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.
- Senate Majority Leader Harry Reid, D-Nev.: "The public option is not a silver bullet, but I believe it is an important way to ensure competition and a level playing field between patients and the insurance industry." - Joseph Antos, health care policy expert at the American Enterprise Institute: "I don't think it will be a budget buster, but it won't be a budget saver and I think it will be a big bust." - Senate Minority Leader Mitch McConnell, R-Ky.: "It will be a thousand-page, trillion-dollar bill that raises premiums, raises taxes and slashes Medicare for our seniors to create new government spending programs. That's not reform." - Judy Feder, senior fellow at the Center for American Progress: "What this arrangement does is allow, as some senators have wanted, is variations across states. That means that in jurisdictions where there is an opposition to a public plan, they don't have to make it available. But it means that it can go forward in what I believe will be many states who want to offer citizens as broad a variety of options as possible." - Karen Ignagni, president and chief executive officer of America's Health Insurance Plans: "A new government-run plan would underpay doctors and hospitals rather than driving real reforms that bring down costs and improve quality. The American people want health care reform that will reduce costs, and this plan doesn't do that." - House Minority Leader John Boehner, R-Ohio: "Whether you call it a public option, an opt-out, a trigger or a co-op, the fact is all of these proposals put us on the path to government-run health care. Forcing Americans off of their current health coverage and onto a government-run plan isn't the answer, but that's exactly what the Democrats' plan would do."
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.