The Congressional Progressive Caucus has been furiously rounding up support for a "robust" public insurance option to be included in the health care bill that Speaker Nancy Pelosi (D-Calif.) is scheduled to unveil Thursday. House Democratic leadership has been part of the effort, whipping the caucus in an effort to find 218 votes to back it.
Leadership isn't confirming that a decision has been made, but all indications are that the progressives have lost this round and that Pelosi will include a public option that is required to negotiate rates with providers. Progressives prefer the robust version -- Capitol Hill code for a public plan that reimburses providers using Medicare rates plus five percent. [UPDATE: Leadership is now confirming they are indeed going with the negotiated-rate option.]
Rep. Raul Grijalva (D-Ariz.) has been pushing strenuously for a robust public option, arguing that tying it to Medicare rates gives it the best chance of competing against private insurers. The public option's intellectual father, Yale Professor Jacob Hacker, makes the same case.
Grijalva, in a statement to HuffPost, insists that he is not being rolled by leadership.
"I am not rolling over. I will insist on a Medicare+5 amendment on the Floor so that the full Caucus can vote on it. We are hopeful that the Rules Committee will allow this amendment, which has tremendous public support, to at the very least be voted on for the record," he said.
Grijalva, in pushing for an amendment rather than including the provision in the bill itself, is in conceding defeat in this round, while vowing to press forward.
Demanding an amendment, however, comes with its own set of problems, because conservative Democrats could then demand their own amendments related to abortion and other issues that would garner enough GOP support to pass.
On a policy level, the negotiated public option will cost taxpayers an extra $85 billion and is the favored choice of Blue Dogs and other conservative Democrats. Observers have noted the irony of the Blue Dogs -- who champion fiscal conservatism -- backing the the more costly public option. But such confusion misreads the Blue Dog Coalition, which is more properly understood as a bloc of Democrats who favor business interests. In the case of the public option, requiring it to negotiate rates means higher payments to providers -- hospitals, doctors and drug makers -- and less competition for insurance companies.
Leadership paved the way for negotiated rates on Tuesday evening, leaking Congressional Budget Office numbers showing that the bill including negotiated rates will cover as many people -- in fact, slightly more -- than the plan with a robust option.
House Speaker Nancy Pelosi (D-Calif.) will unveil the bill that will hit the House floor on Thursday morning.