A debate among House Democrats over whether to include a government-run health insurance option in the broader healthcare legislation now comes down to a counting exercise.
Answering a challenge laid down by Speaker Nancy Pelosi (D-Calif.), the Congressional Progressive Caucus and several other caucuses have started a “whip count” to demonstrate that a public option tied to Medicare rates plus 5 percent can pass the chamber.
It would take 39 Democrats to defeat a proposal if Republicans unite against it, as is expected. But Blue Dog opposition may be fading.
“The exercise is less of a policy discussion now. The exercise is on vote-counting,” said Rep. Earl Pomeroy (D-N.D.), a Blue Dog member.
Pelosi has said that a House bill must include a public option to compete with private insurance companies, and like her fellow liberals, she wants the version that ties reimbursement rates to Medicare. Blue Dog Democrats and other centrists are skeptical of any public plan, and especially don’t want one linked to Medicare.
Pelosi on Sept. 24 asked supporters of the public option tied to Medicare rates to prove the strength of support for that version — a challenge that set in motion the competing whip counts.
“She said ‘We need 218 votes,’” Progressive Caucus Co-Chairwoman Lynn Woolsey (D-Calif.) said. “ ‘Show me what your people can do.’ ”
It takes 218 votes to pass a bill in the House, but Progressive Caucus Co-Chairman Raúl Grijalva (D-Ariz.) said they don’t expect to find that many for the Medicare version. Instead, he said if an overwhelming number of House Democrats favor a public option, leaders should work to persuade enough members to pass it.
“The overwhelming majority of Democrats will be for Medicare-plus-five,” Grijalva said. “At some point, the whip operation has to kick in.”
The Progressive Caucus undertook a whip count of the four caucuses, which showed solid support. Then Pelosi’s office asked them to expand it to all Democrats, Woolsey said.
But even as she did that, Pelosi has signaled increased willingness to consider the Blue Dogs’ version of a public option rather than the liberals’ Medicare-based plan.
“The differences are not as great as some people have said,” Pelosi said.
But there is an $85 billion difference. Democratic leaders have circulated Congressional Budget Office numbers showing that the Medicare public option saves $85 billion more than the Blue Dog version, which would go a long way toward cutting the price tag by $200 billion, as President Barack ObamaBarack ObamaA closer look at McCain's proposed defense budget Scarborough: Missed opportunities in Trump’s inauguration speech Juan Williams: Ethics cloud hangs over Trump MORE has demanded.
Pelosi also sparked the Blue Dog survey when she suggested that as many as 20 Blue Dogs would support some version of a public option. Blue Dog leader Rep. Stephanie Herseth Sandlin (D-S.D.) told The Huffington Post that the survey had found about a dozen Blue Dog supporters of the public option. But she said among the rest, stopping the public plan was not their top priority.
While it seems certain that some form of public option will be included in the House version, the prospects are much less likely in the Senate.
The Senate Finance Committee on Tuesday rejected two public option proposals, one tied to Medicare, the other with the negotiated rates.
But Sen. Tom HarkinTom HarkinGrassley challenger no stranger to defying odds Clinton ally stands between Sanders and chairmanship dream Do candidates care about our health or just how much it costs? MORE (D-Iowa), the chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, bucked conventional wisdom this week when he said the Senate “comfortably” has a majority of votes to pass the public plan, and that he believes Democrats can muster 60 votes to break a filibuster.
But that idea hasn’t caught on among House liberals. They say they realize that even if they pass their version of a public plan, it will probably be changed in negotiations with the Senate. Woolsey said the Senate committee vote showed the need to strengthen their hand for those negotiations.
“It proves even more that we have to be strong when it comes out of the House,” Woolsey said.