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Nelson, Klobuchar Mull the 'Trigger' Option on CNN's 'State of the Union'

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Sunday, September 6, 2009; 1:02 PM

JOHN KING (Host): And Senator Nelson, the White House says the president will be more specific. You know the big flashpoints in this debate. What is the one specific where you think the president needs to say, this is the way I need it to be? I'm the president of the United States. This is what we're going to do?

SEN. BEN NELSON (D-NEB.): Well, I think he has to say if there's going to be a public option, it has to be subject to a trigger. In other words, if somehow the private market doesn't respond the way that it's supposed to, then it would trigger a public option or a government-run option, but only as a fail/safe backstop to the process.

And when I say trigger, you know, out here in Nebraska, in the Midwest, I don't mean a hair trigger. I mean a true trigger, one that would only apply if there isn't the kind of competition in the business that we believe there would be.

KING: Are you ready to accept that, Senator Klobuchar, a three, maybe a five-year period where you see if the private market responds, and then a public option would kick in only if you don't get more access, more affordability, more competition?

SEN. AMY KLOBUCHAR (D-MINN.): You know, I'd want to see what those triggers are, what the benchmarks are. Because when I get around our state, talk to, like, a small business, a backpack company up in Two Harbors, a guy there owns a company, $24,000 a year he's paying for his family of four, and he says he wouldn't even have started the company 15 years ago if he knew that.

So what I want to see is something where small businesses, self- employed, small businesses are paying 20 percent more than people who work at big corporations, that they have a chance to buy into something. And certainly it's worth looking at, but we have to push competition. We have to do a better job of putting some rules on the insurance companies.

I got involved in this when I got kicked out of the hospital when my daughter was born. She was incredibly sick, couldn't swallow, and I got kicked out in 24 hours. And I went to the legislature with other moms and got one of the first state laws passed guaranteeing new moms and their babies a 48-hour hospital stay. We know we need new rules, so that when your kid gets sick, you don't get cut out of your health care. When you leave a job, you're still able to access health care. So I think a combination of pushing on with some competition, whether it's some kind of a public option, or any kind of a push, and also have those kinds of rules. We need to do something, and that's a consensus I see developing.

KING: In the Senate, Senator Nelson, Max Baucus, the chairman of the Finance Committee, has been trying for months to come up with a bipartisan approach. He has been calling moderate and conservative Democrats. I understand you're one of the Democrats he has called recently. Has he convinced you that he has a plan that not only can pass the Senate but pass the Senate with bipartisan support?

NELSON: No, he doesn't have a consensus at this point in time. I think he still remains optimistic, and is going to wait and see what the president has to say Wednesday night. That might break the logjam and bring some Republicans on.

I know that Senator Grassley seems to be concerned that only three Republicans is not bipartisan enough for him. So perhaps with the right combination of ideas and a trigger and things like that, others might join in the process.

KING: Is that enough for you? The question is, do you do this with 55 or 60, and maybe should the president slow down, or do you do this with 50 and the Democrats use their muscle, 50, 51 votes and go through?

KLOBUCHAR: You know, I'd like to see us at 60. I'd like to see some bipartisan support for this bill.

KING: Is there any possibility of that?

KLOBUCHAR: I do. Olympia Snowe is still hanging in there. She understands how important this issue is for the people of Maine. You see some of the Republican senators coming back, like Senator Corker, saying we hope we can find some common ground. So I do think that it is a possibility.

The problem with going down to 50 is we just have more limited tools in terms of getting the kind of work that needs to get done to help people. The one thing I'd focus on here is just the affordability of care.

You're right in Minnesota, John, home of the Mayo Clinic. A national study came out saying if all the hospitals in the country just followed the protocol that the Mayo uses for chronically ill patients, just on that population we'd save $50 billion every five years in taxpayer Medicare money, with some of the highest quality care in the country. So putting those kinds of incentives in place and getting a comprehensive plan is where we have to go, and that's why getting to that 60 votes would be much more helpful to get the broad support.

KING: Does it have to be a sweeping plan... NELSON: Can I add one thing, John?

KING: ... Senator Nelson -- or should -- please, jump in, sir.

NELSON: I was just going to say, if I might add one thing about that 50 votes, that reconciliation process. People in Nebraska are already concerned that we've been rushing things through, and if we went to some sort of a parliamentary shortcut, I think they would be even more alarmed than they are right now. That's what I heard during the town hall meetings.

KING: Well, then help me out on that point, then. Should the president then drop the idea of having sweeping reform in one bill and go with a more incremental approach and have the people prove, even here at the state fair, Democrats are saying I'm worried about the deficit, I'm worried, can we afford this with 10 percent unemployment and record deficits. Should the president's message be, let's do this in incremental steps and we will prove to you that we will bend the health care cost curve and then do more sweeping things, or is the White House right in saying that you've got to do it all at once?

NELSON: I think that's the appropriate approach. I thought all along that we need to do it in a more incremental fashion. There are things we can do with prevention and wellness, increasing the workforce, coming up with the idea of an exchange, where people can check out rates and there would be more competition available, and people would be aware of it. So there are a number of things to bend the cost curve. Wellness programs would be a part of that, as well as improving the quality of care, moving away from the quantity of care. These are things that can be done.


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