Health Care For America Now

Jon Cohn has a must read piece today, laying out (accurately, to my knowledge) the current state of play on the public health insurance option:

Brian Beutler and Carrie Budoff Brown have the essentials on the Senate situation. In a nutshell, Harry Reid thinks he has the votes to sustain a bill that includes some sort of public option compromise, whether it's a trigger or an opt-out. Max Baucus is not happy about this and, perhaps to a lesser extent, neither is Olympia Snowe. But other centrists, most notably Ben Nelson, are making pretty clear they can find a way to live with at least some versions of the public insurance compromise. That's news.

Over in the House, according to several sources, the drama began in the morning when Speaker Nancy Pelosi addressed a meeting of the Democratic caucus and laid out two main possibilities. One was the "Medicare-plus-five" version–that is, a government-run plan that would pay physicians at roughly Medicare rates with an extra five percent on top. (It'd pay hospitals standard Medicare rates without the additional five percent.) The other possibility was a "negotiated" version–that is, a government-run plan that bargained with doctors and hospitals over rates.

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Friday morning brings another caucus meeting and there, perhaps, the House Democrats will make a final decision about which way to go. There isn't much time, given the schedule Pelosi wants to keep. She wants to unveil a bill early next week and, perhaps, have a floor vote the week after that. The leadership has already sent language over to the Congressional Budget Office for scoring. As one staffer says, "it's all locked in–except for the public plan."

This is, by and large, great news. In the House, there is no question that we're going to get a public health insurance option that's national and available on day one. The only question is will we get one that saves taxpayers about $80 billion (that would be the one that pays Medicare +5 rates) or not.

In the Senate, things are also looking up. While we're not nearly as far along as the House, public support for the idea is clearly giving Senate leaders pause. As a result, there has been serious discussion of putting a real public health insurance option in the Senate merged bill. While there is still a large danger that we'll get a trigger - a catch-22 plan to kill the public health insurance option - I'm much more hopeful about the Senate negotiations than I've been in a while, especially with Senators like Nelson hinting they wouldn't support a filibuster and leaked reports saying Reid has 60 votes for cloture.

We've clearly come a long way, and the fact that the public health insurance option is a must with the American people is seeping into the conventional wisdom that surround this country's capitol.

Up next: Floor votes!