Speaker Pelosi and other Democrats say a public option is still necessary for any bill.
White House officials are warning fellow Democrats that the party lost Congress in 1994 not by trying to do too much on Clinton-style health care but by failing to get any reforms done at all – drawing a parallel to the dangers of inaction this year.
“The lesson of 1994 is not that tackling health reform is politically perilous. It’s that failing to act could be devastating,” said Dan Pfeiffer, the White House deputy communications director.
The new White House message comes as President Barack Obama is under growing pressure from his party’s liberal wing to insist on a public health insurance option when he addresses a joint session of Congress Wednesday. Aides have said Obama will make clear that he doesn’t believe a public option has to be part of the final bill.
On Thursday, Obama got a taste of just how firmly entrenched some in his party are on the public option, as both the House progressive caucus and Congressional Black Caucus issued letters warning him to stick by it.
And House Speaker Nancy Pelosi reaffirmed her belief that a bill can’t clear the House without a public option, after seeming to waver on the idea early in the day.
“Any real change requires the inclusion of a strong public option to promote competition and bring down costs. If a vigorous public option is not included, it would be a major victory for the health insurance industry,” Pelosi said in a statement.
Obama will attempt Wednesday to break the gridlock on Capitol Hill with a primetime address to Congress – and with it, force a reexamination of how lawmakers might piece together a bill that can win 60 votes in the Senate and a majority in the House.
The options under consideration hinge on at least two wild cards: Sen. Olympia Snowe (R-Maine) breaks with her party on the bill, and the president convinces progressives that the absence of a public insurance option must not derail health care reform all together.
The three legislative options, according to congressional and administration aides, include winning support from Snowe and perhaps Sen. Susan Collins (R-Maine) and holding all 59 Democrats in the Senate; asking Democratic senators to vote in favor of breaking a Republican filibuster but allow those who don't like the bill to vote against it; and invoking reconciliation, the last-resort procedural maneuver that allows a bill to pass with a simple majority rather than a 60-vote filibuster-proof threshold.
It will be a major test of Obama’s leadership, persuading Democrats that legislation without a government-run insurance plan would still expand coverage, lower insurance costs and provide competition, and that progressives should abandon a position on which they have staked considerable political capital.
The progressive caucus wrote Thursday that anything short of a public option based on Medicare rates is “unacceptable,” and must not be contingent on a trigger, which Snowe has advocated as a compromise. Under the trigger approach, if private insurers fail to meet benchmarks within a certain period of time, the government could set up a public insurance option.
“A health reform bill without a robust public option will not achieve the health reform this country so desperately needs,” read the Congressional Progressive Caucus letter, which was first reported on The Plum Line blog. “We cannot vote for anything less.”
Two liberal groups, the Progressive Change Campaign Committee and MoveOn.org, also launched efforts Thursday to place pressure on the president.
Elsewhere, however, the signs were not as discouraging for the White House. Signaling a split within the labor community, Teamsters President James Hoffa said on Bloomberg Television’s “Political Capital with Al Hunt” that he wouldn’t object to dropping the public option.
“We’ve got to find out what’s doable,” Hoffa said in the interview, which airs this weekend. “I think it’s important to get something done this time and declare a victory.”
The bipartisan “Gang of Six” will talk by phone Friday for the first time in two weeks. No major developments are expected because the group wants to sit down next week and talk about what has transpired over the last month before they make any decisions about the fate of their negotiations, congressional sources said Thursday.
The call will unfold as expectations for a deal reach an all-time low. Unlike a month ago, when Democrats were loathe to talk openly about post-Gang of Six preparations, all parties involved have acknowledged they are deep into this stage of planning.
But even as those talks go on, the White House is in the midst of discussions with Snowe on a bill that does not include a public option, which she has opposed. Instead, it would include the public option “trigger” and insurance market reforms that have won broad support within Congress.
Snowe's office confirmed the talks Thursday, but said her first hope is reaching a compromise with the group of six.
"Conversations are taking place on her safety-net fallback option as they have throughout the debate this year, as well as other approaches to make certain people have access to affordable options," Snowe spokeswoman Julia Wanzco said in a statement. "The Senator has had an open line of communication with the White House over the course of the past few months, and looks forward to participating in tomorrow’s tele-conference call with the Gang of Six -- as the Senator’s foremost goal remains to achieve bipartisan consensus among the six members of the group on a path forward for meaningful health care reform."
While the "trigger" approach appeals to conservative Democrats and moderate Republicans, progressives are likely to balk at the idea, saying there is already lack of competition among insurers. Progressive activists have taken to blogs in the last 24 hours to grumble about how Democrats won the White House and racked up huge margins in Congress only to hand over power to Snowe.
The second option might be more palatable to progressives, who have advocated for it: The congressional leadership would ask Democrats to break a Republican filibuster, which requires 60 votes, but allow those who oppose the bill to vote against it on final passage.
There is one wrinkle, however. With the death last month of Sen. Ted Kennedy (D-Mass.), Senate Democrats no longer have 60 votes. This scenario would hinge a move by the Massachusetts legislature to allow the governor to make an interim appointment, which is not permitted under current law. It would also require participation from Sen. Robert Byrd (D-W.V.), who has been in and out of the Senate as he fights illness.
The last option is using reconciliation, the procedural maneuver that allows the Senate to bypass a filibuster and pass a bill with a simple majority. This approach would produce a more liberal bill because congressional leaders would no longer need Republican votes. It is the path most favored by progressives, but opposed by some moderates and Senate traditionalists who fear that reconciliation throws up too many obstacles.
Republicans, who have used reconciliation to pass bills when they were in charge, can ask the parliamentarian to strike any aspect of the bill that is not germane to the federal budget. There is no way to know ahead of time how the parliamentarian would rule, setting up a situation where the bill that passes would have significant holes.