Monday, August 17, 2009

Is the public option for health insurance reform now dead?

The public option for health insurance reform has been on shaky ground for about a month or so, ever since the Senate Finance Committee effectively endorsed co-ops as a preferred alternative. Even before the recent town meeting brawls, President Obama had taken to emphasizing the public option more lightly or even de-emphasizing it. Does that mean that the public option is dead? No, not at all. What it does mean is that the supporters and proponents of the public option are on notice that they must come up with a reformulated public option which is a lot more palatable and far less "socialist" than the current proposals, otherwise the public option will die in favor of the co-op approach. Personally, I do not expect the public option crowd to simply roll over and play dead, but I am not necessarily optimistic that they are emotionally ready to admit defeat and "go with the flow."

Personally, I think the president really does want the public option, but he is enough of a politician to be able to read the writing on the walls and recognize that "the perfect cannot be the enemy of the good."

I personally even think the president really wants a single-provider solution, but he is enough of a realist, pragmatist, and moderate to understand that single-provider is a non-starter, now and for the foreseeable future.

I would rate the prospects for the public option at 50-50. The votes in the Senate are close enough that the balance between the public option and co-ops probably wobbles back and forth on a weekly if not daily basis. How the vote might go today is not an indication of how the vote might go in September or October, especially if the public option is reformulated, possibly even with a "trigger" that puts the insurance companies on notice that it is up to them to take the lead in reforming themselves, otherwise the public option would almost automatically be "triggered" into existence.

The bottom line is that regardless of the fate of the public option, President Obama is still definitely on track to preside over passage of health insurance reform legislation before the end of the year.

-- Jack Krupansky

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