The Congressional Progressive Caucus is pressing Democratic leaders to allow a vote on the House floor on a measure that would allow individual states to adopt a single-payer health care system.
"This could end up being one of the most important developments to come out of the bill," Rep. Dennis Kucinich (D-Ohio), the sponsor of the amendment, told the Huffington Post Monday night.
A vote on the bill isn't guaranteed, but progressive Democrats are working behind the scenes to make sure the House either pushes it through or puts representatives on record against it.
"If it doesn't stay in the bill, I think it's something that you can count on a lot of us asking that we have a stand-alone vote on," said Rep. Lynn Woolsey (D-Calif.), co-chair of the progressive caucus.
"Progressives have already given up what we really want. We want the single payer and by-golly we deserve to vote on it for our states," she said. Kucinich's single-payer option measure recently passed the full Education and Labor Committee.
The impetus for the bill stems from the fact that the Employee Retirement Income Security Act (ERISA) could allow insurance companies or other stakeholders to sue a state that enacted single-payer health care. Kucinich's measure would give states the freedom to enact a single-payer program without the threat of legal action.
Any chance that the Republican Party, which traditionally backs states' rights, could sympathize with the Kucinich amendment?
"On our side you mean?" asked Rep. Mike Pence (R-Ind.), a leading conservative voice. "No."
"No," said Pence. The vote would pit two competing principles against each other - states' rights and opposition to public health care. The latter wins.
"We believe that the cure for what ails health care in America is more competition, not putting government at the state or national level on the pathway to socialized medicine," he said.
Kucinich said he is "cautiously optimistic." He added that the measure is designed as a backup plan in case health care reform passes but fails in its objective of providing universal access to affordable care.
"There's been a very strong response to this once it passed the Education and Labor Committee," he said. "I would compare it to a lifeboat that saves health care if this plan somehow doesn't work and saves the right of a state to be able to protect the health care of its own residents."