Liberal activists fret over public option for healthcare

Liberal activists are concerned that Congress will leave out what they see as the most important element of healthcare reform: a government-backed insurance program.

The so-called public option has dominated the political debate over healthcare reform on Capitol Hill and elsewhere. Though President Obama, House Democrats and many Democratic senators support the proposal, unanimous Republican opposition and resistance from centrist Democrats have got the left worried — and ready to fight.

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“Healthcare reform is the No. 1 priority for our members this year and a public option is a non-negotiable part of real healthcare reform,” said Nita Chaudhary, the campaign director at MoveOn.org Political Action.

“I’m very concerned that Congress is missing the boat here,” said Richard Kirsch, national campaign director of Health Care for America Now (HCAN), an umbrella group of labor unions and other liberal organizations.

With Democrats in the White House and in Congress already steeling themselves for a bloody political battle with Republicans and the prospects of facing fearsome campaigning against the public option by business and healthcare interests, pressure from the left wing could make for a long summer and autumn.

But to liberals who really want to scrap the private, for-profit healthcare market with a government-run, single-payer system, the public option already represents a huge concession and they are not willing to budge any further.

Liberal groups such as MoveOn.org and HCAN have been airing television ads targeting Democratic lawmakers such as Sens. Dianne Feinstein (Calif.), Mary Landrieu (La.) and Kay Hagan (N.C.), and Rep. Jim Cooper (Tenn.), for their stance on the public option.

Their efforts will not just focus on pressuring Democrats not committed to the public option, activists said. Liberal groups will closely scrutinize friendly lawmakers to gauge whether they are doing enough to carry their message that healthcare reform without a public option is inadequate.

“There are a number of folks who have been extraordinarily vocal,” said Chaudhary, who singled out Democratic Sens. Jay Rockefeller (W.Va.), Charles Schumer (N.Y.) and Sherrod Brown (Ohio.).

Lawmakers such as these must not let up, Chaudhary said. “Our members are looking to the champions to really go to the mat right now,” she said. “If they go to the mat, they will see the people rise up and stand with them and fight with them.”

Obama has continually defended his proposal for a public option by saying it's essential to promoting competition among private insurers and driving down healthcare costs, and has rebutted claims that a government-run entity would squeeze private companies out of the market.

But Obama has also said he will not draw “lines in the sand” on any aspect of healthcare reform, leading some to conclude that he would be willing to support a bill without a public option. For liberals, this is anxiety-inducing.

“Do I wish he was more firm about it?” Chaudhary said. “Certainly.”

Liberal proponents of the public option are not short of allies on Capitol Hill.

The draft healthcare reform bill introduced this month by House Democrats includes a public option. In the Senate, the Health, Education, Labor and Pensions Committee is developing legislation that will include a strong public option, according to Sen. Chris Dodd (D-Conn.), who is overseeing the panel in the absence of ailing Chairman Sen. Edward Kennedy (D-Mass.).

But the Senate Finance Committee, where much of the activity and attention on healthcare reform has been centered, appears unlikely to move legislation with a public option.

“We’re very pleased with what they’ve done in the House,” Kirsch said. “In the Senate, obviously, things are much more halting.”

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Though he has predicted in the past that any healthcare reform bill that eventually passes the Senate would feature a public option, Committee Chairman Max Baucus (D-Mont.) has apparently set aside the proposal in an effort to win Republican support. Instead, committee members are weighing a proposal by Sen. Kent Conrad (D-N.D.) to set up not-for-profit healthcare cooperatives as an alternative to traditional insurance companies.

More than anything else, this has got the left up in arms.

“We would prefer that the debate around the public plan in the Finance Committee was starting out in a stronger place,” said Chaudhary, who said MoveOn.org will be “making sure that every single member of the entire Senate, and particularly the Finance Committee, is hearing from our members every single day.”

“We’re going to do everything we can to make sure that the Senate [bill] … is not the only marker that’s laid down,” Kirsch said. Supporters of the public option do not want to see a “minority of Democrats blocking what most Democrats want to do,” he said. “That is not acceptable.”

Though some on the left are confident that the efforts of Obama, House Democrats and liberal senators will prevail, others are less sure.

“It’s — at least right now — about a 50-50 chance” that healthcare reform will include no public option or a weak one, said Sidney Wolfe, director of Public Citizen’s Health Research Group and a staunch proponent of a single-payer system that excludes private health insurance.

To the sizeable contingent of liberals who continue to argue for a single-payer system, like Wolfe, the entire process of crafting a healthcare reform bill — public option or no — is an “exercise in futility.”

“Something is likely to pass … but it’s not going to work,” Wolfe said. “It’s not going to work at all.”