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Renewed Public Option Push in Senate Tests Democratic Unity

October 27, 2009 at 12:00 AM EDT
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The push by the Senate Majority Leader Harry Reid to include a public option into a health care reform bill drew sharply different reactions on Capitol Hill on Tuesday, with liberals voicing support, moderates airing concerns, and Republicans promising a filibuster.
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JIM LEHRER: Fault lines spread through the U.S. Senate today over including a public option in health care reform. The decision by Majority Leader Harry Reid set off a struggle for votes to pass or to block the bill.

Betty Ann Bowser begins our lead story report.

BETTY ANN BOWSER: The Reid announcement dominated the Senate floor from the start this morning.

Republican Charles Grassley of Iowa and other opponents of any government-run plan wasted no time.

SEN. CHARLES GRASSLEY, R-Iowa: Let’s hope the Democratic leadership and the White House aren’t willing to push a bill that forces 200 million people to pay higher premiums unless they enroll in a new government entitlement insurance program.

But that is certainly what it sounds like. Whatever the motive may be, the facts are undeniable. Health insurance premiums will increase for every individual and small business as early as next year.

BETTY ANN BOWSER: Supporters of a public option, like Illinois Democrat Dick Durbin, argued it would make insurance companies improve coverage, cut costs. And, he noted, there’s an opt-out provision for states.

SEN. RICHARD DURBIN, D-Ill.: Individual states can decide whether they want to have a public option available to the people who live there.

If the state of Iowa, whose senator came to the floor this morning, decided they don’t like a public option, they can pass a law in the Iowa legislature, sign it by the governor. They’re opting out of public option, their choice. Each state can make their choice. That’s what opt-out is all about.

BETTY ANN BOWSER: Even to move a bill to the floor, majority leader Reid will need 60 votes. And, this afternoon, it was unclear how close he is to that number. Several moderate Democrats have warned openly they will oppose any bill that includes a public option.

One of those Democrats, Louisiana’s Mary Landrieu, said in a statement she remains “very skeptical.” And independent Democrat Joe Lieberman said he would vote with Republicans, if necessary, to stop a public option from being part of any health care reform bill.

Senator Olympia Snowe of Maine, the lone Republican to vote for the Senate Finance Committee bill, minus a public option, said today she’s deeply disappointed with the Reid decision.

SEN. OLYMPIA SNOWE, R-Maine: I think it’s important to improve the legislation as it moves through the process, even though I cannot support the public option proposal that the leader has offered.

BETTY ANN BOWSER: Snowe said she expressed her concern when President Obama telephoned her over the weekend.

SEN. OLYMPIA SNOWE: I said I would have just — that I would be disappointed, that I thought that there was a way of building the bipartisan support for this initiative. And that’s why I had proposed the trigger initially, which included the public option as a fallback mechanism, rather than creating it initially in the program at the forefront.

BETTY ANN BOWSER: Maine’s other senator, Republican Susan Collins, said, Reid has made a real mistake.

SEN. SUSAN COLLINS, R-Maine: I realize, no matter what decision Senator Reid made on having a Washington-run public plan, that he was probably going to lose votes.

I think that his decision, however, forecloses any attempt to get Republican votes. And I think that’s really unfortunate, because we do need to pass a health care reform bill. And I believe that there are members on both sides of the aisle that are committed to that goal.

BETTY ANN BOWSER: The majority leader defended his decision on the public option today, and he rejected charges he catered to his party’s left wing, at the expense of bipartisanship.

SEN. HARRY REID, D-Nev.: Our public option isn’t a left proposal or a right proposal. This is a consensus, a compromise, that represents months of hard work and debate that will benefit all Americans. It’s an important way to ensure competition, to level the playing field for patients. It protects consumers and keep the insurance companies honest.

BETTY ANN BOWSER: Reid drew support from Democratic liberals, who called his action courageous.

West Virginia Senator Jay Rockefeller:

SEN. JAY ROCKEFELLER, D-W.Va.: I think it was a smart thing to do. And I can’t exactly prove it to you, but I know, in my soul, in my gut, that the momentum is moving in our direction, that we are unified in our purpose, the issue is huge, the American people care, and that we’re going to end up with a bill. And that makes me feel good.

BETTY ANN BOWSER: The chairman of the Finance Committee, Max Baucus of Montana, acknowledged there’s a fight ahead for 60 votes. But he said supporters have the wind at their backs.

SEN. MAX BAUCUS, D-Mont.: This is really a torturous route. This is not easy. But underlying it all is the sense of inevitability, the sense that, yes, we are going to pass health care reform, and it’s going to lower costs, provide better health insurance coverage, and cover — and reform the health insurance market. It’s going to happen. And that’s what’s really underlying momentum that’s starting to grow here.

BETTY ANN BOWSER: Democratic leaders on the House side already plan to include a public option in their bill. Majority Leader Steny Hoyer said today they could have details of their bill later this week.

Reid's gamble

Norman Ornstein
American Enterprise Institute
It's not a surprise that a senator from Nevada would gamble -- that he could get the 60 votes, because, as Betty Ann said, it's really a 60-vote hurdle. And they have precisely 60 Democrats and independents who caucus with them.

JIM LEHRER: Ray Suarez has more about the politics surrounding these latest moves.

RAY SUAREZ: And, for that, we turn to Norman Ornstein, congressional expert and resident scholar at the American Enterprise Institute.

And, Norm, you heard senators pro and con. But did Harry Reid's change in approach give the public option a chance today that it didn't have even a few days ago?

