Public Option, Compromised


The focus of President Obama's message to Congress tonight, which probably will take place before most people read this, is becoming increasingly clear.

Firedoglake's Jane Hamsher, who arguably has been following the fight over, and leading the fight for, a public option more than anyone in the country, refers to an ominous, if somewhat predictable, development reported today by The Hill:

Sens. Susan Collins (R-Maine) and Joe Lieberman (I-Conn.) both cast doubt Tuesday on their support for a public-option component to the Democratic healthcare reform effort, which suggests that the Obama administration is still struggling to win over key Senate centrists.

However, Collins and Lieberman both told The Hill they are more supportive of a “trigger” concept floated by Collins’s Senate colleague, Maine Republican Olympia Snowe, which calls for a public option to be implemented if insurance companies fail to fix the current system’s cost inefficiencies.

Reform supporters and critics alike are watching Collins, who cast a key vote this winter for President Barack Obama’s stimulus bill, and Lieberman, who occasionally breaks with Democrats, although he caucuses with the party and generally supports it on domestic issues....

Collins’s comments suggest that the administration approached her for support and determined her to be an unlikely ally. Collins did say she spoke for a half-hour last week with Finance Committee Chairman Max Baucus (D-Mont.), who is leading a six-way series of bipartisan talks on a Finance Committee health bill.

According to Politico today

Aides say Obama thinks it would be hard to get to true choice and competition without a public option or a fallback to a public option — such as the so-called trigger, which would kick in based on the insurance market....

But White House officials privately say they know they don't have the votes in the Senate for a public option. It is clear Obama will gladly compromise on this point, hence the loose language in the speech, allowing for future horse trading.

In a break for the White House, the American Medical Association is endorsing Obama-style health reform, in an “Open Letter to President Obama and Members of Congress,” signed by President J. James Rohback, M.D.

Hamsher noted that the "groundwork was laid" for House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid "to push triggers yesterday." But give credit to Major Garret of GOP TV, who in a blog on September 3 reported

That is true," Pelosi said of stepped up talks on a trigger mechanism as a replacement for the public option. "But I don't know what particulars are of the trigger. Here we have a situation where in the Kennedy bill in the Senate, there is a public option, it's not as strong as the public option in the House bill. If they want no public option, but a trigger, you can be sure that the trigger will bring on a very robust public option. So, if I were advising insurance companies, I'd tell them take this bill the way it is now."

In retrospect, it was fairly clear by then that President Obama favored the "trigger," (warning: hedge ahead) whether or not he would formally and directly endorse the concept in his remarks tonight. Pelosi, obviously, was not exactly "advising" insurance companies; she is a dynamic critic of theirs. Rather, she sounded like an individual who knows that her approach is facing powerful, organized opposition (from the industry, the Senate Finance Committee, and the President) is not likely to prevail. And the comment "you can be sure that the trigger will bring on a very robust public option," gives her an out in eventually supporting a trigger, when eventually the only alternative is no bill at all.

And if Hamsher believes "the needle will soon be impossible to thread," that day- that hour- is fast approaching. The GOP will not jump up to support a trigger, especially now that the leader of the Party has criticized it. As Steve Benen wrote Monday in his blog at The Washington Monthly

Republicans aren't looking for concessions; they're looking to kill the legislation. Indeed, asked about whether a trigger is a possible compromise move, Newt Gingrich and Tim Pawlenty both rejected the idea outright yesterday.

It's hard not to be impressed with these negotiations. Dems say, "How about a public option that would offer consumers a choice, and lower prices through competition?" Republicans reply, "No." Dems say, "OK, how about a system of non-profit co-ops"? Republicans reply, "No." Dems say, "How about a trigger, which would bring added competition to the system if private insurers fail to meet certain benchmarks?" Republicans reply, "No."

It's one thing to entertain the idea of a trigger to bring Sen. Olympia Snowe (R-Maine) into the fold and keep Nelson from helping the GOP. But if the idea is that a trigger is a compromise measure that would generate broad, bipartisan support for reform, forget it. Republicans don't support health care reform, and no combination of concessions will change that.