We are almost inexorably heading for a showdown on the public option between the House and the Senate. President Obama will have to play referee.
As Kent Conrad has declared that there are not enough votes for the public option in the Senate, today the Senate Finance committee released a health care "reform" proposal without a public option.
However, House Progressives have drawn a line in the sand on the public option, saying that they won't vote for health care reform without a public option. This has led Speaker Pelosi to declare that there are not enough votes in the House to pass health care reform without a public option, and to strongly reiterate her personal support for a public option. the House released a health care reform bill with one:
Where the Senate Finance Committee's outline of a bill didn't include a public health insurance option for people to buy into, the House version includes a robust public plan that would operate nationally and compete with private insurers on a level playing field to keep them honest.
The public plan would be self-sustaining and not subsidized by the federal government, although an upfront infusion of capital would be needed. It would initially be tied to Medicare reimbursement rates, to capitalize on the existing infrastructure, but would evolve into a separate plan that paid higher rates. Participation by doctors would be voluntary.
So, there you have it. The Senate appears to be unwilling to pass health care reform with a public option, while the House claims it is impossible to pass health care reform without one.
As long as we hold the Progressive Block on health care together in the House, this debate is ultimately going to have to be settled by President Obama himself. The direction where he throws his weight will have a lot to do with how much support the Democratic Party deserves from progressive activists for years to come.
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