The Senate will vote on a sweeping health care reform bill that includes a government-run insurance option, but in a nod to significant opposition among lawmakers in the Democratic party, states will have until 2014 to “opt out” of the public plan.
Senate Majority Leader Harry Reid, D-Nev., gave few details about the proposal, which he has been crafting for two weeks behind closed doors with a handful of top Democrats and White House officials.
The public option would be available among plans made available in health care exchanges that the government would operate.
Doctors who participate in the government-run plan would have to abide by government regulations and rules regarding care and spending.
Reid acknowledged that a plan to charge a tax on expensive health insurance plans has been changed in his plan to include family plans worth more than $23,000 per year, instead of $21,000. Those taxes and others required to fund the $6 billion public option would be collected from all states, including those that opt out of the plan.
Reid called the opt-out plan “the fairest way to go at this stage” and indicated he would deliver the legislation to the Congressional Budget Office for a cost analysis. The Senate is hoping to begin debating a health care bill soon and wants to pass legislation by the end of the year.
By choosing the “opt-out” public plan, Reid has devised a compromise that appears to be the strongest, most passable version of the government-run insurance proposal that party liberals were seeking. Even House Speaker Nancy Pelosi, D-Calif., said she was not opposed to the idea, though the House bill features a public option with no way to opt out.
While Reid will likely lose the support of Maine Sens. Olympia Snowe and Susan Collins, two Republican moderates who oppose the public option, he will win the backing of liberals and some moderate Democrats. Reid indicated he believed he would “have the full support of the caucus” to reach the 60-vote threshold needed to block a filibuster and begin floor debate, though moderates including Sen. Ben Nelson, D-Neb., have signaled they may vote to block it.
But critics say the bill, if enacted, could put private insurers out of business by eventually running them out of the marketplace if reimbursement rates are tied to Medicare, which pays doctors and hospitals much less than private insurers.
