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Opt-Out Public Option Gains Steam Among Dems, But Questions Remain

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With Reporting By Jeff Muskus

Democratic senators were largely caught off-guard on Thursday as a compromise approach to health care reform -- emerging seemingly without warning -- began picking up praise from progressive and centrist lawmakers.

In the halls of Congress few had actually heard of or seen the proposal, which would establish a national public option for insurance coverage but grant a state government the right to exempt itself from the system. And, as such, there was a clear and sensible hesitancy to weigh in on the so-called "opt-out" approach.

But the early reviews were, nevertheless, politically promising. In a debate where proponents and opponents of expanding the government's role in providing health care insurance coverage have failed to find middle ground, the newest compromise to the public option was -- at the very least -- intriguing to all.

"It's worth looking at," Sen. Joseph Lieberman (I-Conn.), told the Huffington Post. The Connecticut Independent, who is one of the foremost skeptics of the public option within the Democratic Caucus, was echoed by an equally-forceful public option naysayer: Sen. Ben Nelson (D-Neb.) "Worth looking at," said the Nebraska Democrat.

Even the author of one of the pieces of health care reform legislation making its way through Congress said he was willing to consider the opt-out idea.

"Senator Baucus will look closely at this proposal," said an aide to the Senate Finance Committee Chairman, "as well as other proposals, and could consider supporting them as part of an overall package as long as it achieved his health care reform goals while getting 60 votes."

On the opposite side of the intra-party ideological spectrum other Democrats approached the opt-out compromise with cautious interest. Fresh off of sending a letter to Democratic leadership in which 30 senators reiterated the importance of a broad-based public option, Sen. Sherrod Brown (D-Ohio) promised to be at the table when the opt-out was discussed.

"Sen. Brown believes the HELP-passed version is one of the best vehicles for achieving affordability, continuity, and access in every area of the country," said his press secretary Meghan Dubyak, "although he will continue to participate in ongoing discussions with leadership and his Senate colleagues about the specifics of the bill."

Former DNC Chair Howard Dean was far more accommodating to the idea, telling the Huffington Post that if he were a member of the U.S. Senate he would vote for the proposal -- provided it was the only one that could get past a Republican filibuster.

"If this passes I won't say it is not reform because it is reform," he said. "If this is what it takes to get 60 votes I say go for it."

And yet, as quickly as the intrigue surrounding the opt-out grew, countervailing forces began to weigh in. Democratic leadership aides told the Huffington Post that the discussion of the compromise approach was getting much too far ahead of reality.

"From the conversations I've had in the last two hours it's not sounding like a lot of folks have even seen the thing," one of those aides emailed mid Thursday afternoon. "I think that people getting so excited about this is dangerous."

The idea of allowing states to opt-out of a national public option has been discussed as far back as last week in conversations between Sen. Chuck Schumer (D-N.Y.) and labor leader Andy Stern. Since then, the table of negotiators has expanded to include Sen. Tom Carper (D-Del.) and at least one progressive senator, according to Democratic aides. The group submitted the idea to Senate Majority Harry Reid's office on Tuesday. But as of Thursday afternoon, no official white paper existed for Senators to work off of.

All that existed, indeed, was a somewhat vague idea with a myriad question marks. What kind of national public plan would be established? How, exactly, would states be able to opt-out? Would consumers be allowed to cross state lines for insurance? Most importantly: was this good policy?

"One problem with the opt-out idea is that Republicans may seize on it in the future and turn it into a general opt-out for states to exempt themselves from the whole bill," said Paul Starr, health care expert at Princeton University. "Remember there will be four years and two elections before the reforms go into effect. This would be the easiest step for Republicans take during that period to ensure that the whole thing would unravel. And it would unravel because states that adopted the reform would become magnets for migration by the sick from states that opted out."

Proponents of the state opt-out approach said that these details would be filled out in the days and weeks ahead. Though, in a reflection of just how nascent the discussion is, no time frame was offered as to whether or when something would be formally considered.

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