While the White House was advertising the potential savings of reforming health care, the real battle being waged in Congress is whether or not to offer a government-run insurance plan and how it would operate.
All signs point to the inclusion of some kind of public-run option in the final bill, likely a government-operated insurance plan to compete with private companies.
The proposals put forward by the Senate health and Senate Finance committees include a public option, and Speaker Nancy Pelosi, D-Calif., has promised the House bill will too.
Most Republicans are opposed to a government-run alternative, saying it will force private insurers out of business and lead to a European-style health care system and the rationing of medical care.
Caught in the middle are moderate Democrats worried about unintended consequences of the plan from the White House and congressional leaders.
“The line in the sand is drawn if it is the kind of public option that undermines or destabilizes the private insurance market,” said Sen. Ben Nelson, D-Neb., who is among a group of centrist Democrats who are critical of a public-run option that mimics Medicare but is open to all.
Nelson said the public option could eventually become the only option “if it costs less, if it was subsidized.”
While Nelson and other moderate Democrats are at least open to considering public-run alternatives, Republicans appear less flexible.
“The public plan is nothing more than a stalking horse for a single-payer system,” said Rep. Judd Gregg, R-N.H. “That will be a hard sell.”
Senate Finance Committee Chairman Max Baucus, D-Mont., told the Billings Gazette on Monday that his panel’s bill would include a “strong public option” that would compete with the private insurers.
Baucus, along with Sen. Chris Dodd, D-Conn., and other Democratic lawmakers, met with President Barack Obama on Tuesday to try to push them into coming to agreement around one health care proposal.
Sen. Charles Grassley of Iowa, the top Republican on the Senate Finance Committee, said the White House meeting was “a fork in the road” in the negotiations on health care.
Obama told Grassley last month he was aiming for a bipartisan bill with broad Republican support. But Grassley said he wouldn’t get that backing if it includes a public-run option that undermines the private system. He is looking to Obama to uphold his pledge to push a bill that the GOP can also support.
“If Democrats come away from the White House with a bipartisan measure, than it can be done,” Grassley said. “I believe we can get a bill through the Senate by August.”
For now, he’ll have to keep waiting as Democratic leaders try to reach a compromise among themselves.
