Point of Information

Point of Information: Two Paths to a Public Option in Health-Care Reform

Thursday, October 1, 2009; 11:19 AM

Two amendments considered, and defeated, Tuesday by the Senate Finance Committee both aimed to get to the same place -- creating a government-sponsored alternative to private insurance -- but by different routes.

The first, sponsored by Sen. John D. Rockefeller IV (D-W.Va.), proposed a program that would piggyback on Medicare for the first two years as it got underway. It would reimburse health-care providers at the same rate as Medicare and would offer a bonus to providers to participate in both programs. Participation by consumers and providers in the insurance plan would be optional.

After two years, the government would negotiate with providers over payment rates. Rockefeller said the plan would save about $50 million over the next 10 years.

Some Democrats on the committee opposed the amendment over its use of Medicare rates for repayment, saying Medicare doesn't pay well enough to keep doctors and hospitals in business.

The second "public option" amendment, sponsored by Sen. Charles E. Schumer (D-N.Y.), sidestepped that issue, stating that reimbursement rates would be negotiated from the start. The measure was not expected to save as much as Rockefeller's plan.

Republicans opposed the broader aims of both proposals, saying a publicly financed plan would inevitably run private insurers out of business.

Five of the panel's 13 Democrats -- Sens. Max Baucus (Mont.), Thomas R. Carper (Del.), Kent Conrad (N.D.), Blanche Lincoln (Ark.) and Bill Nelson (Fla.) -- joined the Republicans in voting against Rockefeller's plan. Baucus, Conrad and Lincoln also voted no to Schumer's amendment.

-- Madonna Lebling

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