Health reform advances, with a ‘public option’

What happened

Senate Majority Leader Harry Reid moved to include a “public option” in health reform legislation this week, aligning the Senate bill with a key goal of liberal Democrats. The Senate legislation will now include a government-run insurance plan to compete with private insurers, along with a provision allowing states to voluntarily “opt out” of the public plan. “I believe there’s a strong consensus to move forward in this direction,” said Reid, who earlier had voiced misgivings about the public option. He vowed to bring legislation to the Senate floor within weeks. But it’s unclear if Reid can retain a public option and still get the 60 votes necessary to overcome an all-but-certain Republican filibuster. Sen. Olympia Snowe, the sole Republican to back reform thus far, said she would oppose the bill, and some moderate Democrats also voiced skepticism. Independent Joe Lieberman of Connecticut said he would join a Republican filibuster if Reid’s public option is in the final bill.

In the House, Democrats were on the verge of finalizing their own version of reform and said they planned to bring it to the floor next week. The House bill is expected to extend coverage to 35 million people at a cost of $900 billion over 10 years. House Speaker Nancy Pelosi has been working to gain support from moderate Democrats for her own public plan. Republican Senate leader Mitch McConnell said Democratic reform legislation would be disastrous with or without a public option. “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,” he said.

Subscribe to The Week

Escape your echo chamber. Get the facts behind the news, plus analysis from multiple perspectives.

SUBSCRIBE & SAVE

Sign up for The Week's Free Newsletters

From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.

From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.

Sign up

What the editorials said

“Bravo, Joe,” said The Wall Street Journal. Earning his stripes as a true independent, Sen. Lieberman has decided to “stand up to the Washington rush to rearrange 18 percent of the U.S. economy.” Let’s hope that other independent-minded legislators won’t be fooled by Reid’s opt-out provision, a “ruse designed to give the impression of political and consumer choice.” In practice, a government insurance plan would “rig the rules in its favor,” eventually creating not a public option, but the only option.

That’s the insurance industry line, but it may not be for long, said The Philadelphia Inquirer. Some lawmakers are suggesting it might be time to repeal the industry’s lucrative exemption from antitrust laws. The threat to “inject more price competition” into the health-care market might suddenly make the public option look like a compromise the industry can live with.

What the columnists said

“The smart-aleck take” is that Reid included a public option to appease liberals, knowing it would be stripped out of final legislation, said Jonathan Cohn in The New Republic Online. But that may be wishful thinking by the anti-reform crowd. In fact, Pelosi and Reid both happen to think the public option represents good policy and “believe they are close to getting the votes to support it.” After all, the public option had been pronounced dead—why revive it if you can’t pass it?

This “Lazarus act” will flop, said Rich Lowry in National Review Online. Eventually, Democrats will have to settle on a final bill, and “they won’t be able to sweep its weaknesses under the rug.” Whatever form it takes, “it will raise taxes, cut Medicare, and—in all likelihood—increase insurance premiums.” Here’s what it won’t do: Reduce health-care costs. When these facts sink in, public support for reform, which has already been fading, can be expected to plummet, and rank-and-file Democrats will be asking themselves what President Obama, Reid, and Pelosi have gotten them into.

That all depends on what happens “after reform passes,” said Paul Krugman in The New York Times. And if the Massachusetts experience is any guide, it will do a lot of good. Like the federal legislation, the Massachusetts reform, enacted in 2006, “relies on a combination of regulation and subsidies to chivy a mostly private system into providing near-universal coverage.” The system there is far from perfect—costs have not been restrained—but it enjoys “broad public support” while improving the lives of millions. Massachusetts may not be “representative of America as a whole,” but it’s close enough. “This thing is going to work.”