President Barack Obama speaks at a fundraiser. Reid leaning toward public option

Senate Majority Leader Harry Reid is leaning toward putting a public insurance option in the Senate health reform bill — a signal that Reid increasingly believes he can get the votes needed for a plan that would allow states to opt out of the program, senators said Thursday.

But President Barack Obama stopped short of endorsing the approach during a hastily called meeting Thursday with the Senate Democratic leadership at the White House, according to an administration official.


Instead, one Democratic source said Obama appeared to prefer a “trigger” option put forth by Sen. Olympia Snowe (R-Maine), who has proposed allowing states to join a national insurance plan if affordable coverage was not widely available. This would suggest the president has not abandoned his goal of striking a bipartisan deal.

Reid’s newfound confidence in passing a Senate bill with a public option — the top priority of his party’s liberal base — has grown recently after months when the idea seemed all but dead. That’s because in recent weeks, some Democratic moderates have signaled an openness to variations on the public option.

Reid has told fellow Democrats that he’s leaning toward a version that would create a national health insurance program but give individual states the chance to decline participation, or “opt out.”

Senate leaders are signaling confidence that they can muster all 60 Democrats to support bringing a bill to the floor because the party recognizes its political fate rests in large part on delivering health care reform, and it would be difficult for senators — even if they disagree with aspects of the bill — to stop the debate before it started, several senators said.

But these senators and others also cautioned that the discussions were evolving, the final proposal has yet to be determined and any determination of a vote count is premature. A handful of key moderates voiced concern about the inclusion of the public option in the merged bill. Snowe (R-Maine), one of the last hopes of giving the bill a blush of bipartisanship, said it would be “difficult” for her to support bringing a bill with a government insurance plan to the Senate floor.

Reid’s decision will determine which side gets the strategic advantage. If a public plan is included in the Senate bill at the outset, opponents would have to muster 60 votes to remove it from the bill, which would be almost impossible to do.



Reid (D-Nev.) and other Senate leaders huddled with Obama at the White House late Thursday, but left without speaking to reporters. Reid was joined in the Oval Office meeting by Democratic Sens. Dick Durbin of Illinois, Chuck Schumer of New York and Patty Murray of Washington.

The leaders presented the national insurance plan with a state opt-out "as one way to get 60 and pledged to keep working on it as one compromise," the administration official said, adding that Obama did not state a preference. But the Democratic source recounted the meeting differently saying Obama expressed a preference for the Snowe trigger.

If Reid included a public option in the Senate bill, it would signal a remarkable shift from where Democrats and Republicans thought the debate was headed after the tumultuous August recess.

And combined with efforts in the House, where Speaker Nancy Pelosi (D-Calif.) is closing in on the votes for the most liberal version of the public option, it appeared more likely than ever this week that the full Congress will be given the chance to offer Americans a health insurance option run by the government as a competitor to private insurance companies.

Pelosi’s lieutenants have been polling House Democrats on whether they support the most robust public option — and say they are closing in on the 218 votes needed to pass a public option. “Getting from 200 to 218 can sometimes take a little time,” Maryland Rep. Chris Van Hollen said as he emerged from a leadership meeting in Pelosi’s office Thursday evening.

Also, a group of 36 moderate House Democrats have written to Pelosi and Majority Leader Steny Hoyer of Maryland, saying they would vote down a House bill that “does nothing to rein in the cost of health care and therefore may not be sustainable outside the 10-year budget window.”

In the Senate, there are still some who question whether Reid can get the public option through.

Senate Finance Committee Chairman Max Baucus (D-Mont.) briefed centrist Democrats on the bill Thursday morning. But Baucus, who has said repeatedly that a public option could not pass the Senate, did not entirely embrace the emerging public option proposal when asked about it.

“Whatever it takes to get national health care passed, I am for,” Baucus told reporters. “The most robust bill that gets 60 votes — that is what I am for.”

It was long believed that a public insurance option could not receive 60 votes in the Senate because a bloc of moderate members would not go for it. They opposed creating a robust government plan that would tie reimbursement rates for doctors and hospitals to Medicare, saying private insurers could not compete.

But during the past month, the energy has shifted.

More variations of the public option were put on the table, providing leeway for the Senate Democratic leadership to find a compromise that would please both moderates and liberals. The insurance industry angered Democrats in the past two weeks with what they viewed as an attempt to scuttle health care reform by releasing critical studies of the Senate bills.

And more public polls were released showing the public option remains popular with voters.

A person familiar with the Senate talks said the negotiations are becoming a race of sorts between the two competing camps to lock in moderates.

The exact proposal remains far from decided, aides said.

Sen. Tom Carper (D-Del.) said senators are still considering a range of questions — any of which could tip the vote count significantly.

Liberals want a national plan on Day One, but some moderates would prefer that it would go into effect only if certain measures on affordability and competition were met. It appears likely that states would be given the chance to drop out of a government plan, but some senators, such as Carper and Sen. Kent Conrad (D-N.D.), want states to then have the option to create their own competitor to private insurers.

Carper said he could support some version of a national plan with options left up to the states. But the public option would have to play on a level field with private insurers, he said.

“We’ve got to make sure this is not the government running this thing,” Carper said, adding that he envisions a nonprofit board operating it.

And in the Senate, Democratic moderates were huddling to determine the best course to take. Snowe and Sen. Ben Nelson (D-Neb.) met with Baucus and Reid several times this week.

“I keep hearing there is a lot of leaning toward some sort of national public option, unfortunately, from my standpoint,” said Nelson, a key swing vote on health reform. “I still believe a state-based approach is the way in which to go. So I’m not being shy about making that point.”

Nelson said he prefers allowing states to decide individually whether to create a public option or some other sort of competitor to private insurance.

“A state public option I can support,” said Nelson, although he added that he hasn’t made any threats to oppose the bill based on the public option.

Reid and White House officials are working to merge two competing Senate bills for floor action in early November.

The pace of the negotiations is picking up. Sen. Chris Dodd (D-Conn.), who is representing the Senate Health, Education, Labor and Pensions Committee, said the merger group hopes to send a package to the Congressional Budget Office soon.

“We have to make a decision fairly quickly,” Dodd said.