In a press conference today, Senate Majority Leader Harry Reid announced that the Senate version of the health care reform bill will include a public option, but give individual states the right to opt out. Although the current House version of the bill does not include the ability to opt out of a public option, Speaker of the House Nancy Pelosi has indicated that a reconciled bill could include the opt out mechanism.
Currently, the Senate is two votes shy of a filibuster proof majority if the public option is included with an opt out. Senator Olympia Snowe, the only Republican to vote for the bill in committee, is pushing a “trigger” instead of an opt out, which would create a public option if and only if local health care insurers fail to provide affordable insurance for consumers.
One major issue that still needs to be settled is being fought out among House Democrats. Liberal leaning Dems want government payments in a public plan to be linked to Medicare costs, which would mean paying less to hospitals and doctors than private plans pay. Conservative Dems favor a competitive system, in which the public plan would negotiate rates alongside private plans. Speaker Pelosi hopes to reconcile those differences in time to unveil a bill later this week.