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Why Isn't the Public Option an Option?

Robert de Neufville

On Monday, Sen. Jay Rockefeller (D-WV) announced
that although he strongly supports the so-called public option, he
wouldn't vote to add it to the health care bill by way of the
reconciliation process. Many senators say that passing the public
option by way of reconciliation—a procedure which bypasses the threat
of a filibuster so that the Senate can pass the bill with a simple
majority—would come across as being too partisan. Now White House Press
Secretary Robert Gibbs says there aren't enough votes to include a public option, even using reconciliation.

The reason to include a provision for a government-run health care plan is simple. As Glenn Greenwald says,
if you're going to force people to buy health insurance, you should
probably give them an alternative to the private plans they don't use
as it is. Allowing people to buy into a government-run health care
program ensures that everyone has access to a minimally-acceptable
standard plan. Giving people the option to use a public plan would
hardly amount to a government takeover of the health care system. If
people didn't like the plan, they wouldn't have to use it.

For all the angry rhetoric about socialized medicine, the public option is actually quite popular. Reuters found
in December that almost 60% of Americans—including almost 60% of
independent voters—would like a public option provision in the final
health care bill. It even appearslist
of 51 senators who seem to have expressed support for a public option.
And 24 Democratic senators—including six committee chairs—have signed a
letter asking that
the public option to brought to a vote under reconciliation rules,
saying it could reduce health care costs by billions of dollars.
to be popular—more popular than the health care bill itself—in the
states of key senators who are on the fence. Liberal activist site
FireDogLake compiled a

Although reconciliation smacks of back-room dealings, it's hardly
undemocratic. By bypassing the filibuster—which actually has no basis
in the Constitution, but is itself simply a customary procedural
rule—it would put the public option to be put to a simple majority
vote, rather than allowing a minority of senators to prevent it from
passing. The argument against reconciliation is, in essence, that it
would be inappropriate to pass major legislation without getting the
Republicans to buy in. But the Republicans have made it clear that they
intend to block whatever plan the Democrats propose anyway. And using
the reconciliation process to pass a major piece of legislation is
hardly unprecedented. As Timothy Noah points out, reconciliation was used to pass welfare reform, COBRA, and the Children's Health Insurance Program. And, as Ezra Klein says,
it's been used more by Republicans than by Democrats. "It's done almost
every Congress," Senate Majority Leader Harry Reid says, "and they're
the ones that used it more than anyone else."

Even so there may not be 50 votes in the Senate for the public
option. Many senators are reluctant to use the reconciliation process
to pass something as polarizing as the public option. And there may
never have been 51 votes for the public option in any case. As Glenn
Greenwald says,
many Democrats were, like Jay Rockefeller, happy to express support for
the public option in theory when they believed it would never come to a
vote. But that doesn't mean that when it comes down to it that they are
willing to give it their vote. An August whip count
found only 43 firm votes for the public option, and one of those was
the late Sen. Ted Kennedy (D-MA). The White House might be able to drum
up the rest of the necessary votes. But it's not all that clear
President Obama was ever all that serious about the public option. And,
as Nate Silver argues,
President Obama may be right to feel that the appearance of
bipartisanship—even if there is no chance of winning any Republican
votes—is more important than the public option. But if, as Ezra Klein says,
the key to holding on to Congress is mobilizing the Democratic base,
then passing the public option "may be the party's last, best hope to
give its passionate supporters the win that would reinvigorate them for

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