The Public Option: Wanted, Dead or Alive

If you could pick one day to stay home from work for the purposes of watching C-SPAN, today should have been it. For five hours, the members of the Senate Finance Committee considered two amendments that would have added a public health insurance option to the Baucus bill, one by Jay Rockefeller (WV) and one by Charles Schumer (NY). Both amendments failed, but there are at least three other opportunities for a public option to come out on top. And the inescapable fact is that more and more Democrats are facing their do-or-die moment -- and choosing the public option.

The box score: Rockefeller’s version, which would have used Medicare rates for providers and hospitals for two years to jump-start the plan, and then segue to negotiated rates like any other insurance plan, failed by an 8-15 vote. Schumer’s version, which uses negotiated rates from day 1, similar to what’s in the Senate HELP bill and the most recent version of HR 3200, failed by a 10-13 vote. No Republicans vote for either amendment, and neither did Sens. Blanche Lincoln (AR), Kent Conrad (ND), or Chairman Max Baucus (MT).

Meanwhile, in the non-Beltway version of the United States, Kaiser Family Foundation released yet another poll which showed that not only is the public option remain popular among the American people, it’s slightly more popular than health care reform in general. For months now, this tracking poll asks if people would favor “[c]reating a government-administered public health insurance option similar to Medicare to compete with private insurance plans.” In this latest poll, 58% responded in the affirmative. When asked if they think it’s “more important than ever” to reform health care, 57% say yes. Not bad for a public option that has been declared “dead” just about every week this summer.

Actually, the public option is less popular in Kaiser than in other polls, if you can believe it, including the New England Journal of Medicine poll which found 63% of doctors favored it -- a poll frequently cited by the Democrats on the committee today. Republican Senator John Ensign at one point asked why, if the public health insurance option was so popular, Democrats were having such a time getting to 60 votes. It was a confrontational question. But for all of its bravado (and his completely lame follow-up that “maybe it isn’t popular after all” -- you’re a senator; don’t tell me you’re not obsessively checking the polls, buddy), it’s the right question. Why excuse did the Democrats on the committee have for voting against it?

Well, Baucus, whose white paper on health care advocated a public option and who praised it today, still voted against it using the argument that he didn’t believe that it would pass in the Senate. It’s kind of a brilliant self-fulfilling argument, if you think about it. The next time I can’t finish a project on time, I’m going to try telling my boss, “I’m not going to finish this project because I believe it won’t be finished.” Conrad seemed most worked up about the fact that the public option would be government-run. He even went so far as to praise, once again, the French health care system for being entirely private -- a description sure to startle the French. As for Senator Lincoln, God only knows. She didn’t even attend the debate, and voted by proxy.

But I wasn’t surprised by any of those no votes. I will admit I was quite surprised by both Nelson (FL) and Carper (DE) voting for Schumer’s amendment, scarcely a few weeks after both suggested they’d only vote for a public option with a trigger. Bingaman (NM) was part of the “gang of six” who delivered an option-less bill, but he voted for both amendments. Two months ago, I would have put Cantwell (WA) in the “probably no” column. Today she was a co-sponsor of Schumer’s amendment. And my biggest surprise of the day is the announcement by Sen. Tom Harkin, new chair of the HELP committee, that he had the votes to “comfortably” get a public option passed in the Senate (if not yet enough to defeat a filibuster.)

We’ll see another round of “is the public option dead or alive” punditry after the events of today. But the one point that seems indisputable is it doesn’t matter what the Senate Finance Committee does or does not do -- the public option is necessary, it’s popular in Congress, popular in the White House, and popular across the country. As such, it can’t be counted out until the final vote is tallied.

(Photo credit: http://www.flickr.com/photos/jaytamboli/ / CC BY 2.0)