The difference is key to reformers, and will be key to the House's bargaining position with the Senate when it comes time to turn the two chambers' bills into one. A 'robust' public option--which sets reimbursement rates just above what Medicare pays doctors and hospitals--saves much more money, and has more potential to drive private insurers' premiums down than does a public option that negotiates rates with providers. That's why reformers like it. And given that the Senate's public option proposal is itself based on negotiated rates, if the House endorses something similar, then it will almost certainly mean reformers don't get the public option that they've been demanding all along.
Hoyer also became the first member of House leadership to weigh in on yesterday's momentous news that Senate Majority Leader Harry Reid had decided to include a public option with an opt-out clause in his health care bill.
"I think we have much stronger support for a public option here in the House, so I think that our bill will be somewhat different on public option," Hoyer said, adding positively: "But we're very pleased that Senator Reid is now talking about including a form of public option so that that will be available for us in conference."
So does the fact that the Senate's public option will be based on negotiated rates have any bearing on what will come out of the House? Hoyer says it's possible.
"There are some members of the House, obviously, who are very concerned about what the Senate does, and they're very concerned about what the Senate does because they want to vote for something that can pass," Hoyer said.
On the other hand there are a whole lot of people in the House--the great majority of the Democrats in the House--who want to see a health reform bill pass in the fashion that we believe is justified and important. And I think the overwhelming majority of Democrats are in favor of a public option. And as a result, my view is, what the Senate does or does not do, does it have an impact? Certainly on individual members. Will individual members have an impact on us in terms of what we can get 218 votes for? Yes that's possible.
There is a third version of the public option under consideration in the House--one that would use negotiated rates at first, but would allow Medicare rates to kick in unless sufficient savings were realized. Hoyer didn't address that option. But nonetheless, those are some very candid, on the record suggestions that the House bill is likely to include a less-than-maximal public option.