NORMAN ORNSTEIN, American Enterprise Institute: This has really emerged quite rapidly, Ray. We never expected that the Senate would go in this direction.

We thought the House would, and then they would try to work out their differences when they got to a conference committee. I think a combination of things happened here. One part of it is that Senator Reid is facing some serious pressure back home in Nevada. He's up for reelection. He's maybe the most endangered incumbent and has been taking a beating from his own left, including the labor movement back there, which is important.

Another part of it is that this has really been something where the genesis has come from other senators trying to find a way out of a dilemma between the moderates and the liberals in the caucus.

Tom Carper, a moderate Democrat from Delaware, and Chuck Schumer, a liberal from New York, began to talk about an option. Carper suggested letting the states opt in to some kind of a public option. And Schumer turned it around and said, let's just have one that's a national one and then let them opt out.

When that got some traction with at least a few of the moderates, Reid decided to go ahead and gamble here -- maybe it's not a surprise that a senator from Nevada would gamble -- that he could get the 60 votes, because, as Betty Ann said, it's really a 60-vote hurdle. And they have precisely 60 Democrats and independents who caucus with them.

Reaching 60 votes

Norman Ornstein
American Enterprise Institute
You may not be able to come up with any votes to supplant Lieberman or some of the other moderate to conservative Democrats who are uneasy about this.

RAY SUAREZ: Well, we saw Olympia Snowe, Republican of Maine, basically take herself out of the calculation, even after being the only Republican who has voted in favor of health care reform in any version so far.

Joe Lieberman, the independent who caucuses with the Democrats, says he will filibuster, rather than let a public option get to the floor. Can Reid get to 60? Are there enough noses to be counted?

NORMAN ORNSTEIN: Right now, he does not have those 60.

An interesting thing about Lieberman, who has said that, in the final analysis, he would join a filibuster, also said that he would let the bill come to the floor. There are two occasions in which you can block a bill or filibuster effectively.

One is a motion to proceed. And, on that one, which really is a courtesy for the leader, I think Reid will be able to bring this bill to the floor. It will be debated. It will be amended. The questions now become whether, when you bring it to the floor and go to amend it, there's a calculus along the way, before they get blocked, to change this, to perhaps bring a few more votes.

If not, then you can always, if you can't break the filibuster, go back to the drawing board and make an adjustment. The White House was not real happy, I think, that they have frozen Olympia Snowe out of this process.

And one of the problems that they have with some of the moderate Democrats going along with this, somebody like Blanche Lincoln of Arkansas, who is up for reelection and in a very tough race, who wanted to be able at least to say, if she supported a bill, that it was bipartisan.

Lose Olympia Snowe, it's all partisan. And you may not be able to come up with any votes to supplant Lieberman or some of the other moderate to conservative Democrats who are uneasy about this.

RAY SUAREZ: Where has the White House been in all of this? Press spokesman Robert Gibbs today said that Barack Obama, the president, was happy with the way things were proceeding, but it sounded like, last week, they were ready to do without a public option altogether.

NORMAN ORNSTEIN: I think the White House has sent the signal that they want a health care bill, and the public option is not a be-all or end-all element of that bill.

The White House preferred Olympia Snowe's alternative of a trigger, where, if, in a state or a region, 95 percent of people do not have access to a reasonably affordable health care plan, then you trigger a public option.

The -- Harry Reid just basically decided to go for broke, to go for something more than that at this point. And that, for now, keeps Olympia Snowe out of the game. The White House would rather have a broader coalition, and doesn't believe that this can get the 60 votes.

They may be proven right in the end, but, of course, they're going to rally behind their majority leader and the decision that he's made in the Senate.

Polls warm to public option

Norman Ornstein
American Enterprise Institute
One of the reasons that the public option has come into more favor with some of the moderates in the House and the Senate among the Democrats is, it appears that it can bend the cost curve, that it does in fact save some money.

RAY SUAREZ: Public opinion researchers say the tide has been shifting over the last several weeks, and now is not spectacularly, but solidly in favor of a public option.

Does that inform what the Senate does at this point?

NORMAN ORNSTEIN: Yes. And I think there are two things to consider here as well, Ray.

We have an -- for example, a new poll out today, an NBC/Wall Street Journal poll that shows quite a significant shift in a question that actually is a reasonable one: Would you favor having a government-run health care plan as an option against private insurers? And it's gone to 48 percent to 42 percent in favor, where those numbers were just about reversed a couple of months ago.

The other element here is remember that we don't have the specifics down yet. Harry Reid has sent this and other options to the Congressional Budget Office, which, as we have discussed many times before, is the arbiter here about whether it reduces costs enough to pass fiscal muster.

One of the reasons that the public option has come into more favor with some of the moderates in the House and the Senate among the Democrats is, it appears that it can bend the cost curve, that it does in fact save some money.

If the Congressional Budget Office says that this plan saves a considerable sum of money, you may get a different calculus on the Senate floor, because some of that money might be able to be used to buy additional support by, for example, easing the pain of middle-class people as they try to afford this kind of insurance.

But this plan, which, in the Senate, has the public plan required to negotiate with providers, rather than just give them the Medicare rates, which means it will probably be a little bit more costly, may not save quite as much money. And that may be a bigger problem for Reid when he finally gets it to the floor.

RAY SUAREZ: Norm Ornstein, thanks for joining us.

NORMAN ORNSTEIN: Thank you, Ray.