Carper option in final Senate health bill

A state opt-out of the public option, first proposed by Delaware Democrat Tom Carper, will be part of the health reform bill Majority Leader Harry Reid is bringing to the Senate floor.

A state opt-out of the public option, first proposed by Delaware Democrat Tom Carper, will be part of the health reform bill Majority Leader Harry Reid is bringing to the Senate floor.

Once the health reform debate is finished all players -- including IT vendors -- will know the business environment they face over the next decade. Businesses will also have visibility on health care costs, on which they can set hiring (or outsourcing) plans.

Majority whip Charles Schumer of New York is being given credit for successfully shopping the Carper proposal, which needs 60 votes in order to come up for debate as part of the larger reform bill.

Politico reports that Reid may still be 3-4 Senate votes short of the 60 needed to break a filibuster. This is a gamble, but the majority could also try to get the bill through on reconciliation -- the procedure used for the Bush tax cuts. (Talk of that may rise if it becomes clear he can't get the needed votes.)

The closeness of the whip count may be why President Obama favored Sen. Snowe's idea for a "trigger" that would launch a public option automatically if costs kept rising. It could also be why he continues to warn the bill could fail.

The Wall Street Journal reports the bill coming to the floor also has other ideas that have been widely discussed, including a national insurance exchange, and new taxes on medical devices and high-cost health plans.

The insurance industry is expected to fight hard against the bill on the floor and Republicans are dead set against it. But there are 60 Democrats in the Senate (counting Connecticut for Lieberman's Joe Lieberman of Connecticut and Socialist Bernie Sanders of Vermont) so if the Democrats can just hold their members on proceeding to debate the bill will pass.

Once the legislative language is written the final leadership bill will go to the Congressional Budget Office (CBO) for "scoring" before it comes up for debate. The non-partisan CBO is providing estimates on the budget impact of various health reform plans, and its reports are considered important.

The CBO had estimated the original Senate Finance Committee bill, for instance, would cut the deficit $81 billion over 10 years. The final bill, as passed by the committee, got an identical score in a preliminary analysis.

Let the trolling begin in earnest.

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