It’s been known for a long time now that a “robust” public option, tied to Medicare rates is a big money saver–bigger than a public option that has to negotiate rates with providers. Now, House Speaker Nancy Pelosi is going to make members reckon with the fact that the more liberal proposal is actually the more fiscally responsible plan.
“One will be what I call the robust public option, Medicare plus five; and then we will have two versions that we are sending that involve the negotiated rates that were supported, and of course passed by the Energy and Commerce Committee.”
She went on:
The thing is, there is absolutely no question, the robust public option scores very well, $110 billion [in savings]. And that is why I so strongly supported it. It is hard to ignore $110 billion, especially when you are trying to lower the cost of coverage.
In all fairness to those who believe that the negotiated rates work better for them in their district, we are trying to get from the Congressional Budget Office how we can have more savings out of negotiated rates, because so far all they have told us is that saves $25 billion.
It is an $85 billion difference. That is a big difference. And I am saying there must be some way we can get more savings; and they have given us some suggestions which we have narrowed the choices to and sent them back.
This is how it will work:The way it will work is this: the House will send the CBO a complete bill with a robust public option (as passed by the Ways & Means and Ed & Labor committees). They will also send over two amendments, which the CBO can substitute and score. One would be a public option with negotiated rates, and the other would call for the negotiated rates of the public option to give way to a robust public option if the former failed to rein in insurance company excesses.
Once this experiment is completed, and the numbers are in, the caucus will decide how to proceed–some conservative Democrats have taken issue with a Medicare-like public option, but they haven’t been confronted by an official estimate of its estimated savings. But despite their opposition, Pelosi insists that that doesn’t mean it can’t pass. “I think that either one of them would pass on the floor,” she said.