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House liberals are keeping up their pressure on key Democrats including President Barack Obama and urging them to embrace a robust public insurance option. But the move comes as their own party leaders have been unable to find the votes for such a plan and have signaled they may take a more moderate approach.
The liberals say a reform plan with rates tied to Medicare instead of higher rates negotiated between the government and health care providers would save taxpayers $85 billion and would insure the most people.
And they are warning of a backlash next year at the polls if Democrats fail to deliver a robust public option that voters can afford.
But liberals are facing a behind-the-scenes effort by powerful doctor and hospital groups to nix the Medicare-linked public option and are having trouble getting the votes that they need with Obama staying on the sidelines.
Speaker Nancy Pelosi (D-Calif.) still hasnt pulled the plug on the Medicare rates option, although she set the stage last week for using the Senates negotiated rates, which the Congressional Budget Office says will cost $85 billion more. Pelosi said she could argue for either.
Pelosi continued to make calls over the weekend to individual Members to gauge their support and still has not made a decision on which way to go, according to a Democratic leadership aide. Leadership will resume their discussions Tuesday morning.
Rep. Raúl Grijalva (D-Ariz.), co-chairman of the Congressional Progressive Caucus, said there is a big difference between the two plans.
Without the robust plan, based on Medicare plus 5 [percent], there is no competition, there is no mechanism to drive down costs for insurance companies and you hurt coverage, Grijalva said.
Hes also not in love with the opt out, where individual states could choose not to participate.
My state would opt out immediately, he said, predicting that Texas and other conservative states would as well, despite having some of the highest rates of uninsured people in the country.
Without protections for those people who would be left behind, I would have a hard time, Grijalva said. The people that I represent would be out of the loop. While it has some convenience politically, what it means practically is you will be denying the public option to millions of Americans.
Rep. Lynn Woolsey (D-Calif.), co-chairwoman of the Progressive Caucus, praised Majority Leader Harry Reids (D-Nev.) push for a public option as a big step forward for the bill but said the House should build on that momentum.
Two weeks ago the Senate wasnt even predicted to have a public option, she said. If they can come that far in just a few weeks, I would certainly think that the House could go for a robust public option. This is what the public wants.
Woolsey, however, said she doesnt think many states will opt out.
The states that are going to opt out will have to go through their legislature, they will have to vote against covering all of their people and they will have to justify it, she said. I dont think many will do that.
Grijalva said there also is growing disappointment that Obama hasnt picked up the phone to help Pelosi advocate for a stronger public option.