Sen. Harkin: Three ways to public option

The Senate has more than one way to get to agreement on the controversial public option, Health, Education, Labor and Pensions (HELP) Committee Chairman Tom Harkin (D-Iowa) said Friday.

Though Harkin insisted he continues to support a "robust" public option, his comments underscored how Senate Democrats are trying to leave themselves adequate wiggle room to approve something smaller in scale.

During a conference call hosted by the liberal activist group Families USA, Harkin indicated that Senate Democrats had narrowed their choices to a full public option, a proposal that would allow states to opt out of the program and Sen. Olympia Snowe's (R-Maine) idea of creating a "trigger" that would launch a public option in any state where insurers fail to meet residents' needs.

Harkin's committee passed a bill that would create a nationwide government-run health insurance public option program that would compete with private insurers, the approach that remains the favorite of liberals. But in an attempt to appease wary centrist Democrats and Snowe, Senate Democrats have been eyeing several compromise proposals.

As he has on previous occasions, Harkin offered a strong defense of the public option in his committee's bill and made clear that he intends to keep pushing for it to be included in the final Senate bill, which must be combined with a Finance Committee measure without a public option.

"As the chairman of the HELP Committee, I'm advocating for what we have in our bill," Harkin said. "Quite frankly, I think we got it right."

And though Harkin said he is "willing to listen" to compromise proposals, he insisted that the handful of Democrats who do not support the public option should be the ones to change their tune.

The full Senate Democratic Conference met Thursday to discuss healthcare. Harkin counted 52 senators who support the public option and about five who do not.

"The vast majority of the Democratic caucus is for the public option that is in the HELP bill," Harkin said. "Should the 52 give in to the five, or should the five come along with the majority?"

Asked about the importance of retaining Snowe's support, Harkin said only that getting the bill done right is more important than who supports it.

Harkin also said that big questions remain about how to pay for the bill. The Finance Committee, which has authority over tax law, would tax high-cost health insurance plans, something opposed by labor unions and many Democrats. Harkin indicated that the Senate might move closer to the House's approach, which is to levy a surtax on people making more than $500,000.

"In the end, we're probably going to have to go outside the healthcare system for some revenues," Harkin said.

Senate Majority Leader Harry Reid (D-Nev.), Finance Committee Chairman Max Baucus (D-Mont.) and Sen. Chris Dodd (D-Conn.) of the HELP Committee are working with the White House to combine the two bills. Harkin said he expects them to finish by the end of next week and predicted Congress would send a bill to President Barack Obama before Christmas.