While the Senate’s version of health care reform moves forward, the debate over the inclusion of a government-run public health insurance program could cause that momentum to stall.
On Saturday (Nov. 21), the Senate voted 60-39 to proceed with discussions on the $848 billion Patient Protection and Affordable Care Act, with debate to begin Nov. 30. All 58 Democratic senators voted in favor of advancing the bill, as did the Senate’s two independents: Sens. Joe Lieberman of Connecticut and Bernie Sanders of Vermont. As expected, all 39 Republican senators voted against further discussion of the legislation.
Following the vote, the bill’s author, Senate Majority Leader Harry Reid (D-Nev.) told reporters that “we can see the finish line, but we are not there yet.”
Joseph Lieberman
Getting to the finish line, however, may be difficult as the issue of the public option continues to divide members of the Senate. Chief among them was Lieberman, who voted to move discussion of the bill forward, but has said he would not vote in favor of a bill that contained a government-run insurance program.
On NBC’s “Meet the Press” Nov. 22, Lieberman reiterated his opposition to the public plan and his intent to filibuster to stall the legislation’s forward progress.
“I don’t want to fix the problems in our healthcare system in a way that creates more of an economic crisis, either short-term to inhibit businesses from hiring more people, creating jobs, or long term to add to the debt,” Lieberman said. “[The public option] doesn’t offer free insurance. It won’t get one more poor person insurance. It won’t force one insurance company to give insurance to somebody who’s got a pre-existing condition. And it won’t even lower the cost of health insurance, which the advocates said it originally would, because the Congressional Budget Office has now said to us that the public option in Senator Reid’s bill will actually charge more for insurance than the average charge by health insurance companies.”
Single-payer predecessor
Meanwhile, Sen. Jon Kyl (R-Ariz.) echoed Lieberman’s sentiments on CBS’ “Face the Nation,” saying approval of the public option moves America closer to a single-payer system. Kyl cited a Lewin Group study that found 88 million Americans with employer-based coverage would move to the public option.
“You have your insurance with your employer,” he said. “He says it’s cheaper for me to send you to the government plan than it is for me to continue to provide it, you don’t get to keep your policy anymore. Now you’re in the government-run system. So that’s the other objectionable feature.”
Sen. Chuck Shumer (D-N.Y.), appearing on the same program, defended the public option as a way to increase competition with private insurers.
“When there is no competition or very little competition, every economist, left, right and center, will tell you the costs go way up,” Shumer said. “And that’s what’s happened here. So you need to inject some competition into the insurance industry. The best way to do that is a public option. And the program that we’ve put together is set up by the government but then it’s on its own. There is no intent for it to compete unfairly against private insurance.”
With Lieberman and other Democratic senators wavering on the inclusion of a public option in the final version of the Senate bill, Schumer said he is confident that it will survive a full debate of the proposed legislation given the “opt-out” clause states have.
“I think, at the end of the day, everyone is going to be together,” he said. “And I think the proposal that Leader Reid wisely put into his bill, which is a moderate, modest proposal, sort of, in the middle of public option land– there are some on the left who don’t like it; they want it to be more liberal, some on the right – will, at the end of the day, be where we end up.”
Negotiations begin
Trying to get some of those Democrats to favor the public option will be former Senate Majority Leader Tom Daschle of South Dakota, recruited by the Obama Administration to aid negotiations with party members. Daschle was also a former nominee for secretary of the U.S. Department of Health and Human Services, but withdrew his nomination amid tax issues.
Speaking with NPR this weekend, Daschle said he feels “very strongly” about the inclusion of the public option and noting the “very difficult” debate ahead. Daschle did not rule out an option proposed by Sen. Olympia Snowe (R-Maine), that would trigger a public option in five years if certain expectations of the private insurance market were not met.
Daschle did note, however, that Snowe’s option may not satisfy liberal senators who seek a robust public option at the end of the day.
“Well, and the question you’d ask those people is, ‘Is having nothing at all better than having no public option?’ And I would argue that having nothing at all, again as I said, is the worst possible option we could choose,” he said.
Debate on the Senate bill is expected to continue into December and any final version will have to be reconciled with a House bill before reaching President Barack Obama’s desk for a signature.
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