Two competing House health care reform proposals would extend coverage to at least 35 million Americans within ten years, according to a Congressional Budget Office analysis that has yet to be made public.
One plan includes a government-run insurance option tied to Medicare rates; the second would require the government plan to negotiate with providers. An outline of the analysis was provided to HuffPost by a senior House leadership aide, who emphasized that the plan requiring the public option to negotiate would cover 36 million people. However, that number includes coverage that is extended by also increasing Medicaid eligibility from 133 percent of the federal poverty line to 150 percent.
Under the plan that includes the "robust public option" favored by progressives, which would tie reimbursement to Medicare rates plus five percent, 35 million additional people would be covered within ten years.
The focus on the roughly equal coverage rates telegraphs a coming leadership strategy. With Majority Whip Jim Clyburn (D-S.C.) uncertain that he can muster the votes for the progressives' favored option, the case will be made that the negotiated-rate version really isn't all that bad after all.
Clyburn met with Congressional Progressive Caucus leaders Tuesday and, aides say, the meeting became tense as he told them he had yet to whip enough support for the Medicare-plus-five plan.
Clyburn spokeswoman Kristie Greco told HuffPost that the count is ongoing but leadership is currently short the votes needed.
Liberals favor tying reimbursement rates to Medicare because it would keep costs down and would help get the public option up and running. Yale Professor Jacob Hacker, the intellectual father of the public option, insists that the public plan would have a very hard time succeeding if it was required to negotiate rates with providers.
The public option tied to Medicare rates saves $110 billion over ten years. Requiring it to negotiate rates only saves $25 billion.
If leadership goes with the negotiated-rate plan, that $85 billion difference will have to come from somewhere to meet President Obama's ten-year, $900 billion price ceiling. The fattest target is the subsidies to help people afford insurance.