Sen. Tom Carper (D-DE) cast serious doubt tonight on whether conservative Democrats will ultimately vote for cloture on the Senate health care bill if it retains a public option with an opt-out clause, and gave new details on yet another compromise that he says might work for them.
Carper, who voted for a public option amendment during the Senate Finance Committee proceedings, first floated his idea last week as a potential alternative, in the event that Reid’s public option proposal failed to muster enough Democratic support to overcome a filibuster. Now he says he doubts the support is there.
“We’re concerned that a number of centrists aren’t prepared to vote for a national public plan, even with an opt-out,” Carper said in response to a question from TPMDC. “We’re trying to find something that addresses their concern about government run, government-funded, but still addresses the need for the affordability needs and the need for more competition in states that don’t have it.”
“What we’re asking centrists is, What concerns do you need to have addressed so that you can vote for cloture, either to bring the bill to the floor, or to take the bill off the floor and to go to conference? And the two concerns we keep hearing over and over again: government-run, government funded.”
(The opt-out plan Reid has proposed would not be government funded, though it’s not clear whether it would be run directly by the government, or outsourced to a non-governmental body accountable to Congress.)The Delaware senator cautions that the bill that comes to the Senate floor in the next several days will almost certainly include the broader public option Reid announced weeks ago, and that this new alternative will simply exist as a possible fallback in the event that the opt-out plan can’t get 60 votes.
Carper’s proposal would share some features with the public option Reid has proposed–it would be a single federal entity that negotiated rates with providers–i.e. built on a “level playing field”–but unlike the Reid plan, it would not blanket all states as a default, and then allow certain state governments to opt out.
Instead, Carper’s plan would erect an affordability standard (the details of which have yet to be determined) and establish this non-profit entity by fiat in states that don’t meet the standard. This is similar in principle to the “trigger” option proposed by Sen. Olympia Snowe (R-ME), but unlike Snowe’s trigger plan, there would be no delay. States that failed to meet the affordability standard would be forced to offer the plan immediately, when the insurance exchanges open in 2013.
“At the end of the day we may need something along the lines of what I suggested,” Carper said. “The idea is to figure out what states don’t meet an affordability standard, those states that don’t meet an affordability standard [will] have another option to list on their state’s exchanges, it would be negotiated probably by a non-profit board, perhaps appointed by the President, confirmed by the Senate, with some involvement, at least initially, by HHS…the Secretary could even be an ex-officio member of the board.”
“The day we stand up the exchange, in the states that don’t meet an affordability standard, this option would go up as an option on their exchange,” Carper added.
Asked about Carper’s plan, Sen. Tom Harkin (D-IA)–a strong public option supporter, and chairman of the Senate HELP Committee–told reporters he’d heard of it, and joked “I’m sure if there’s some way of making this bill even more convoluted, I’m sure that someone will probably come up with it at some time or another.” But he did say everyone’s keeping their options open.