Senate healthcare bill revives public option. But can it pass?

Majority leader Harry Reid said Monday that the Senate healthcare bill will include a public option that states can decline. But it is not clear how he can get the needed votes.

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Kevin Lamarque/Reuters
Senate Majority Leader Harry Reid of Nevada speaks about health insurance reform on Capitol Hill in Washington on Monday.

A public option in healthcare may be OK with Senate majority leader Harry Reid. But it has yet to pass muster with a more important audience: the full Senate itself.

Senator Reid announced Monday that he will send to the Senate floor a healthcare-reform bill that includes the option government-run insurance plan – though states could opt out if they wished. Yet all indications are that the Nevada Democrat remains just short of the crucial threshold of 60 votes needed to defeat a likely Republican filibuster.

Asked flatly on Monday whether he had those votes in hand, which would enable him to shut off debate and move to a final vote, he punted.

“We’ve been working on healthcare, as a Democratic Party – and much of the time we had Republicans helping us – since 1948,” said Reid at a press conference. “We’ve made significant progress these past months.”

The reality is that a number of different versions of a public option may come up for a vote during full Senate debate on a healthcare reform bill.

Under the version backed Monday by Reid, states would have a year following the 2013 phase-in of the new healthcare plan to decide whether to opt out of the public option.

That opt-out clause might soften the opposition to the public option among some conservative Democrats, such as Sen. Mary Landrieu of Louisiana. But as it stands now, Reid’s version of the public option likely has lost the vote of Sen. Olympia Snowe (R) of Maine.

Senator Snowe voted to approve the Senate Finance Committee health reform bill, which did not contain a public option. Instead, it contained a provision, suggested by Snowe, that would trigger a public option if private insurance firms did not hit certain cost-containment goals.

“I would not be surprised one bit if Reid has to reverse course over the next few days and reintroduce the plan with a ‘Snowe-trigger’ rather than the ‘Reid opt-out,’ " says Jordan Sekulow, a political analyst and director of international operations at the American Center for Law and Justice. "Neither liberals nor conservatives seem pleased with Reid’s proposal.”

Sen. Tom Harkin (D) of Iowa, chairman of the Senate Health committee, has said that there are 52 firm votes in favor of the public option in the Democratic caucus and five or so opposed.

On Monday, Senator Harkin issued a statement praising Reid’s inclusion of the public option.

“There is strong support among Senate Democrats and around the country to improve access and affordability and an effective public option can achieve,” said Harkin.

Still, 52 Democratic votes will not get a healthcare bill through the full Senate. Reid has to convince all Democrats (and the Senate’s two independents) to vote as one if he is to push through a bill with no GOP votes.

That would only be to shut off debate, however. It is possible that some Democrats would vote to end talking and move to a final showdown – and then vote against the legislation itself.

“While all the rumblings indicate that Reid is still short two to three votes, the majority leader is betting that moderate Senate Democrats who oppose this version of the public option will still vote to invoke cloture and then later vote against the Senate bill,” says Mr. Sekulow of the ACLJ in an e-mail .

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