Public option seen buoyed by ‘opt out’

A leading Senate Democrat said Sunday that a health care proposal that lets states decide whether to participate in a “public option” insurance plan is close to gaining the 60 votes needed for passage, and a key moderate Democrat hinted at being open to such a plan.

Sen. Charles E. Schumer of New York, the chamber’s third-ranking Democrat, said that Senate Majority Leader Harry Reid, Nevada Democrat, “is leaning strongly” toward a state “opt-out” proposal.

“I think we’re very close to getting the 60 votes we need to move forward, and my guess is that the public option level playing field with the state opt-out will be in the bill,” Mr. Schumer said on NBC’s “Meet the Press.” “But Leader Reid will make that decision after he talks to everybody several times.”

While Democrats control the filibuster-proof 60 votes needed to advance legislation under Senate rules, some moderate Democrats are wary about supporting the creation of a government-run health insurance program. At the other end of the Capitol, however, House Speaker Nancy Pelosi has insisted that her chamber’s bill will have a “public option” insurance alternative, and several liberal lawmakers have said they will not support a proposal that doesn’t have one.

Negotiations in recent days have focused on crafting a public option that would satisfy liberal and moderate Democrats and not drive away others. Meanwhile Sunday, the Associated Press reported that senators likely will drop from the final bill a provision that would mandate that most U.S. companies provide their employees with health insurance.

In his NBC appearance, Mr. Schumer said the state opt-out approach, crafted as a compromise to win over centrist Democrats — and possibly liberal Republicans — has been well-received by liberals and moderate Democrats.

One of those moderates, Sen. Ben Nelson of Nebraska, said Sunday he would consider a government-run health insurance program if states are given the choice whether to participate. However, he said he would prefer an “opt-in” proposal, in which states would have to sign up for the plan, rather than an “opt-out” plan that would automatically include each state unless it affirmatively decided to withdraw.

“I’m a Jeffersonian Democrat. I think the states can make decisions on their own about their own citizens,” Mr. Nelson said Sunday on “State of the Union” on CNN. “And so I certainly would look at that.”

The state-option provision also would win support from some Republicans, Mr. Nelson predicted.

“I think we’re all more comfortable, the people will be more comfortable if the states are engaged in taking care of the situation, recognizing that Utah’s problems and California’s problems are different than Nebraska’s problems,” he said.

But Mr. Nelson said he won’t decide whether to support the bill until all the details are hammered out and won’t support even procedural maneuvers to advance debate on the measure “until I see the underlying bill.”

“I don’t think I can make any decision about anything until I’ve seen everything,” he said. “It would be, I think, reckless to say I’ll support the procedure without knowing what the underlying bill consists of. And it’s not put together yet.”

Sen. Sherrod Brown, Ohio Democrat, said he is “fine” with the opt-out option.

“If Nebraska or Utah doesn’t want to do the public option, their governor and legislature can pass a law saying, ’We’re not going to give our citizens that right,’ ” Mr. Brown said on “State of the Union.”

In one of the other key measures in the health care bill, Democratic officials familiar with the talks among lawmakers are saying that the Senate legislation being prepared will not require businesses to provide health insurance, but will impose major penalties on businesses whose workers need government aid to buy coverage themselves.

The Democratic officials told the AP on the condition of anonymity that the penalty for firms with more than 50 employees could be as high as $750 for every member of the work force, even if only a few workers needed federal aid. The bill that recently passed the Senate Finance Committee had much less draconian fines.

The officials also said individuals would generally be required to purchase affordable insurance if it were available, and be fined if they did not.

The Democratic officials spoke on the condition of anonymity because, AP reported, they were not authorized to discuss the talks between a few Senate Democrats and the White House. The officials also cautioned that no final decisions had been made.

The public option plan is one of the most contentious proposals in the debate over remaking the nation’s health care system. Senate Republicans, who number just 40 in the 100-member chamber, oppose the public option, saying it would undermine the free market. Moderate Democrats are skeptical of the plan’s cost and how it would reimburse doctors.

Sen. Claire McCaskill, Missouri Democrat, said Sunday she believes Congress will pass health care reform legislation this year that includes “some kind of opportunity to go to a public, not-for-profit option among many private options.”

But “by and large, most of this country is going to continue to get their health insurance through their employer,” Mrs. McCaskill said on”This Week” on ABC.”It’s all about options.”

Senate Minority Leader Mitch McConnell, Kentucky Republican, said Sunday he was far less certain of Democratic success with the bill.

“I’m not going to predict the outcome,” he said on “This Week.” “We know there is nervousness among Democrats over this increasing view that Congress is acting like a teenager with their parents’ credit card, not worried about who’s going to have to pay the bill.”