'Public Option' Remains Possible Snag As Vote Looms

Senate Majority Leader Harry Reid needs 60 votes — that's every Democrat and both Independents — to clear the way for a vote on historic heath care legislation Saturday. The final two Democrats fell in line Saturday afternoon — Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas. But the holdouts still expressed strong reluctance about the "public option" in Reid's bill.

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GUY RAZ, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Guy Raz.

We begin the hour with news from Capitol Hill. Democrats appear to be one step closer to passing a health care bill. Senate Majority Leader Harry Reid needed 60 votes � that's every Democrat and both Independents � to overcome a threatened Republican filibuster and formally begin debate on the bill. The final holdout was Arkansas Democrat Blanche Lincoln, who announced her yes vote this afternoon.

Representative BLANCHE LINCOLN (Democrat, Arkansas): Although I don't agree with everything in this bill, I have concluded that I believe it is more important that we begin this debate to improve our nation's health care system for all Americans rather than just simply drop the issue and walk away.

RAZ: NPR's health policy correspondent Julie Rovner is here with the latest.

Julie, explain to us exactly what this evening's vote means for the bill.

JULIE ROVNER: Well, this is in fact the end of the beginning. The Senate, as you know, makes it pretty hard to do much of anything and requires 60 votes to do most things. In this case, this is the vote to break a filibuster on the motion just to get the bill on to the floor or out of the starting gate, if you will.

RAZ: This was sort of seen as quite a test for the bill and for the Majority Leader Harry Reid, wasn't it?

ROVNER: Absolutely. Reid had to put together the two bills that came out of two different Senate committees. He had to get all 60 members of his caucus to defeat the united front of Republican opposition. To keep his liberal members satisfied, he included a so-called public option as one choice people could make in this new insurance marketplace called an insurance exchange.

But to keep his moderates on board, he had to let states opt out of that public option if they wanted to, and that almost cost him this vote. There were three Democrats in particular who really have doubts about that public option. Senator Lincoln, Ben Nelson of Nebraska, and Mary Landrieu of Louisiana all refused to say until the very end how they would vote today. And in her floor speech this afternoon, Senator Landrieu issued a pretty stern warning.

Representative MARY LANDRIEU (Democrat, Louisiana): My vote today to move forward on this important debate should in no way be construed by the supporters of this current framework as an indication of how I might vote as this debate comes to an end.

RAZ: Julie, what is it about this bill that Republicans dislike so much?

ROVNER: Well, pretty much everything. They don't like requiring people to have insurance. They don't like interfering with the private insurance market. They really don't like that the bill would be paid for by reducing Medicare spending and raising taxes.

And in the debate today and yesterday, Republicans zeroed in on the estimate from the Congressional Budget Office that the bill would in fact reduce the federal deficit by $130 billion over the next decade. New Hampshire Republican Judd Gregg called those numbers dishonest.

Representative JUDD GREGG (Republican, New Hampshire): What they don't tell the American people is that they're not spending anything in the first four or five years in the bill, no. They do raise your taxes in the first - throughout the 10-year period, they do cut Medicare throughout the 10-year period, but they don't spend the money. They don't start the programs until the year 2014.

RAZ: And Julie, does Senator Gregg have a point?

ROVNER: Yes, he does. But that's in part because it takes really that long to get the programs up and running. I would point out; the Democrats made exactly the same criticism of the Republican's Medicare prescription drug bill back in 2003, so now the pot's calling the kettle black.

RAZ: That's NPR's Julie Rovner.

Julie, thanks so much.

ROVNER: You're very welcome.

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