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Outline Of Senate Health Bill Agreement Emerging

First Posted: 03/18/10 06:12 AM ET Updated: 05/25/11 03:55 PM ET

Ben Nelson

Senate Democrats emerged from a caucus-wide meeting Wednesday evening tight-lipped about the elements of the "broad agreement" that has been reached on health care reform - in some cases literally so: Sen. Jeff Merkley (D-Oregon) declined to answer questions by pointing at his sealed lips.

There's a reason for the opacity. If details of the policy proposals sent to the Congressional Budget Office are leaked, the CBO no longer feels as if it needs to keep the analysis confidential. Keeping the many pieces secret for a few more days gives Senate Majority Leader Harry Reid (D-Nev.) the opportunity to share them first with colleagues and combine them in a way that gets all 60 members of the caucus on board.

Reid reiterated the importance of confidentiality during the meeting. Fortunately, HuffPost spoke to Sen. Ben Nelson (D-Neb.) before the gathering began.

He confirmed that at least four items had been sent to the CBO for an estimate known as a score: an expansion of Medicaid; broadening Sen. Maria Cantwell's (D-Wash.) Basic Health program to people within 300 percent of the federal poverty limit; the much-discussed national plans that would be run by the Office of Personnel Management; and allowing people 55-64 to buy into Medicare -- first reported here. It's still unclear how the "trigger" for the public option, which is still on the table, will be designed. On Tuesday evening, TPMDC reported that the public option would be triggered into effect if private plans did not come into being. The details of the trigger are crucial: written by a public option advocate, a hair-trigger could bring a public plan into being on the first day; written by insurance companies, it would never be triggered, just as the trigger for Medicare Part D's prescription drug program has never been pulled despite soaring prices.

Nelson said that he'll have to wait for the CBO score, but is open to supporting all parts of the agreement.

The purpose of the negotiations is to find a way to compensate public-option backers for the loss of their key policy objective.

Some liberals in the House, however, aren't sure they're going to go along with whatever deal the Senate strikes. Rep. Raul Grijalva (D-Ariz.), co-chair of the Congressional Progressive Caucus, said the group will meet Wednesday evening to craft a response.

Rep. Anthony Weiner (D-N.Y.), a vocal backer of the public option in the House, is on board, however. "Extending this successful program to those between 55 and 64, a plan I proposed in July, would be the largest expansion of Medicare in 44 years and would perhaps get us on the path to a single payer model," Weiner said in a statement. "Medicare provides health care to all Americans over 65 and has an overhead of barely 1 percent."

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