Democrats are becoming bolder about their idea that middle-class familes get the option of joining a government insurance plan in any overhaul of the health care system. Their fervor carries a risk.
Liberals, citing polls that show support for a public plan, say they are increasingly frustrated with negotiations to make the idea more palatable to Republicans. Moderates, however, warn that abandoning the talks could jeopardize efforts to draft a bill that can pass a closely divided Senate.
"It is important not to draw lines in the sand and rule out options before they are fully explored," Sen. Kent Conrad, D-N.D. said Monday. "If we do, we could easily wind up with no viable option at all."
Conrad has proposed creating nonprofit health insurance co-ops as an alternative to a full-blown government plan. His idea was seen as perhaps the last hope for compromise on the issue. But another influential Democrat is complaining that talks with Republicans may be headed for a dead end.
"I don't think I could say with a straight face that this (co-op proposal) is at all close to a nationwide public option," said Sen. Charles Schumer, D-N.Y. "Right now, this co-op idea doesn't come close to satisfying anyone who wants a public plan."
Striking a deal
Two recent news media polls have found public support for a government plan, even if many people are unsure about its implications. The most recent survey, a New York Times-CBS News poll released Sunday, found that 72 percent supported the idea, including half of those who identified themselves as Republicans.
House leaders are planning to use the poll results to shore up support for a public plan among moderate Democrats, as three committees hold hearings on legislation this week. In the Senate, divisions over a public plan and concerns about costs are holding up the work of the Finance Committee and may delay Health, Education, Labor and Pensions Committee as well.
Schumer's role is important because he's been acting as an intermediary between liberal Democrats and moderates who are trying to strike a deal on the issue with Republicans on the Finance Committee. Of the five House and Senate committees working on health care, Finance is the only one that appears to have a chance at reaching a bipartisan agreement. Schumer and Conrad are both Finance members.
Schumer told The Associated Press that negotiation with Republicans have proved frustrating, saying that he and his Democratic colleagues now may have to go it alone on the issue of a public plan.
He said Finance Republicans had rejected several proposals designed to beef up the suggested nonprofit insurance co-ops. These included setting up a national structure for the co-ops, $10 billion in government seed money, power to negotiate payment rates to medical providers nationwide and creation of a presidentially appointed board of directors.
Conrad said nothing has been finalized.
"Negotiations for a national health care cooperative are ongoing," said Conrad. "The members of the Finance Committee are focused on getting a plan that will pass the committee and be adopted on the floor. "
The contentious issue threatens any remaining prospects of bipartisan support for President Barack Obama's sweeping plan to remake the health care system.
Checking the power of insurers
The public plan that most Democrats envision would be offered alongside private plans through a new kind of insurance purchasing pool called an exchange. Individuals and small businesses would be able to buy coverage through exchanges, but eventually businesses of any size might be able to join.
Proponents say having a public plan in the marketplace would put a brake on costs and check the power of insurers. But Republicans, insurers and many business leaders say the government could drive private insurance companies out of business.
House Minority Whip Eric Cantor, R-Va., Cantor, said Monday that "a government plan, no matter what you call it, will increase costs" and limit choices. He spoke on ABC's "Good Morning America."
Obama also has been sending signals that he's ready to draw a line. He recently said that if Congress wants a bipartisan bill, it's up to House and Senate Republicans.
It's unclear when Finance Committee Chairman Max Baucus, D-Mont., will unveil his proposal. Initial cost estimates well above their 10-year, $1 trillion target forced senators to start over.
The next few weeks will be critical. Democrats want to push ahead as far as they can before the July 4 congressional recess. Over the break, comments from constituents could determine whether Congress sticks to its goal of passing legislation this summer.
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