Senate Democrats say they are convinced they can get enough support among lawmakers in their own party to pass a health care bill with a public option, but not the kind that liberal Democrats are envisioning.
The Senate's most conservative Democrats, including Sens. Ben Nelson, of Nebraska, and Blanche Lincoln, of Arkansas, are still opposed to a pure, government-run insurance program open to all Americans, despite personal pleas from President Obama. Those moderate members are far more likely to back one of a handful of ideas now being circulated, such a a trigger-induced public option, or a system of state-run health insurance plans, but even that's not guaranteed.
“I think Senator Nelson's views on a public option are pretty well known,” his spokesman Jake Thompson said. “He has always said if you could create a public option that did not undermine existing private health insurance, he'd look at that.”
In Nelson's view, a House bill and separate Senate bill that feature robust federal public options would harm the private insurance industry and he remains uncommitted to any proposal.
Sen. Charles Schumer, D-N.Y., said on MSNBC that he was just four to six lawmakers short of the 60 votes needed to pass a public option.
Democratic centrists, who have been the holdouts, are “very open to” a public option, Schumer said.
But that may be because Democratic leaders in the Senate seem to have softened the definition.
Senate Majority Leader Harry Reid, D-Nev., told reporters he favors a public option, but he added, “remember, a public option is a relative term.”
In the coming days, Reid will have to assemble a final bill for a vote before the full Senate and it is unlikely he will write legislation that includes the public option as defined by liberals.
To do so would almost certainly require passing the bill with a parliamentary tactic of reconciliation, which requires 51 votes instead of 60 but risks a political backlash.
“I think we are going to do it with 60 votes,” Senate Majority Whip Richard Durbin, D-Ill., said
To get to 60, Reid may have no choice but to implement one of three other proposals loosely based on the public option. The first, preferred by Sen. Olympia Snowe, R-Maine, would base a public option on a trigger, such as affordability of health insurance. Another plan, by Sen. Tom Carper, D-Del., would provide federal seed money to states to create their own public health insurance options, if they chose to do so. And a third idea, by Sen. Maria Cantwell, D-Wash., would give states the power to bargain with insurance companies on behalf of low-income residents. Cantwell's idea is included in a health care reform bill that is expected to pass the Senate Finance Committee this week.