October 22nd, 2009
09:25 PM ET
11 years ago

Senate Democrats look at adding public option to health care bill

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.

Filed under: Democrats • Health care • Obama administration • Olympia Snowe • Senate
soundoff (116 Responses)
  1. m smith

    Thank you Public oprtions are the way to go. Keep up the good work .

    October 22, 2009 07:51 pm at 7:51 pm |
  2. m smith

    Thank you. Public options are the way to go. Keep up the good work .

    October 22, 2009 07:52 pm at 7:52 pm |
  3. annie s

    Every single poll now shows that the majority of Americans support a public option. Apparently, though, our esteemed legislators have to decide who they care more about – the people who vote or the people (insurance lobby) who fund their campaigns. If there is no public option, there is no true reform!

    October 22, 2009 07:52 pm at 7:52 pm |
  4. Hilary

    I'm all for the opt-out provision as long as the people of the state are allowed to vote on it rather than the decision being left solely to the state government.

    October 22, 2009 07:53 pm at 7:53 pm |
  5. Perusing-through


    A Public "Medicare-like" Option will bring competition to the health insurance cartel, and force them to cut their ridiculous profits made on the backs of hardworking middle-class Americans, who are finding it increasingly difficult to afford decent health care.

    October 22, 2009 07:54 pm at 7:54 pm |
  6. Joanna in PA

    We need a public option now, stop fooling around and get it done. while your at it, get ride of the Anti trust exemption.

    October 22, 2009 07:56 pm at 7:56 pm |
  7. Liz T., Tucson

    Really!! I mean really!! Is someone finally going to consider the opinions of the millions of democrats who voted for this administration and the majority in Congress? We wanted single payer and now we may or may not even have a "public option"!!

    Talk about being afraid of the opposition and taking your base for granted!! Get on with putting the public option in, do a little polling and see how happy people are with you!

    October 22, 2009 07:56 pm at 7:56 pm |
  8. Caroline Karamian

    We need the public option for bringing down the insurance prices and distribution of fair health care in U.S.

    October 22, 2009 08:01 pm at 8:01 pm |
  9. christopher hamilton

    I have no problem with a public option i think its needed especially to keep insurance companies honest. It seems that republicans want to leave healthcare up to the freemarket and private sector that doesnt always work, we can see that when it came to the economic mess we had a few months ago theres no doubt in my mind that these private insurers will do all they can to deny people of insurance to save money for their pockets.

    October 22, 2009 08:01 pm at 8:01 pm |
  10. Jeff in AZ

    We NEED a public option. Call it whatever makes it palatable, but we need it. Hell, just expand Medicare. It works pretty darned well, all things considered.

    October 22, 2009 08:04 pm at 8:04 pm |
  11. Fred in VA

    I applaud Obama for cracking down on these Wall Street fat cats. Next, we need to limit the pay of some of these pro athletes. Millions of dollars to throw a ball around? That's not right!!! Also, these fat cats in Hollywood need to be limited. Millions of dollars to act in a movie? Come on, man! I know it will be hard because they are for Obama but it is the right thing to do.

    October 22, 2009 08:06 pm at 8:06 pm |
  12. ThinkAgain

    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 their wealth in the first place.

    October 22, 2009 08:09 pm at 8:09 pm |
  13. GI Joe

    Snowe does NOT represent the majority of the people in the country. The Democrats need to do what we voted them into office to do – to hell with the party of NO.


    October 22, 2009 08:12 pm at 8:12 pm |
  14. Michael

    Isn't it obvious? If Congress makes mandatory to have health insurance (a good thing in itself), but does not establishing a public option to compete, there'll be nothing to stop the insurance companies gold-plating the premiums. That would led to a rip-off by the insurance companies that will make the investment bankers' greed look moderate by comparison.

    The public option is an essential ingredient of heath-care reform. In all likelihood , most people who already have insurance will will stick with their private insurance plans, and that's fine. But the public option has got to be there to discipline the private insurance companies.

    October 22, 2009 08:12 pm at 8:12 pm |
  15. ThinkAgain

    Another good way to help pay for meaningful health care reform:

    Collect the tax owed by all the corporations who are not paying their fair share by hiding it offshore, borrowing huge sums of money to use as a tax deduction, etc.

    Think of how much money there'd be if we collected what we're legitimately owed!

    October 22, 2009 08:12 pm at 8:12 pm |
  16. Rob

    GOOD. This had BETTER include a public option or Senators who oppose will have difficulty come re election.

    October 22, 2009 08:14 pm at 8:14 pm |
  17. gary davis Harbor Oregon

    SO she is just like the rest of her republican butt wipes ..no public option for america means insurance companies win the issue .. no compatition we need a choice of a government option . just like social security and medicare.. they work with out insurance companies control 🙂

    October 22, 2009 08:19 pm at 8:19 pm |
  18. They call me "tater salad"

    There had better be a public option, or ,like they say, "don't let the door hit ya, where the good lord split ya!

    October 22, 2009 08:20 pm at 8:20 pm |
  19. Gwen K.Smith

    Democratic leader should listen to the voters that give them their seats in congress. Not to consider a strong public option / competition to For Profit Insurance Companies, and strong health care reform is why we vote the way we did. We wanted President Obama who is compassionate, has leadership and the interest of all US citizens. Like him we want a better nation that care of all. It not about politics and Washington and Big money and corporate games play. "We the people" say stand strong Democrates and do the right thing.

    October 22, 2009 08:20 pm at 8:20 pm |
  20. JILL

    We have to have the public option in order for reform to work!

    October 22, 2009 08:20 pm at 8:20 pm |
  21. JBS

    Democrats should consider a way to get moderate Democrats to support a bill with a public option.
    Sen. Olympia Snowe of Maine, opposes the public option this will be her downfall.

    October 22, 2009 08:20 pm at 8:20 pm |
  22. Keith in Austin

    Of course the progressive left-wing spenders will try and sneak the Public Option into law against the will of "working" Americans. Healthcare and free Government cheese to all citizens! Pathetic and driven by Socialistic hunger to get as many Americans DEPENDING on the Democrat party to refortify votes to keep them in power! Pathetic,

    October 22, 2009 08:24 pm at 8:24 pm |
  23. Phat Elvis

    Opt-out of a public option sounds like a reasonable compromise, what is the problem?

    October 22, 2009 08:24 pm at 8:24 pm |
  24. Henry Miller, Libertarian, Cary, NC

    The opt-out provision is only acceptable if it includes a mechanism whereby people can opt out of paying additional fees, taxes, or any other financial disaster caused by this imbecilic waste of money.

    October 22, 2009 08:28 pm at 8:28 pm |
  25. Tony

    We must have a public option, it's the only way reform to work.

    October 22, 2009 08:29 pm at 8:29 pm |
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