Public option down, but not defeated?

Progressives say they aren't worried by the defeat of two key healthcare amendments


Mike Madden
September 30, 2009 12:14AM (UTC)

Socialism threatened to overwhelm the nation Tuesday in the marble corridors of the Hart Senate Office Building. Fortunately, the Senate was ready to stop it.

At least, that's the spin you might expect out of Republicans after the Senate Finance Committee voted down two amendments to add a government-run public insurance option to healthcare reform proposals. The first, by West Virginia Democrat Jay Rockefeller, would have established a public option that paid hospitals and doctors Medicare rates plus 5 percent. It was defeated, 15-8. The second, by New York Democrat Chuck Schumer, would have set up a public plan that negotiated its rates with providers, just like private insurance firms do. It lost 13-10.

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Democrats split over the amendments, which doomed them, as the GOP voted unanimously against each. (Because Democrats hold 60 seats in the Senate, they also have a 13-10 majority on the panel.) But progressives were pleased to see a majority of Democrats on the panel supported both amendments -- which could mean some form of public option has a chance of making it into a final bill. All four other committees in the House and Senate that have passed reform legislation have included some kind of public option.

"We are right on track," said Jacki Schechner, spokeswoman for Health Care for America Now, a union-backed group pushing for reform that includes a public option. "Finance is the most conservative committee and clearly out of step with the rest of Congress and the American public. Eight votes on Rockefeller is good. Very."

Chairman Max Baucus, of Montana, voted against both amendments, saying the public option -- because it doesn't have the full support of all 60 Democrats -- would stand in the way of passing a healthcare bill. "The public option would help hold insurance companies' feet to the fire," Baucus said. "But my first job is to get this bill across the finish line."

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Democrats Kent Conrad of North Dakota and Blanche Lincoln of Arkansas voted against both amendments, as well. Florida Democrat Bill Nelson and Delaware Democrat Tom Carper both voted for Schumer's plan after voting against Rockefeller's.

Still, don't expect the GOP to let any form of public option into the bill without a fight; Republicans painted both amendments as nothing less than the beginning of the end of the free market in America.

"I think it is a slow walk toward government-controlled, single-payer healthcare," said Chuck Grassley, the Iowa Republican who Finance chairman Max Baucus courted in vain all summer. "If you support government bureaucrats, not doctors, making medical decisions, then you should vote for this amendment."

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As the committee debated the amendments for about six hours, Republicans resorted to more and more outlandish arguments against them. Nevada Republican John Ensign said the U.S. healthcare system is actually better than people think it is -- because certain types of bad health outcomes simply can't be compared to those in other countries. Namely, gun deaths, which add a lot to U.S. mortality stats every year. "We like our guns in the United States," he said.

Arizona's Jon Kyl, the second-ranking Senate Republican, said the public option was completely unnecessary because the insurance market works just fine: "It's a solution in search of a problem." Grassley accused the government of being a "predator," and then minutes later stood up for Medicare, which is, of course, a government-run healthcare program.

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Meanwhile, supporters tried to point out that the government plan would enroll a very small share of the public, and that it would be fully paid for, and that private insurance companies aren't exactly the most trustworthy corporate citizens in the country. None of that mattered.

"For my West Virginians, [a public option] makes sense," Rockefeller said. "They feel out in the cold. They feel helpless in front of their insurance companies ... The people are on the short end of the stick, and the insurance companies are making all the money."

Private insurers have lobbied furiously against any public option, but especially against the one like Rockefeller proposed, because they fear providers will mark up prices for private insurance to make up for a shortfall from government plans. So far, they've had a lot of help from the GOP. The liberal Center for American Progress released a study Tuesday showing at least 47 of the 534 amendments proposed by Finance Committee members would change the legislation to directly suit the insurance companies' wishes. All have come from Republicans.

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Still, the bottom line Tuesday was that the bill was still on track to move out of the committee. That would give Democratic leaders the chance to merge it with a more liberal version passed by the Senate Health, Education, Labor and Pensions Committee. Schumer, a key member of Senate leadership, sounded optimistic that some careful negotiations could still save a public plan. And Rockefeller was positively combative. "The public option is on the march," he said.


Mike Madden

Mike Madden is Salon's Washington correspondent. A complete listing of his articles is here. Follow him on Twitter here.

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