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Public Option Rejected Twice - What Happens Next?

September 29, 2009 - by Donny Shaw

The Senate Finance Committee’s health care bill officially will not include a public option. Today, the Committee rejected two separate amendments to add a public option plan to the bill. The Rockefeller public option amendment, which is similar to the “robust” version contained in the House bill, failed on a vote of 15-8. The toned-down Schumer version, which is not tied to Medicare reimbursement rates, was rejected as well. The Finance Committee bill’s chief Democratic architects – Sen. Max Baucus [D, MT] and Sen. Kent Conrad [D, ND] – secured the failure of the Schumer amendment by voting against it.

Sen. Conrad, the main proponent of the co-op plan, voted “no” on Schumer’s amendment even after stating that it was “moving much closer to a package that can get 60 votes on the floor.”

As it stands, the Senate Finance Committee health care bill wouldn’t get the 60 votes needed on the Senate floor to break a Republican filibuster. No Republicans support it, and Sen. Jay Rockefeller [D, WV] has said that he and four to six other Finance Committee Democrats would oppose it unless big changes are made in the amendment process. We’re in the middle of the second week of the mark-up now, and so far the bill hasn’t changed at all.

The only big amendment left with a chance of passing is Snowe’s “trigger.” Basically, her idea is to add a mechanism, on top of Baucus’ co-op plan, that would trigger the creation of a public option in states where insurance coverage isn’t expanded enough once the bill’s other reforms take effect. If it passes, it will be a signal to Democratic leaders that there is a grand compromise to be struck around this “trigger” idea. It will become the basis for the health care bill that finally comes to the Senate floor.

But if it doesn’t, Senate Democrats will likely push forward with a Democrats-only bill, containing a public option, that they can pass with a tactic that lets them block a filibutser, known as budget reconciliation. As Schumer noted today, right now the aren’t 60 votes on the Senate floor to overcome a Republican filibuster of a bill that includes a public option.

This creates an incentive for the six or so Democrats on the Senate Finance Committee who oppose their committee’s public option-less bill to vote against Snowe’s trigger. If the Snowe amendment fails, the whole Senate Finance Committee bill fails because it stays unchanged from what it was initially – a rough “compromise” that lost too much support off both the left and the right to actually be viable.

The only one choice remaining for Senate Democrats to pass health care reform at that point will be budget reconciliation.

Conveniently for the progressives, including the six or so on the Senate Finance Committee, the rules governing budget reconciliation provide an incentive for the bill to be as progressive as possible. Under the budget reconciliation process’ “Byrd Rule,” only legislation that has a direct effect on the budget is eligible to pass without being susceptible to a filibuster. The ruling on this would be made by the Senate Parliamentarian, and it’s not clear how he would rule on health care reform. This has been written about over and over on this blog and many others by now. It basically means that a “robust” public option will help make health care reform eligible for budget reconciliation. The Congressional Budget Office has estimated that including a public option tied to Medicare reimbursments rates (a.k.a. a “robust” one) in the bill would save the government $125 billion over 10 years. It’s something that experts have concluded over and over again will work. And if they go through budget reconciliation, the Democratic leadership’s goal will switch from assembling a bill designed to pass with the support of moderates, to assembling a bill designed to work well and drive down costs. It’s a bit of a gamble, but a “robust” public option improves the odds significantly.

So, the progressives in the Senate face a historic decision it their vote on the Snowe amendment when it comes up this week. Continue letting the bill’s provisions drift to the right until there is something, weak as it may be, that they know can pass, or sink the compromise and put all cards on the table for a bill that they know will be strong, but can’t be positive will pass.

As for who these six or progressives in the Finance Committee that Rockefeller refers to are, it’s safe to assume that they are among those who supported the Rockefeller amendment today. They were Rockefeller, Schumer, Bingaman, Wyden, Stabenow, Menendez, Kerry and Cantwell.

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