Whip count shows Democrats lack votes on 'robust' public option for healthcare

Speaker Nancy Pelosi’s (D-Calif.) leftward push on the public option in healthcare reform ran into turbulence Thursday when a survey of her caucus showed she needs more votes to pass such a bill.

The survey ordered by Pelosi turned up 46 Democrats who said they would vote against the so-called “robust” public option, according to a Democratic lawmaker who spoke on the condition of anonymity.

If Republicans unite against the health bill, as they’re expected to do, 39 Democratic defectors would block it from getting the 218 votes needed to pass.

The Democratic lawmaker, who is in favor of the public option, said leaders are considering pulling the liberal public option from the bill and looking at other alternatives, such as a public option detached from Medicare coupled with an expansion of Medicaid, the healthcare program for the poor. That approach, called “negotiated rates,” is supported more by House centrists, including many Blue Dog Democrats.

A House leadership source said the decisions Thursday were “in flux.”

Meanwhile, The New York Times on Thursday reported that Senate Majority Leader Harry Reid (D-Nev.) is leaning toward including a public option in the healthcare reform bill he takes to the Senate floor.

After a meeting at the White House with President Barack Obama on Thursday, Reid said, “We had a good meeting, but no decisions were made.”

While Pelosi apparently needs to persuade more of her caucus to get behind her yet-to-be-released bill, she has a proven record of getting controversial bills to 218 votes. Earlier this year, Pelosi defied many pundits by passing a climate change bill, 219-212.

Pelosi on Thursday reaffirmed her support for some sort of government-run plan to compete with private insurance companies. But she did not insist on the “Medicare plus 5 percent” plan her fellow liberals are demanding. That plan ties provider reimbursement rates to Medicare, adding 5 percent.

“We will have a bill that will go to the floor, and it will have a public option in it,” Pelosi told reporters. “The question is, what form does that take?”

But she also said that the “negotiated rates” option, in which plan administrators negotiate reimbursement individually with providers, pushes costs higher than the $900 billion threshold set by President Barack Obama.

“The negotiated rates, which has some support in our caucus, is over $900 billion,” Pelosi told reporters.

Supporters of the more liberal option said their plan was still very much alive, and questioned the whip count.

Rep. Anthony Weiner (D-N.Y.) said many of the lawmakers who said they’re against the robust option want something else.

“The closer we get to 218, the more leverage there is for someone to raise concerns,” Weiner said. “There are definitely some things we need to address.”

Other lawmakers complained that some of the vote counters on the whip team were themselves against the Medicare-based public option. Some said members of the Congressional Hispanic Caucus raised concerns about how legal immigrants would be covered. But Hispanic Caucus Chairwoman Nydia Velázquez (D-N.Y.) told The Hill her group supports Pelosi’s plan.

Opponents of the liberal approach have hinted that they could block it. Rep. Jim Matheson (D-Utah), a Blue Dog leader, said Wednesday that there are only 12 Blue Dogs who support the Medicare-based plan, suggesting that the other 40 oppose it. But he added that Blue Dogs hadn’t done their own vote count recently.

Other “no” votes could come from the left, because some members believe the final bill will fall well short of a single-payer approach.

And though the public option has dominated the debate among House Democrats, there are lawmakers threatening to vote against the bill for other reasons. Rep. Jason Altmire (D-Pa.) said he’d vote for the robust public option, but would vote against the bill because of the income surtax it would impose on the wealthy.

Rep. Bart Stupak (D-Mich.) has said he thinks there are many anti-abortion rights Democrats who are ready to block the bill because of their belief it would subsidize abortion. He said Thursday that he has negotiated with leadership, but they haven’t been able to come up with legislative language that satisfies both sides of the abortion debate.

Jared Allen contributed to this article.