Policy-ish

Despite Compromise On Public Option, Hurdles Remain For Overhaul

With key Senate Democrats having struck a tentative deal on a private alternative to the controversial government-run public option for health insurance, there's plenty of crowing about health overhaul being just around the corner.

Sen. Harry Reid i

Sen. Harry Reid says the compromise will stick. Alex Wong/Getty Images hide caption

itoggle caption Alex Wong/Getty Images
Sen. Harry Reid

Sen. Harry Reid says the compromise will stick.

Alex Wong/Getty Images

"We have confronted many hurdles and had to take some big steps and a lot of little steps," Majority Leader Harry Reid said late Tuesday. "But tonight we have overcome a real problem that we have had."

Maybe. But there are plenty of big hurdles remaining. For starters, there are the details and cost of the compromise, which would allow people as young as 55 to buy Medicare coverage and let the feds contract with private insurers for coverage that would be offered to uninsured individuals and small businesses in state exchanges.

Can Medicare, already facing financial difficulties, handle the millions more people, especially the sick ones, who might pile into the program given the chance? And hospitals and doctors aren't likely to hop on board Medicare expansion because they're already grumpy about skimpy payments.

We look forward to the Congressional Budget Office's estimate of how much all that would cost, which should focus the minds and debate. But we aren't holding our breath that will happen today.

Oh, and there's the little matter of regulating insurers, requiring them, reportedly, to spend at least 90 percent of premiums on medical care. That's not going to be very popular with the underwriting set.

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