51 Vote Rules May Force a Public Option Too Liberal for Some Dems

51 Vote Rules May Force a Public Option Too Liberal for Some Dems

Brian Beutler

As Senate leaders begin work on a Democrat-only health care bill, they're finding themselves confronted with an unexpected irony: Though the caucus has reached an uneasy consensus around a public option that's modeled in many ways after a private insurer, it may be necessary to make the public option more liberal, and thus, more politically radioactive, if it's to overcome a number of unique procedural hurdles.

This is the needle Democrats may have to thread if they want a public option, and at the same time, want to bypass a Republican filibuster. And the key for them will be keeping conservative Democrats on board.

"A very robust public option that scores significant savings would presumably be easy to justify doing through reconciliation," says a Senate Democratic aide. "But it is still being studied whether other, more moderate versions of a public option could pass parliamentary muster."

According to Martin Paone, a legislative expert who's helping Democrats map out legislative strategy, a more robust public option--one that sets low prices, and provides cheap, subsidized insurance to low- and middle-class consumers--would have an easier time surviving the procedural demands of the so-called reconciliation process. However, he cautions that the cost of subsidies "will have to be offset and if loses money beyond 2014...it will have to be sunsetted."

And there the irony continues: Some experts, including on Capitol Hill, believe that a more robust public option will generate crucial savings needed to keep health care reform in the black--and thus prevent it from expiring.

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