Leading Blue Dog suggests opening Medicare to uninsured

First he was for it. Then he was against it. Now Rep. Mike Ross is back on board with a government-run healthcare plan. Sort of.

Ross (D-Ark.), who had emerged as a leader among centrist Blue Dog Democrats opposing the public health insurance option, has suggested something his colleagues consider even more drastic – opening Medicare to those under 65 without insurance.

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He made the suggestion in meetings with House Democratic leaders and brought the idea to the closed-door House Democratic Caucus meeting Thursday.

"I — speaking only on behalf of myself — suggested one possible idea could be that instead of creating an entirely new government bureaucracy to administer a public option, Medicare could be offered as a choice," Ross said in a statement to The Hill.

Medicare would then compete with private insurers across the age spectrum. It would be open to those who don't have insurance through their employers, the same people who would be covered by the public option already under discussion.

But Ross said he would want reimbursement for providers to be at a "much greater rate" than it is now. Medicare reimbursement rates have been a sore point for rural lawmakers who feel that Medicare shortchanges their hospitals.

His statement went on to say that he does "not support a government-run public option" and he does "not endorse this idea" of opening up Medicare. He said he is looking for solutions in the healthcare debate.

The hostility directed at Medicare by rural, centrist, Blue Dog lawmakers is what makes Ross's Medicare suggestion so surprising. He is all three – a rural, centrist Blue Dog. Indeed he is a former co-chairman of the coalition, and is the leader of the Blue Dogs' Health Care Task Force.

Ross's fellow Blue Dogs distanced themselves from the Medicare idea, but handled the question gingerly.

"There has never been a discussion about that among the Blue Dogs," said Rep. Jim Matheson (D-Utah), the Blue Dogs' new co-chairman for communications.

And a leading liberal in the healthcare debate suggested the idea might be too liberal for most Democratic lawmakers, because it sounds like a "single-payer" concept, which Democratic leaders have rejected.

"The idea of a public option was to provide competition, but opening up Medicare would be the precursor to single-payer," said House Energy and Commerce Chairman Henry Waxman (D-Calif.). "This may be an issue of semantics, but it would be very difficult to implement."

But Waxman and others said the idea arose from many voters being spooked that a public option would be a "government takeover." Medicare, however, is a popular program that people know and like.

"Why have this huge, divisive fight trying to pass a public option when you could pretty much do the same thing if you just added Medicare to the list of options in the exchange?" said a Democratic aide. "And the fight would be way less controversial."

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Still, Ross has been seen as a skeptic or opponent of the public option since he led a group of seven centrist Blue Dogs who blocked consideration of the health bill in the Energy and Commerce Committee, in part because of their dislike of a public option.

Talks with Chairman Henry Waxman (D-Calif.) produced the "negotiated rates" compromise. Ross signed on with three other Blue Dogs, and the committee voted on the bill in late July.

But Ross returned from the stormy August recess and reversed his position, saying he could not support any kind of public option.

Since then, Ross has taken heat from liberals who believe he's selling out to the healthcare industry, and conservatives who say he caved in to Waxman and Pelosi.

His prominence also brought scrutiny to his 2007 sale of his family pharmacy. And the watchdog group Citizens for Responsibility and Ethics in Washington has requested a Justice Department investigation into the sale after news reports indicated that a large healthcare company may have paid him more than it is worth.

Some colleagues suggested that the political heat may have pushed Ross to change position. But Ross said he hasn't changed his position, he is just proposing alternatives to keep the process moving.

"Let me be clear," Ross said in his statement, "I do not endorse this idea, as it was just one of many ideas we, as legislators, have brought up and discussed in the numerous, ongoing negotiations and discussions we have had on healthcare reform over the past several months."

This story was updated at 5:40 p.m.