insurance companies accountable.
"What I have said, as I've always said to my members, give the Senate room," Pelosi said, adding, "We will know a great deal more when the paper comes back from the Congressional Budget Office. But seeing their bill and our bill, I know one thing for sure - we'll have a great bill when we put them together."
In particular, the idea of expanding Medicare to those 55 and older was appealing, Pelosi told reporters after the briefing.
Obama said Wednesday that the Senate agreement created "a new framework that I believe will help pave the way for final passage" of what he called historic health care reform legislation.
"I support this effort, especially since it's aimed at increasing choice and competition and lowering cost," Obama said.
However, the American Medical Association and American Hospital Association both told CNN Wednesday they oppose the Medicare expansion provision in the Senate package.
"We are extremely concerned about the approach because it removes people from the private sector and puts them in government care, which is chronically underfunded," said Alicia Mitchell, a spokeswoman for the hospital association.
In addition, two moderate Democratic senators who took part in the talks said the package must first be analyzed by the CBO before anyone can claim a final agreement.
"There is not specific compromise. Those were discussions," Sen. Mary Landrieu, D-Louisiana, told reporters.
Some liberals also had reservations. Sen. Russ Feingold of Wisconsin, one of 10 Democratic senators involved in talks on the deal, said he had concerns about the lack of a public option to ensure affordable coverage for those younger than 55 and therefore ineligible for the Medicare expansion.
Two senators who oppose a public option, moderate Republican Sen. Olympia Snowe of Maine and independent Sen. Joe Lieberman of Connecticut, said they were open to the non-profit private alternative in the deal.
"It can be an innovative approach," said Snowe, considered perhaps the lone GOP senator who might support the health care bill. "I just would need to understand more about how it would work."
Lieberman, a member of the Democratic caucus who has said he would join a Republican filibuster if the health care bill contained a public option, called the alternative "an idea worth considering, so long as it remains private insurance companies that would be essentially regulated by OPM."
However, Lieberman and Snowe expressed concern over the idea of allowing Americans 55 or older to buy into Medicare.
"I want to make sure we're not adding a big additional burden to the Medicare program, which we need to figure out how to save, because it's going bankrupt," Lieberman said.
Updated: 3:40 p.m.
–CNN's Dana Bash contributed to this story.
What kind of irony is it when you are concerned with 'keeping the insurance companies honest' and the American people are concerned with keeping you honest.
I'm open to this old BOTOX bat being out of office permanently.
They are doing nothing to reduce the costs of health insurance. Reports are to buy in to the Medicare at age 55 would cost over 7,000 per year. We want affordable health care, not more expensive. Work on reducing costs, not quality.
The Dems have no back bone so much for change you can believe in! The GOP in the minority still has the Dems number. The Dems could have 80 senate seats and they are all bought off by the insurance companies.
I will sit out the next election because it makes no difference neither the GOP or Dems will do what right for the America public.
I support you Madam Speaker and the rest of the progressive dems in the House. It's that darn Senate that's getting on my last nerve. Vote all ConservaDems OUT!!!
I just don't know what to say, such absolute incompetence. We need an entirely new Congress, both House and Senate. These people could manage a real business or organization I guess that is why they are politicians.
IF NOSEY PELOSI....is signaling some "openess to negotiate" on the Public Health Care Option....when she formerly SAID NO WAY...this IS going to happen....."Watch Out...Something is going on!" After All....CAN YOU REALLY 'BELIEVE' THIS WASHINGTON BUREAUCRAT...WHO IS TOTALLY INEPT AT THE JOB SHE IS IN.. She and Harry are "GONERS" next time around.
I think that the alternative to the public option is acceptable as long as Medicare becomes the "new public option" and is enhanced and expanded. Pelosi and other liberal Democrats should embrace the alternative and I think that they will.
Somehow, pelosi will SNEAK in a PUBLIC OPTION in the final bill that gets signed. Them liberals are SNEAKY – sneakier than those Dec 7 japs.
So let's see, Medicare will go bankrupt shortly, so the logical answer is to add more people to it? Is there an alternate universe I can go where Democrats have been eliminated?
Just goes to show that she is only about her team winning and that it really has nothing to do with the American people to her.
we need the public option!!!!
Now, you see there gOP, that is how bipartisan cooperation should be handled. Not by stubbornly refusing to participate because you can't have everything your way. I suggest you take this carrot, because when the country finally tires of your childish behavior, then you will REALLY feel what it's like to have health care reform "shoved down your throat."
We wanted a single payer system now they are giving up the public option. What a bunch of wimps. I say we vote liberal for real democrat in 2010 so these middle of the way of progress moderates can quit playing republican. No public option no deal!
One truly terrible idea–the "public option"–down, and probably one more to go: the trillion-dollar price tag. The country just can't afford it.
Keep trying to put lipstick on this healthcare PIG Democrats! So how much money is the government (US!) going to pay to subsidize people on it? Why don't we ever hear the true costs of these idiot plans?
Nothing in life is free. We all know this. Why don't the politicians in Washington??!!
folding up like a cheap suit....public option....R I P
Pelosi + Obama + Reid = Three fools without a clue.
The Medicare Expansion is a ruse that will build a path into "managing" your 401K retirement savings to cover your health care after 55. These greedy bas_t_rds are sneaky and can't be trusted, especially Pelosi who is on record in favor of "equalizing" income by taking from the rich and giving to the poor (as long as it's not her money). See the big picture, she hasn't changed her philosophy, only her tact and language.
There you have it – right from the providers mouths.
And this is why, as I've been saying all along, that this bill will INCREASE costs. Hospitals and physicians will be receiving less revenue due to more people being on Medicare, which pays far less than private insurance. Their alternative will be to shift costs to those with private insurance, forcing private insurers to raise premiums.
The chronic underfunding of Medicare has ALWAYS been the number one reason why healthcare costs have risen – it's plain to see that since the inception of Medicare, healthcare costs have been rising at a rate directly proportional to the number of Medicare covered lives. Adding more to the Medicare rolls is throwing gasoline on the fire – but what did you expect from Washington?
I'm not afraid of big government giving too much to the American people but I am really scared of once again seeing a dishonest government focused on giving everything to the select few (ref. Bush-Cheney, 2001-2008).
I wish this alien would go back to what ever planet she is from. Good grief if there is ever a reason not to have plastic surgery she is it. Looks like a cartoon character and she is the best of the best of Democrats, that should tell you something.
The most evil and brain-challenged woman in America. What a combination of total incompetence and danger to all of us.
What afaarce...the 'new bill; without the public option states that if a national, non-profit for al health insurance overseen by the government is not creatwed in a year then a trigger mechanism is pulled for a public option...more double-talk..and they are both the same thing anyhow...
How kind of her. Perhaps she finally got a chance to look at the polls – The American people don't want government run health care. Get a clue! Now, Nancy, can you explain all of this to Harry? Perhaps you can get someone from the other side of the aisle to explain it to both of you.