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Negotiators mull public option in Senate bill

Officials say the White House and senior Senate Democrats are considering a requirement for the federal government to compete directly with private industry in the sale of health insurance.
/ Source: The Associated Press

White House officials and senior Senate Democrats at work on health care legislation are strongly considering a requirement for the federal government to sell insurance in direct competition with private industry, officials said Thursday, with individual states permitted to drop out of the system.

Liberals in Congress long have viewed such an approach, called a public option, as an essential ingredient of the effort to overhaul the nation's health care system, and President Barack Obama has said frequently he favors it. But he has also made clear it is not essential to the legislation he seeks, a gesture to Democratic moderates who generally have shied away from it.

Sens. Ben Nelson, D-Neb., and Kent Conrad, D-N.D., said in separate interviews they had been told the private negotiations were considering the plan. Neither senator is involved in the discussions, but said they had been in touch with fellow lawmakers who are.

The White House had no comment on the remarks by Nelson and Conrad. Other officials said no final decisions had been made, and it seemed clear any such provision would generate resistance among moderate Senate Democrats.

The issue has been one of the most vexing of the yearlong effort by Obama and his Democratic allies in Congress to remake the nation's health care system.

Vote expected in the next few weeks
Legislation taking shape in the House is also expected to include a public option, although it is unlikely states will be allowed to opt out.

After months of struggle, both houses are expected to vote in the next few weeks on sweeping legislation that expands coverage to millions of people who lack it, ban industry practices such as denial of coverage for pre-existing medical conditions and slow the growth of medical care in general.

The House and Senate measures aim to expand coverage to about 95 percent of the population, and include federal subsidies to help lower-income families afford coverage and permit small businesses to provide it for their employees.

The two bills differ at many points, although both are paid for through a combination of cuts in future Medicare spending and higher taxes — a levy on high-cost insurance policies in the case of the Senate and an income surcharge on very high income individuals and families.

In the House Speaker Nancy Pelosi said at a news conference she and her leadership were entering the "final stages" of assembling a health care bill to be voted on this fall.

The Senate negotiations have proceeded in unusual secrecy, attended by Senate Majority Leader Harry Reid of Nevada, two Senate committee chairmen, Sen., Max Baucus, D-Mont., and Christopher Dodd, D-Conn., and a small group of administration officials led by White House Chief of Staff Rahm Emanuel.