What’s really behind the Obama administration’s apparent wavering over a public option in health-care reform?
It could be a simple case of math. We already know that most Republicans won’t support a public option.
President Obama told a town hall in Grand Junction, Colo., this weekend that the “public option, whether we have it or we don’t have it, is not the entirety of health care reform,” says Talking Points Memo. “This is just one sliver of it, one aspect of it.”
Meanwhile, Health and Human Services Secretary Kathleen Sebelius told CNN’s “State of the Union” that a public option is “not the essential element” of health reform. Essentials include lowering insurance premiums and stopping insurers from dropping customers with pre-existing conditions or for surpassing their coverage caps.
“I think there will be a competitor to private insurers,” she said. “That’s really the essential part, is you don’t turn over the whole new marketplace to private insurance companies and trust them to do the right thing.”
43 Dems on record in favor
Back to the math. The U.S. Senate needs 60 votes to pass a health-care reform bill. So far, 43 Democrats have gone on record in favor of the option, according to OpenLeft.com, which keeps track of members of Congress for targeting purposes. Sixteen are maybes, two are unknown and two are definite nos.
But Open Left says a public option is not dead yet. “With 43 supporters of the public option, we only need seven of these twenty Senators to flip in order to pass the public option through reconciliation. Even amid the din of right-wing astroturf protesters and a media giddy at the prospect of health care reform failure, meaningful health care reform is very doable in 2009.”
Open Left says Sen. Amy Klobuchar, D-Minn., is among the uncertainties, although Howard Dean’s Stand with Dr. Dean website lists her as a supporter on his “Where Congress Stands” list. Minnesota’s junior senator, Al Franken, is presumed to be a supporter of a public option, although he has advocated for a single-payer system. (Franken, a Democrat, apparently is so junior that he is not listed on Dean’s site.) Open Left lists Franken as a supporter.
MinnPost has a call into Klobuchar’s office for comment and will update this post when we get a response.
The FiveThirtyEight: Politics Done Right blog says it’s not entirely clear where Klobuchar stands. She is among five senators “who have either given signals that they’d support the public option or, when push came to shove, would be more likely than not to do so.” That list of five includes Sen. Herb Kohl of Wisconsin and Sen. Tim Johnson of South Dakota.
Klobuchar ‘ambiguous in e-mails’
Even so, Klobuchar has been “decidedly more ambiguous in e-mails to constituents, and Minnesota has lots of skin in the health care game in various forms,” says FiveThirtyEight’s Nate Silver. “Still — although Klobuchar is not as liberal as you might expect from a Minnesota Democrat — this seems to me like an eminently whippable yea vote.”
Klobuchar’s health-care policy statement on her website makes no mention of her stance on a public option. This statement seems to show what she supports:
“We must expand health insurance coverage and make that coverage meaningful rather than riddled with high deductibles and exclusions. But we cannot do so without simultaneously tackling a health care payment system that rewards volume rather than quality services and preventive care. As Senator, I will work to pass health care reform legislation that dramatically expands coverage and redesigns the perverse incentives in our health system that drive up health spending and make our current system unaffordable.”
Other senators are doing the math, too.
Michael Tomasky of the United Kingdom’s Guardian writes today: “If you’ve been watching this closely, you’ve known or at least suspected for some time what North Dakota Democratic Senator Kent Conrad said yesterday — that there aren’t the votes in the Senate for a public option, and ‘there never have been.’ “
Several GOP votes would likely be needed
Sen. Dick Durbin, D-Ill., told The Wonk Room that he would “reluctantly” support a bill without a public option. “We have the reality of 60 votes in the Senate and two Senators who are sick,” Durbin explained. “Senator [Robert] Byrd, who may be able to return. We hope he can. Senator [Ted] Kennedy, we hope he can return. Without them, we need at least two, maybe three Republicans to support our effort and there seems to be universal opposition to a public option among all Republican Senators.”
And the House? Republicans and Blue Dog Democrats are expected to oppose a public option. And, progressives could throw a wrench into the works of any legislation.
“House progressives, meanwhile, have vowed to oppose a health care reform bill that doesn’t include a public option — an inconvenient reality for the White House, and one which could set the stage for a major showdown after the August recess comes to the end,” Talking Points Memo notes.