During the presidential campaign, Mr. Obama suggested that a broadly available public plan could resemble Medicare, the existing federal health-insurance program that is only open to the elderly and certain other groups. Now, a Medicare-like plan is highly unlikely, Senate aides say. White House officials also have signaled they are open to other approaches. Two other options are still on the table. One is to create a public insurance plan run by multiple regional third-party administrators. The other is to have states create their own insurance plans, possibly by allowing people to buy policies through the plans available to state employees. The idea is that state plans wouldn't have the clout that would enable a national plan to muscle out private insurers. Yet another option, proposed by Sen. Charles Schumer (D., N.Y.), is to create a public plan that pays for itself and adheres to private-insurance rules. If Senate Democrats and Republicans can't reach a compromise on the public plan, there are still several ways it could make its way into legislation. Although leading Democrats have said they want a bipartisan deal, they could forgo that and push through their own measure using a tactic known as "reconciliation," which shields bills from procedural delays and requires just 51 votes in the Senate to pass rather than a filibuster-proof 60.

We must make it CLEAR that we will NOT accepted mandated health care insurance WITHOUT a strong, robust Medicare-like public option. The White House has to hear from us that we won't ACCEPT mandates without a strong, robust Medicare-like public option.

CALL the White House at: 202-456-1111 and E-MAIL them as well!

These Senators also have to hear from us that we WANT a strong, robust Medicare-like public option, and that we will NOT accept their so-called health care plan without it.

The public option is the line in the sand for me. Is it the line in the sand for you as well?

Then let's fight to have the BEST possible public option, which is a Medicare-like public option, as outlined in the white paper proposal released by the Senate Finance Committee. In that white paper, there were three proposals for the public option:

Approach 1: Medicare-Like Plan This proposal would establish a "Medicare-like" public health insurance option to be offered through the Exchange. The public option would be administered by a new agency within the Department of Health and Human Services (HHS). Eligibility rules, markets, and income-related tax credits for the public option would mirror those for all other plans offered through the Exchange. Medicare providers would be required to participate in the public option, and would be paid Medicare rates plus 0-10%. Rating rules would apply to the public option in the same way that they apply to plans offered through the Exchange in the non-group and small group markets. (Rating rules restrict the variation in price of insurance policies according to the risk of the person or group seeking coverage and are explained in the section on non-group market rating rules and risk adjustment.) Risk adjustment would apply to the public option in the same way that it applies to plans offered through the Exchange in the non-group and small group markets. (Risk adjustment is an adjustment in the payment for an insurance policy which reflects the expected variation in expenditures of sicker or healthier individuals. See the section on non-group market rating rules and risk adjustment.) The public option would incorporate any medical delivery system reforms adopted from the overall reform effort. The public option would not have solvency requirements. The public option would start and accept enrollees on the same date that the Exchange begins. Approach 2: Third Party Administrator Proposal 2 would be similar to Proposal 1 with the following differences. First, instead of being operated by HHS, the public option would be administered through multiple regional third-party administrators (TPAs) who would be required to report to the Secretary. This governance structure will be separate from the agency overseeing competition among other private plan options. Second, the TPAs would be required to establish networks of participating medical providers. Payments for participating providers would be negotiated by the TPAs. Lastly, the public health insurance option would be required to have reserve funds.



Approach 3: State-Run Public Option Proposal 3 envisions a State-run public option. This option could either be mandatory or optional for States but the details of its administration will be left to the States. One possible option for the States might be to allow individuals to purchase coverage through the State employee plans.

As was written about earlier, we have 21 Democratic senators out of 59 Democratic senators that have come out in support of the public option. Here are the names below:

Please CALL these senators listed above and thank them for supporting a strong, robust Medicare-like public option. When you call, please ask them not to support legislation that has a watered-down public option or does not have a Medicare-like public option. Ask them to oppose the so-called Schumer public option compromise. We need them to have stronger leverage in the Senate when it comes to the ultimate passage of health care reform, instead of allowing the Senate Blue Dogs, led by Senator Bayh, to have that leverage.

It's also sad that we only have 21 Democratic senators in the Senate in support of a public option in health care reform. And that these senators below, led by that odious Senator Bayh, might block the inclusion of a Medicare-like public option in favor of the so-called Schumer compromise.

Sens. Mark Udall (Colo.),

Evan Bayh (Ind.),

Michael Bennet (Colo.),

Mark Begich (Alaska),

Tom Carper (Del.),

Kay Hagan (N.C.),

Herb Kohl (Wis.),

Mary Landrieu (La.),

Joe Lieberman (Conn.),

Blanche Lincoln (Ark.),

Ben Nelson (Neb.) ,

Bill Nelson (Fla.),

Jeanne Shaheen (N.H.), and

Mark Warner (Va.).

Can you please CALL these senators above and ask them to support a strong, robust Medicare-like public option and to oppose the so-called Schumer compromise? Here's the link which has their office phone numbers, so just scroll down the list and call their offices.

And don't forget to call Senator Kennedy's office at (202) 224-4543 and ask him to fight with us for a strong, robust Medicare-like public option in health care reform.

I get tired sometimes when I think about the odds facing us in passing a strong, robust Medicare-like public option, but I know I'll feel even worse if I don't try to stand and FIGHT for the BEST public option possible.

We have until June for the public option in health care reform. That's when the initial legislation gets dropped. That's when the huge mother-of-all-battles begin between us, the lobbyists, and Congress. We'll have to fight the Blue Dogs, the New Democrats, Republicans, and the lobbying ads.

I'm going to fight every day for the best public option possible, and I ask you to please recommend this diary so that more people can help join in the fight by using these numbers of Senators that I've provided above.

As I've said before above, the public option is the line in the sand for me. Is it the line in the sand for you as well?

Edit: Try these congressional toll-free numbers below:

1 (800) 828 - 0498

1 (800) 459 - 1887

1 (800) 614 - 2803

1 (866) 340 - 9281

1 (866) 338 - 1015

1 (877) 851 - 6437

Edit #2: If you're a single-payer advocate, please feel free to rec this diary upand follow the action list over there, and use the phone numbers provided on this diary to call in support of it.