If conservative Democrats can't support a public option, they'd better be prepared for alternative solutions that also involve more government involvement in health care, said a a leading liberal senator on Tuesday.
Senate leaders have called for a final answer on the public plan by the end of Tuesday, and it looks increasingly unlikely they'll be able to corral the 60 votes they need to pass health care reform with a public option. In the meantime, many of the ongoing negotiations among the party's opposing wings have centered on compromise proposals -- some of them supplement the public option with other programs, others further weaken the public plan and still others knock it out of the bill altogether.
"We're trying to do things which will make up for the fact that the public option appears not to be very popular with just enough people to kill the bill," longtime public option champion Sen. Jay Rockefeller (D-W.V.) told reporters following the weekly Democratic caucus lunch Tuesday afternoon.
However, the holdouts are going to have to trade the public option for something else they probably won't like, Rockefeller said. "If we're not going to do that then we've got to get in return things which accomplish other things, like health insurance regulation, and Medicaid and Medicare buy-in is in fact a discipline on the insurance industry. You wouldn't think of it at first, but it is."
The buy-in proposal -- which would allow the 55-to-64 crowd to enroll in Medicare at a premium, and Americans living below 150 percent of the poverty line to join Medicaid -- won a cautious endorsement from public option skeptic Sen. Kent Conrad (D-N.D.), who said he is generally inclined to support nonprofit alternatives. As always, however, Conrad is thinking of his constituents first.
"I'm intrigued by it. I think it has real potential," Conrad said of the buy-in. "I would not be intrigued by a Medicare buy-in that did not deal with the fact that my state is the second-lowest or third-lowest reimbursement state in the nation."
Rockefeller's public option ally Sen. Sherrod Brown (D-Ohio) stressed that liberals have yet to concede any piece of the public option as it stands. "Everything's still up for discussion," Brown said.
With all that discussing left to do, plus a mountain of amendments and obstructionist GOP tactics, can the Senate still finish health care by the end of the year? "Yes," Senate Majority Leader Harry Reid (D-Nev.) said simply at an afternoon press conference, before adding a familiar refrain. "We're making progress."