The Kel Word: Will the Public Option Survive?

Although the confabulation about the war in Afghanistan has usurped the news this week, the health care reform bill is still a very disputatious topic between liberals and conservatives.

On the left side of the aisle are staunch supporters of a public option, with the most robust version currently on the table being one that allows states to opt out of coverage. On the right, conservative Democrats have banded with Republicans in their heels-dug-in position favoring no public option whatsoever. In the middle, though, are a handful of Senators who currently control the ball.

Both of Maine's Senators, Olympia Snowe and Susan Collins, seem to be staking their ground in that latter category. Speaking about the latest Congressional Budget Office estimates of cost savings, Snowe said, "We have to be sure that we are providing the most affordable plans to Americans, and that's not abundantly clear at this point. That's what's of concern to me." She indicated that the bill's approach to affordable coverage "makes strides, without question," but still doesn't go far enough for her liking.

For her part, Collins signaled some wiggle room in her position when she told reporters, "I made very clear that I could not support the bill as it's currently drafted, and that there would have to be substantial changes, but I certainly hope that that will be possible. I think there is unease on both sides of the aisle about specific provisions in this bill, and that it's possible that we can come up with alternatives that will garner bipartisan support."

As for the CBO findings themselves, in September Senator Max Baucus received word that "CBO has not modeled all of those factors and is unable to quantify them or calculate the net effects at this time." Now, though, after some pressure, the CBO has released two sets of estimates.

What seems to be indicated is that a majority of people who purchase their insurance through the newly created exchanges will have incomes sufficiently low enough to qualify them for subsidized coverage, making their premiums 56 to 59% lower than they would be if health care reform is not passed, but a mandate is. Employer-based coverage will see a minimal decrease in affordability, in the neighborhood of 1 to 3%.

Slate breaks it down this way: “...health reform isn't aimed only at reducing the cost of health insurance; it's also aimed at imposing minimum standards on the policies that are sold. By law, these would contain significantly fewer deductibles, co-payments, and other out-of-pocket expenses, and would provide a slightly wider range of benefits. This "better" factor raises prices by 27 percent to 30 percent. Balanced against this is a reduction in cost of 7 percent to 10 percent attributable to efficiencies in the new exchanges and a separate reduction in cost of 7 percent to 10 percent attributable to the introduction of a younger, healthier clientele newly required to buy health insurance and newly able, through subsidies, to do so.”

All in all, the CBO predicts that the public option will lower premiums in the private market, but will that be enough to sway those moderate hold-outs into voting in favor of it?