Reid Bows To Pressure, Bill Includes Public Option

A week of closed door negotiations among Democrats has produced a compromise health-care overhaul bill. To the delight or dismay of many, it includes a public option — or government-sponsored insurance plan. Majority Leader Harry Reid yielded to intense pressure from his party's liberal wing to include a public option. It is still unclear whether there's enough Senate support to keep it intact.

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It's MORNING EDITION from NPR News. Good morning, I'm Steve Inskeep.

RENEE MONTAGNE, host:

And I'm Renee Montagne.

The debate over health care has two parts. There is a very loud public discussion. There's also the private negotiation.

INSKEEP: And it was the private talks, this week, that led a key part of the health care plan to resurface. Senate Democrats came up with a bill that includes a government sponsored insurance plan - or public option. It would compete with private companies. Now the Senate Majority Leader, Harry Reid, faces the challenge to round up enough votes for it.

NPR's David Welna reports.

DAVID WELNA: The Senate's new health care legislation blends huge bills passed by two committees. The legislation itself hasn't been made public. First the Congressional Budget Office has to give it a price tag. But aides say much of it closely tracks the more conservative bill passed by the Finance Committee. For instance, it has no requirement for employer provided insurance and it's paid for, in part, by taxing expensive insurance plans.

But one thing the finance bill did not have, that the more liberal Health Committee bill did, was a public option. Yesterday Majority Leader Reid said the chairman of those two committees, as well as the White House, all agreed the best way forward is to include such a public option - which individual states could opt out of until the year 2014.

Senator HARRY REID (Democratic, Nevada; Senate Majority Leader): The public option is not a silver bullet. I believe it's an important way to ensure competition and to level the playing field for patients with the insurance industry.

WELNA: Still a number of more conservative Senate Democrats have expressed strong misgivings about a public option. Every one of their votes is important, because in the Senate it takes 60 votes to overcome a filibuster, and the Democrats have precisely 60 members in their Caucus. Pressed by reporters on whether he actually has those 60 votes, Reid seemed confident.

Sen. REID: As soon as we get the bill back from CBO and people have a chance to look at it, which they'll ample time to do that, I believe we clearly will have the support of my caucus to move to this bill and start legislating.

WELNA: One Senator, who likely won't be voting with the Democrats when their health care bill hits the Senate floor is the only Republican in Congress who has voted for such a bill and committee, Maine's Olympia Snowe. She put out a statement, yesterday, saying she was deeply disappointed that a public option would be in that bill. Reid said he hopes Snowe would eventually come around on the issue.

Sen. REID: We hope that Olympia will come back. She has worked hard, she is a very good legislator. I'm disappointed that the one issue, the public option, has been something that has frightened her.

WELNA: Other Senate Republicans immediately derided Reid's opt out public option. John Cornyn of Texas, who is a member of the GOP leadership team, called it a brand new entitlement program.

Senator JOHN CORNYN (Republican, Texas): And I would urge my colleagues not to take the bait on this so called public option, whether it has an opt out or not, because it is just another disguised way to try to end up with a single-payer government-run health care system here out of Washington D.C.

WELNA: Another member of the GOP leadership, Tennessee's Lamar Alexander, said there already is an opt-out government run health plan, the Medicaid program that covers nearly 60 million poor and disabled people.

Senator LAMAR ALEXANDER (Republican, Tennessee): The first thing to know about a government run health insurance program which states can opt-out of, is that, they really can't. I mean, in the real they real world, they really can't -none has.

WELNA: That prompted a sharp retort from the Senate's number two Democrat, Dick Durbin. He said the opt-out public option would be nothing like Medicaid, in which the government dictates payment levels for Medicaid providers. Durbin said the public option would have to negotiate payment levels with providers, just as private insurers do.

Senator DICK DURBIN (Democrat, Illinois): I think there is fairness to it, allowing each state to make the decision on what it will do based on the needs of people who live in that state. And the people of the state will have the final say at the next election, as to whether the legislature and the government made the right choice.

WELNA: Democrats are clearly baiting state governments would feel pressured by constituents, not to opt-out of a public option. But that's assuming the opt-out public option survives the legislative gauntlet and tests of party cohesion that lie ahead. As Durbin said of his fellow Senate Democrats yesterday, we agree on some things but there is disagreement when it comes to other things.

David Welna, NPR News, the Capitol.

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