Without a Public Option, Is It Really Reform?

(Dec. 15) -- The holiday season rush is on in Washington. President Barack Obama is pushing the Senate to pass a health care reform bill by Christmas. Now it looks like the legislation won't include everything on his wish list.

Senate Democrats have decided to drop a proposal to let people buy into Medicare starting at age 55. The concession is intended to win over Joe Lieberman, the Connecticut independent who caucuses with Senate Democrats but has been giving them fits with his threats to filibuster anything resembling a "public option" for health insurance. The Medicare expansion was an alternative to a government-run coverage option that would compete with private insurers.

Lieberman -- who's getting blasted from the left because he supported Medicare expansion until recently -- now says he's ready to vote for a health care reform bill as long as it has no public option or Medicare buy-in. Leading Democratic senators sound willing to go along for the sake of passing something that can be called health care reform.

"There's enough good in this bill" even without the Medicare buy-in, Iowa's Tom Harkin said Monday.

"We're not going to get all that we want, but we're going to get so much more than we have," added West Virginia's Jay Rockefeller, who authored the original public option plan.
Satisfying Lieberman is part of Senate Majority Leader Harry Reid's attempt to assemble a filibuster-proof 60-vote majority needed to pass a bill. But there is another option for supporters of a public option: a maneuver known as budget reconciliation, which Democrats could use to push through legislation with just 50 votes.

Some liberals who see trading away the public option as a betrayal are demanding reconciliation. Such a move would tip the bill toward "expansion of the public sector rather than a restructuring of the private sector," which would alienate moderates and conservatives, according to The Washington Post's Ezra Klein. "You lose too much in reconciliation, and gain too little," he said.

Instead of resorting to strong-arm tactics now -- which Reid and Obama reportedly oppose in the name of bipartisanship -- Democrats could pass a bill and then use reconciliation later to add what they want, noted The Atlantic's Marc Ambinder.

But a bill without some form of public option could have consequences at the polls for Democrats. One-third of Democrats would be less likely to vote next year if Congress fails to pass a public option, according to a new Research 2000 survey commissioned by two liberal groups.

So can any legislation that doesn't include the Medicare buy-in really be called a reform bill? Here's Rockefeller's view: "The answer to that is yes. Is it perfect reform? The answer to that is no. But does it help the people where I come from? Yes."