Greg Sargent’s numbers are right: “47 House Dems are committed No votes, and eight are Leaning No,” on a health care bill if it includes a public option, preferred by reformers, that pays providers Medicare rates plus five percent.
House Speaker Nancy Pelosi can only afford to lose a maximum of 38 votes in her own party, and she’s still well over that. Nobody I’ve asked has gone so far as to say this is the end of the road for the so-called “robust” public option, but it’s certainly not a good sign.
This morning, House Majority Leader Steny Hoyer said he was fairly confident a more modest public option, using negotiated rates, would win out in a vote count.
For her part, Pelosi asked CBO to score three versions of a public option: the two described above, and a hybrid public option that would start out using negotiated rates, but set them at “Medicare +5” rates after a number of years if the negotiated rates don’t realize sufficient savings on their own. That may still be an option for House Democrats, but at this point the purest form of public option is looking like a reach.
The Senate’s public option proposal uses negotiated rates, too, so if the House can’t force through a more maximal measure, it’s difficult to see how reformers and liberals will get the public option they’ve been fighting fore.
