Essentially, a public option is a a public option is a government government-sponsored insurance plan, similar to Medicare, that would compete with private insurers in hopes of driving down the cost of premiums. Even though the plan advanced by Senate Majority Leader Harry Reid (D-Nev.) allows states to opt-out of the plan, a handful of Democrats still oppose the bill.
We've seen this scene before: The Obama administration, obsessed over gaining Republican support for its stimulus plan, made sure that the concerns of Maine Senator Olympia Snowe were addressed before pushing the legislation through Congress. Now, we're having a replay. The difference this time, however, is that less progressive Democrats seem to be in the driver's seat.
This became clear when a procedural vote was held Saturday night to allow the bill to reach the Senate floor for debate and amendments. Senators Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, Democrats from two of the poorest states in the nation, held out until the last minute before siding with their party.
On a strict party-line vote, Democrats prevailed 60-39. In addition to the two wavering lawmakers, Senators Ben Nelson of Nebraska and Joseph Lieberman, an independent from Connecticut who usually caucuses with Democrats, stated that although they went along with the procedural vote, neither would support a health reform bill that includes the public option. Two other Democrats, Mark Pryor of Arkansas and Evan Bayh of Indiana, may also balk.
As Senate Majority Leader Reid tries to garner support for final passage, he and other leaders are huddling with the wayward Democrats and Maine's two senators in hopes of fashioning a compromise that will win them over.
The one favored by Olympia Snowe features a trigger mechanism that would be activated when private insurers fail to provide affordable choices.
Like President Obama - who has vacillated from calling the public option essential to health care reform and later dismissing it as a "slither" of a larger process - Senator Dick Durbin, the assistant majority leader, is apparently willing to capitulate to the vocal minority in his party.
In an appearance on "Meet the Press," he said, "There are many variations on the theme. We are open because we want to pass this bill."
But at what cost?
Almost overlooked in the debate is that most Americans, upset with rising health premiums and mounting restrictions, favor a public option.
A recent USA/Today/Gallup poll found that 50 percent of the public favors a public option and 46 percent oppose it. A CNN poll found even stronger support, with 61 percent in favor of an insurance option administered by the federal government and 38 percent opposed.
Although moderates and centrists are at the center of this debate, progressives are finally pushing back, letting Reid and the Obama administration know that their support is not automatic.
"I don't want four Democratic senators dictating to the other 56 of us and to the country, when the public option has this much support, that it's not going to be in it," Senator Sherrod Brown (D-Ohio) said Sunday on CNN's "State of the Union."
Senator Roland Burris of Illinois and Bernie Sanders, an independent from Vermont, said they will not vote for any bill without the public option.
"The overwhelming majority of Americans want to be able to choose between a strong public option and a private insurance plan," Sanders said. "Without that competition, there is very little in this bill that would keep health insurance premiums from escalating rapidly. This legislation cannot simply be a huge subsidy to private insurance companies that will get millions of new customers and be able to raise their rates as high as they want."
The nonpartisan Congressional Budget Office predicts that because the public option will be restricted to those who are not covered by their company's insurance plan, only 3 to 4 million people will participate in the plan. And because the pool being insured is likely to have a higher percentage of sicker people, the premiums might actually be higher than those charged by private companies.
Some health care reform advocates don't feel the legislation goes far enough, arguing that it's not true health reform if states have the option of rejecting coverage for their residents.
After the Senate vote Saturday, Harry Reid said, "We can only see the finish line. We have not yet crossed it."
If Democrats end up crossing the finish line without a robust public option, it will be a Pyrrhic victory.
George E. Curry, former editor-in-chief of Emerge magazine and the NNPA News Service, is a keynote speaker, moderator, and media coach. He can be reached through his Web site, www.georgecurry.com You can also follow him at www.twitter.com/currygeorge.
