Public option still plagues Dems

The most controversial component of healthcare reform promises to vex Democrats the rest of the year.

The spotlight this week will continue on the Senate Finance Committee, where amendments to add the public insurance option will be offered by Democratic Sens. Jay Rockefeller (W.Va.) and Chuck Schumer (N.Y.).

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The issue will also continue to be a battle in the House, where liberal and centrists Democrats are fighting over whether it should be included in a House healthcare bill.

The Finance committee votes, which could come as early as this week, promise to be discomfiting for both liberals and Sen. Max Baucus (D-Mont.), the embattled chairman of the Finance panel who is likely to vote against them.

Baucus has personally signaled an openness to the public option but steadfastly maintains that it lacks enough support to pass the Senate, making it a pointless and politically volatile exercise to include it in his bill.

But it’s not going to be fun for Baucus – who’s been a punching bag for the political left -- to join Republicans and vote against a Democratic amendment when the time comes.

Sen. Kent Conrad (D-N.D.), the chief advocate for the not-for-profit healthcare cooperatives that are included in the Finance bill as an alternative, is also expected to vote against the Schumer and Rockefeller amendments. Liberals have rejected the co-op compromise out of hand.

Conrad and Baucus on Thursday joined Republicans on the panel in defeating an amendment that would have caused the pharmaceutical industry to pull its support for the bill. That’s a pattern that could be repeated.

Rockefeller, Schumer and likeminded liberal senators begrudgingly acknowledge the votes are not there in the committee for the public option.

But they intend to force their colleagues to take a stand on the issue and possibly face the wrath of powerful interests such as labor unions and grassroots liberal activists.

The vehemence of support for the public option among liberals can hardly be overstated. Rockefeller summed up that view on Thursday when he said, “A healthcare plan without a public option is not much of a healthcare plan.”

Schumer declared that he and likeminded liberals would triumph in the end. “The healthcare bill that is signed into law by the president will have a good, strong, robust public option,” he said.

More votes on the public option are promised once the bill hits the Senate floor.

The issue will then become a headache for Senate Majority Leader Harry Reid (D-Nev.) instead of Baucus.

Before a healthcare bill even reaches the Senate floor, Reid will have to decide whether to abide by the Finance Committee position (no public option) or the Health, Education, Labor and Pensions Committee position (strong public option).

Reid sent a clear signal that he is prepared to compromise on Thursday.

Republican Sen. Olympia Snowe’s (Maine), a crucial swing vote, has proposed establishing a “trigger” for the public option that would be pulled in markets with insufficient private competition. During a conference call with Nevada reporters, Reid described the trigger as a “pretty doggone good idea,” according to the Las Vegas Sun.

“My first choice is a public option, because I think it will create competition and make the insurance companies more honest,” Reid said. “My No. 2 choice is the trigger that Snowe talked about.” A trigger would be preferable to co-ops, Reid indicated.

In the House, Speaker Nancy Pelosi (D-Calif.) isn’t having any easier a time despite having a large majority dominated by liberals. The centrist voting bloc, led by the Blue Dog coalition, is holding its ground against the public option.

House Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) broke the deadlock on his panel over the issue in July by weakening the power of the public option in the bill but the deal did not survive the rocky August recess intact.

Pelosi insists time and again that the House bill will have a public option. She went to great lengths this week to sell it to the centrists but did not appear to make much progress.

Pelosi has also came out against the trigger option. “I don't even want to talk about a trigger,” Pelosi said, describing it as “an excuse for not doing anything.”

It’s not clear whether Pelosi will have the votes to win a healthcare vote on the floor if the public option is not included in the bill. But it’s also not clear she’ll win a vote with the public option, since Republicans are expected to vote en masse against the bill.

There’s no easy way out of this predicament. To paraphrase one of President Barack Obama’s favorite sayings, if it were easy, somebody would’ve done it by now.