IT'S TIME FOR UNIVERSAL HEALTH CARE

Pelosi lacks votes for most sweeping public option


Mike Allen " Fri Oct 23, 7:53 am ET
Speaker Nancy Pelosi counted votes Thursday night and determined she could not pass a “robust public option” " the most aggressive of the three forms of a public option House Democrats have been considering as part of a national overhaul of health care.

Pelosi's decision"coupled with a significant turn of events yesterday during a private White House meeting"points to an increasingly likely compromise for a “trigger” option for a government plan.

Administration officials have been telling POLITICO for weeks now that this the most likely compromise because it can probably satisfy liberals"albeit only reluctantly and after many vent frustration and some even threaten to walk away from the bill.

This would clear the way for backers to sneak a limited public option through the Senate by attracting moderate Democrats and then to win President Barack Obama's signature.

Obama told Democratic leadership at the White House Thursday evening that his preference is for the trigger championed by Sen. Olympia Snowe (R-Maine) " a plan that would allow a public plan to kick in if private insurers don’t expand coverage fast enough, a top administration official told POLITICO. It’s also sign Obama is interested in maintaining a sense of bipartisanship around the health reform plan.

At that meeting, Obama did not sign on to a plan being floated by Senate Majority Leader Harry Reid to include a different variation of the public option in the Senate bill " a plan that would create a national public plan but allow states to “opt-out.” Reid now believes he can get 60 votes to bring a bill with that plan to the floor by breaking an expected GOP filibuster " and then secure the 51 votes needed to pass it.

But Pelosi’s vote-counting didn’t go as well in the House. There has been a flurry of rumors that a robust government option remains viable. But top House Democrats privately concede that is wishful thinking that ignores the power of moderate Democrats in this debate.

The House is now likely to include one of the two weaker versions in the bill that will be considered on the floor as Obama’s historic health-reform plan chugs toward passage " possibly a version that would set rates for the public plan by allowing doctors and hospitals to negotiate them with Medicare.

Nadeam Elshami, deputy communications director and senior adviser to the speaker, said: "Speculation that a final decision has been made about the public option are not accurate. We continue to work with all the members of the caucus to build consensus."

A House Democratic official said: "The leadership did not tell progressives last night that the robust public option is off the table. The votes are still being counted."

The vote count is a disappointment to liberal members in the House, after two days in which Pelosi seemed increasingly confident she could secure the votes needed for the most liberal option. She had her top lieutenants polling members and even enlisted progressive leaders in trying to corral more support.

“Votes aren’t there,” a top official said. “The progressives are always more optimistic than reality.”
But the final outcome could be helpful to the crucial members of her caucus from conservative-leaning districts, who opposed the most liberal version of the public option, one tied to Medicare rates.

The speaker has proven herself a reliable vote counter, and she wants to release a bill that she knows can get at least 218 votes. Aides say the count was somewhat of a surprise, but not completely.

The speaker plans to roll out the House bill with a big ceremony on the West Front of the Capitol.

That was planned for Tuesday or Wednesday, and may still happen then. But aides say that disappointing first tally could delay the timeline a bit as they scramble to finalize the bill that will be considered on the House floor.

House leadership sources are telling TPMDC they think news on the "robust" public option is leaking out to pressure House Speaker Nancy Pelosi as the health care discussions are getting hotter, and closer to the final deal.

Politico's story this morning suggests Pelosi doesn't have the votes, but our sources insist the leadership isn't yet at that stage.

Presidential adviser Valerie Jarrett jabbed at the Politico story while appearing on MSNBC's Morning Joe today, saying of the reporter who penned the piece, "I don't know whether Mike Allen can actually count votes or not."

But House sources think Democrats may have spoken with Allen to apply pressure on Pelosi at this late stage in the game.

What's All the Confusion About?

There've been a number of conflicting reports about the fate of the Public Option this morning, especially in the House. We just had our morning editorial meeting. And I wanted to give you a quick read on what the confusion seems to be about.

The issue really doesn't seem to be whether the House thinks it can pass a Public Option. The confusion and conflicting reports seem to stem from not distinguishing between two versions of the Public Option that most TPM Readers are probably already familiar with -- namely, a Public Option like that advanced by Sen. Schumer and the more turbo-version proposed by Sen. Rockefeller.

Basically, it's not clear the House really has the votes for a Rocky-style Public Option. That's where this morning's Politico piece may be on solid ground -- because Pelosi, or at least her office, had appeared to be saying they had that locked. But that doesn't mean the Public Option is dead in the House because it seems pretty clear they do have the votes for Schumer-style Public Option. And that latter, critical point was lost in this morning's headlines.

--Josh Marshall

maporsche, It's not only the public option issue that hasn't been resolved. We still don't know how much this plan is going to cost.

We now have runaway spending by congress and the president, and we can't keep adding onto the deficit.

They're all crazy! The dollar is already losing its value across this planet, and they still can't control spending. Our monopoly money will be hit with such a huge inflation, we're going to lose our international trades, and the cost of all goods and services will skyrocket into the hemisphere.

I'm scared, because this will happen during my short lifetime.

You say "cost projections?" ROFLMAO

From what I've been reading, they still don't have any idea how much UHP is going to cost - and it depends on what comes out of congress before any "real" projections can be made.

From the latest studies done on cost, most Americans are against higher insurance premiums or taxes to subsidize low and moderate income Americans.

The interesting somewhat contradictory finding was that most Americans, or 62%, would support a program that will help the chronically ill.

These statements are supported by an article by David W Brady in the WSJ.

They haven't done a very good job at transparency, and I'm not sure they are capable of it. When the government throws around numbers on how much it'll cost, they have "never" been very accurate. On top of all that, they're providing numbers without knowing who will be covered with what kind of limits. It's not only about the Iraq war they projected it'll cost $50 billion, but also Medicare and other long-term federal programs. I'm leery and worried.

Brady has used polls from credible sources such as Washington Post/Kaiser Foundation and on a survey that asked 3344 US adults across the country.

If you have better info, I'd like to see them.

What exactly are those "conclusions" that you disagree with?

On the other hand, Americans' willingness to pay for health reform has limits. Our results show that, for a majority, the cost of the policies currently under consideration by Congress exceeds those limits.