Pelosi to Go With Not-So-Robust Public Option

Posted by John Nichols, The Nation at 10:35 PM on October 28, 2009.

The public option was always a compromise for serious supporters of health-care reform, who -- like Barack Obama when he was running for the Senate in 2003 -- knew that a single-payer "Medicare for All" system was what America needed to provide health care to everyone while controlling costs.

But, in the reform legislation that will be debuted Thursday by House Speaker Nancy Pelosi, the compromise will be even more compromised.

According to The New York Times:

Under pressure from moderate-to-conservative members of the House Democratic caucus, Speaker Nancy Pelosi has decided to propose a government-run insurance plan that would negotiate rates with doctors and hospitals, rather than using prices set by the government, aides said Wednesday.

Ms. Pelosi said the public plan, which she prefers to call a "consumer option," would compete with private insurers. But the speaker was apparently unable to muster the votes needed for the "robust" liberal version of a public plan, which she has repeatedly said would save more money for consumers and the government.

Translation: The "public option" Pelosi and her team will not make payments based on Medicare rates. It will, instead, be forced to negotiate rates with doctors and hospitals, as private insurers do. That weakens the flexibility and muscle of the public option.

Pelosi's plan also drops a number of provisions that had been advanced at the committee level to promote consideration of "Medicare for All" models and to allow states to experiment with single-payer plans.

Progressives were disappointed, to say the least, as they were counting on the House to advance a strong alternative to the Senate Democratic leadership's very weak public option proposal -- which would allow states to opt out of the plan.

Congressional Progressive Caucus co-chair Lynn Woolsey, D-California, said she and her allies would continue to battle to muscle-up the public option.

"It's not even the fourth quarter,'' said Woolsey, who noted the public option had only recently been dismissed as dead by many pundits. "We will be insisting on (the option) being as strong as it possibly can be.''

Woolsey and other progressive Democrats are set to meet with President Obama Thursday.

"He needs to hear from us that he needs to support the public option,'' Woolsey told the Los Angeles Times. "He's not saying it loud enough. We want to make sure he lets the Senate know he wants a public option in the bill.'

John Nichols writes about politics for The Nation magazine as its Washington correspondent.