As lawmakers try to work out the final form a public option will take in health care reform legislation, interest groups are avoiding wading into the debates over the various versions of the public option until the dust has settled, staying more broadly on message as for or against a government-sponsored insurance plan.
"Our major objective is we would like to see the most robust public option we can achieve," said Chuck Loveless, legislative director at the American Federation of State, County and Municipal Employees. "As far as making compromises, we just have to wait and see as we get through the legislative process."
On the other side, Blue Cross Blue Shield Association's Senior Vice President for Policy and Representation Alissa Fox said her group is continuing its campaign against a public option generally because "any form" of a government-run insurance plan is "clearly going to lead to a single-payer system."
"We've made [the public option] a priority all year long," she said. "We have been to as many offices as we could physically go to multiple times."
In the Senate, revised versions of a public option have emerged as senators work to combine the Health, Education, Labor and Pensions Committee bill, which includes a public option, and the Finance Committee bill, which does not. Majority Leader Harry Reid, D-Nev., announced Monday that he supports including a government-sponsored plan that would give states the ability to opt out. An opt-in plan has also been suggested. Sen. Olympia Snowe of Maine, the only Finance Republican to support the bill, favors a triggered public option that would take effect if private insurance prices are not lowered to an affordable level.
Negotiations over the structuring of the public option in the House bill are focusing on how reimbursement rates would be determined. House Speaker Nancy Pelosi, D-Calif., prefers basing reimbursement rates for doctors and hospitals on Medicare rates, while many moderate Democrats want rates negotiated by the Health and Human Services secretary.
But while Democrats hash out the details, labor groups have mostly avoided backing the suggested compromise options, holding their fire at the same time that they say they prefer a more interventionist approach by the government. "We're pushing for the strongest public option possible," SEIU spokeswoman Lori Lodes explained. But when it comes to the different options now being discussed, Lodes said the group would "have to see what happens" before determining if it supports a compromise plan.
"We've been keeping a steady drumbeat on" the public option, said AFL-CIO spokeswoman Amaya Tune. She said that approach has been effective, citing a Washington Post poll released last week that found 57 percent of Americans favoring a public option, up from 52 percent in mid-August. Tune said the AFL-CIO was still taking time to examine the latest options on the table, and even when union President Richard Trumka on Monday objected to an opt-in/opt-out arrangement, he took care to cast Reid's announcement as a step forward for the overhaul effort.
Last month, SEIU President Andy Stern said he supported an opt-out plan that would give the states more flexibility in determining the needs of citizens, but Lodes said the more moderate opt-in plan was "something we're not even talking about really at this point."
Business groups and insurance organizations, many of whom have lobbied on the issue since the beginning of health care talks, are working to keep any form of a public option out of a reform bill, and they're focusing on that general message rather than the specifics of the new compromise ideas.
"We believe a government-run plan in any form isn't needed," America's Health Insurance Plans spokesman Robert Zirkelbach said. He added that the cost-lowering goals can be accomplished through reforms that the insurance industry has already agreed to, such as guaranteeing coverage regardless of pre-existing conditions and eliminating the practice of basing rates on health status or gender.
But when it comes to the specifics of the most recently discussed public option plans, the group needs more information. "We haven't seen the details on a lot of those," Zirkelbach noted.
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