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Is the Public Insurance Option Gone for Good?

Janice Simmons, for HealthLeaders Media, December 22, 2009

When Senate Majority Leader Harry Reid (D-NV) finally released his manager's amendment on Saturday, noticeably missing was the state opt-in public insurance option that had been included in the original Senate healthcare reform bill last month.

The public option became a hot issue when it became apparent that several Democratic and independent senators—who are needed for the 60 votes to advance the bill—would oppose the bill if the option remained.

Though not part of the Senate plan, a public option is still found in the House reform bill that was passed Nov. 7. The question is: Will it remain after the conference committee?

House Speaker Nancy Pelosi (D-CA) was adamant throughout the summer and fall that the legislation should contain a "robust" public option. However, speaking earlier this month at her weekly press conference, she declined to agree or challenge the Senate proposal to remove the option, which she had not seen at the time.

The House believes "that the public option was the best way to keep insurance companies honest… and also to increase competition. If you have a better way, put it on the table," she said. But she declined to elaborate further on keeping the option intact in the reform legislation: "What I have said is—as I always say to my members—give the Senate room."

But several senators have expressed their displeasure that the president did not make a stronger push for the public option. One of those senators, Russ Feingold (D-WI), said in a statement on Sunday that "the lack of support from the administration made keeping the public option in the bill an uphill struggle."

"Removing the public option from the Senate bill is the wrong move, and eliminates $25 billion in savings," he said. "I will be urging members of the House and Senate who draft the final bill to make sure this essential provision is included."

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