Falling Short of Robust Public Option

SETTLING FOR GOOD ENOUGH.... You can't always get what you want, but if you try sometimes, you just might find, you get what you can pass in a House caucus with 51 Blue Dogs.

Speaker Nancy Pelosi will unveil a bill Thursday that falls short of the liberal vision of a public option -- and the liberals, so far and somewhat surprisingly, are going along with that.

After months of public hand-wringing and strident proclamations in support of the strongest possible government-run health coverage, liberal Democrats are bowing to the reality that party leaders don't have the votes.

So Pelosi will unveil a bill that creates a public option but one that would allow doctors and hospitals to negotiate rates with the government. Liberals wanted a bill tethered to Medicare rates.

House progressives put up a good fight. Indeed, it was their diligence on this specific provision that helped keep the public option alive when much of the establishment thought it was dead. But it became apparent this week that the votes weren't there for a robust public option, so House liberals are doing the right thing -- fight like hell, for as long as possible, and then go with the best bill you can pass.

This is not to say there's unanimity on the point. Arizona Rep. Raul Grijalva, one of the leaders of the Progressive Caucus, will continue to pursue a Medicare+5 amendment, but in general, most of those who worked for the robust public option are prepared to go with the bill as presented this morning by Speaker Pelosi. As Rep. Jim McGovern (D-Mass.) put it, "I would have preferred the other way, but we're looking at this bill holistically."

Part of this is fueled by the recognition that the Speaker's office did everything it could. "They did everything possible," said Rep. Jerry Nadler (D-N.Y.). "There's no sense pushing back for something that can't be done."

Also keep in mind, though, that the compromise to a public option with negotiated rates was reportedly made easier by Senate Majority Leader Harry Reid's decision to include a public option in the Senate reform bill. It signaled to House progressives that a final bill with public-private competition is more likely.

And what happens if the Senate has to scuttle the provision in light of Republican obstructionism and opposition from center-right members of the Democratic caucus? Time will tell.