Health Care Reform Round-Up: Public Option Dropped From Senate Bill

September 30, 2009

By Astrid Fiano
Originally Published: DOTmed.com

The Senate Finance Committee, a key arbiter of health care reform, firmly rejected a public option Tuesday.

Senators Jay Rockefeller (D-WV) and Charles Schumer (D-NY) introduced public option measures, which a majority of the Committee voted down by a large margin. The idea of a public option, a federally funded health plan to compete with private insurers, suffers from both too little and too much support. Some lawmakers have pledged that they won't vote for a bill without the provision, while others oppose it just as strongly fearing it will lead to socialized medicine. President Obama has endorsed the approach.

Compromises that would allow for a public insurer include the possibility of a "trigger" provision that creates a government plan if other approaches fail to protect citizens sufficiently. Or, the plan might apply in some states but not others.

While the Senate bill won't contain the provision for now, its inclusion will be hotly debated as the bill moves out of Committee. In addition, the House of Representatives is mulling several health care reform bills.

Other Issues Debated

Finance Committee member Senator Chuck Grassley's (R-IA) criticism wasn't limited to a public option. He has also expressed disappointment that the Committee has voted to defeat his amendment to require states to raise reimbursement rates for Medicaid providers including pediatricians, children's hospitals; and dentists providing care for eligible children. Senator Grassley had planned to fund the measure through reduction of the health care reform bill's federal subsidies for families in the $66,000 to $88,000 a year income range. The subsidies are to assist in buying health insurance. The Senator's press release said children's access to care would likely decrease without financial incentives, and therefore give "short shrift" to children through a lack of doctors willing to participate in Medicaid.

Pundits, Public Weighing In

Also critical of both White House policy and Committee Chair Max Baucus' Chairman's Mark-up is Newt Gingrich, former speaker of the House of Representatives and founder of the Center for Health Transformation. Gingrich authored an Op-Ed piece in the Wall Street Journal last week in which he defended the U.S. health care system as "still the world's leading source of medical innovation." Gingrich characterized President Obama and the Democrats' ideals of reform as measures that would destroy economic incentives for innovation as assuming government bureaucrats are better at health care spending than health care professionals. Gingrich also expressed concern that investment for breakthrough treatments would be eradicated, and that Baucus' plan contained taxes to the medical device manufacturers that would squelch innovation.

In contrast, the public's perspective is showing a new positive light. According to a new Kaiser Family Foundation Health Tracking Poll, public support for health care reform had a modest uptick in September. The poll numbers reflect a small rise in the number of Americans who feel that addressing health care from is more important than ever, those Americans who believe their families will be better off with health reform, and that the country would be better off.

More of the pubic prefers a bipartisan effort on health reform; the current efforts are leaving Americans feeling most hopeful, although at least half those polled also feel anxious about reform and a third are angry. A majority of respondents have reported some type of struggle with health care, such as cost, and most support individual reform components to expand coverage, such as an individual mandate, an employer mandate, and expansion of state programs such as Medicaid and the Children's Health Insurance Program.

Overall, White House Press Secretary Robert Gibbs commented this week that President Obama believes that health care is in "better shape," and that as the Senate Finance Committee continues progress. "I think soon they'll finish their work, and each of the committees that has jurisdiction of this legislation will have worked through their issues."