House lawmakers laud new CBO score of $871 billion, including a public option

Oct 22 2009

A government-run public insurance option is in the House Democrats' health overhaul measure which the Congressional Budget Office has "scored" at $871 billion over 10 years.

The Washington Post: "The measure would include a government-run insurance plan that pays providers at rates tied to Medicare. ... That so-called 'robust' public option is preferred by liberals because it would save the government money and could force private insurers to lower their own reimbursement rates, driving down the cost of health care overall. But the idea is opposed by many conservative Democrats from rural areas, where Medicare rates are well below the national average" (Montgomery, 10/21).

The Associated Press/The Boston Globe: "The [CBO] figures were preliminary because no final decision on the design of the public plan had been made, said the aide, who requested anonymity in discussing the bill because the deliberations were private. The House bill with the strong public plan would extend coverage to 96 percent of uninsured Americans and significantly reduce budget deficits" (Werner, 10/20).

CongressDaily reports that under the plan, hospitals would be paid Medicare rates and physicians Medicare rates plus 5 percent. "Leaders also asked CBO to score two other versions of a public insurance option. The second plan, which many Blue Dog Coalition members backed, would require the HHS Secretary to negotiate rates directly with providers, a change that costs the government more money. To bring the price tag under $900 billion, lawmakers combined that plan with an expansion of Medicaid and a reduction in the required actuarial value of the basic benefit plan (Hunt, 10/21).

Bloomberg: "'Whatever choice we make will reduce the deficit,' (Pelosi) the California Democrat told reporters yesterday in Washington, 'not only under 10 years but over 20 years'" (Rowley, 10/21).

Reuters reports that the final CBO numbers on the other two plans are due this week as well, though a showdown with the Senate over inclusion of a public plan in the final piece of legislation is likely (Whitesides, 10/20).

Meanwhile, The Hill reports that House Democrats are trying to rebrand the public option as a "Medicare for All." Democrats see benefit in this strategy because it could help overcome the gap between party liberals, who support the public option, and moderates, who worry about its impact on private insurers. "Rep.  Mike Ross (D-Ark.) spoke out last week in favor of re-branding the public option as Medicare, startling many because he has loudly proclaimed his opposition to a public option" (Soraghan, 10/20).

Politico: "Pelosi, who has long favored the most robust public option, made clear to members that part of her strategy was to strengthen her hand by taking a strong public option bill into the House-Senate conference. She left open the possibility of going with a different version of the bill if she couldn't muster the votes" (O'Connor, 10/20).

House leaders are being asked to post the health reform legislation 72 hours before voting on it, McClatchy Newspapers/The Miami Herald reports. "An unusual coalition of conservatives, watchdog groups and a handful of Democrats has joined the push by Rep. Brian Baird, D-Wash., to put the 72-hour measure into a binding rule for the House of Representatives. Similar efforts in the Senate haven't gained much momentum" (Lightman, 10/20).