Will There Be a Public Plan?

October 23, 2009

Irony describes this week’s activity on Capitol Hill. Despite the first bipartisan action in the health care debate – a Republican Senator’s support for a Senate Finance package that did not include a public plan – and notwithstanding signals over the weekend that the Administration is not demanding a public plan, leaks from the Senate’s “back door” discussions suggest the bill going to the Senate floor will include a public plan.

Since a merged Finance/HELP bill has not yet surfaced, Senate floor action is unlikely to occur before the first week in November. The Congressional Budget Office will first need to score the merged language and both Democrats and Republicans are pushing to have legislative language available online at least 72 hours before any floor action. Senator Snowe (R-ME) has stated she believes that two weeks is insufficient time to debate the overhaul on the floor, thus potentially pushing a vote into December. The NAM and other employer groups have ramped up our call for a bill that bends the cost curve while maintaining the positive policy provisions in the Senate Finance bill for manufacturers and other employees.

While the details of the merged bill are unknown, it appears that several moderate Democrats have indicated their willingness to support a public plan in some form. Access to affordable, private competing plans and the ability to develop broad pools and purchase across state lines would move us in the direction to improve access and competition in the market, but in absence of cost control measures that are equally or more aggressive as efforts to expand insurance, costs will quickly out pace any efforts to contain them.

Manufacturers are not alone in our concern over increased health care costs. A recent Gallup poll indicates that 49 percent of Americans believe the cost their family pays for health care will increase if a health care bill passes. Reform in the way health care is delivered is critical to drive efficiency — as are other efforts like utilization of health information technology, a focus on wellness and medical liability reform.

According to Gallup, 58 percent of Americans would generally prefer to see Congress deal with health care reform “on a gradual basis over several years” rather than “try to pass a comprehensive health care reform plan this year.”

In the House, leadership is counting every vote, and at press time Speaker Pelosi did not have enough support to move a bill with a strong public plan – yet a weaker version of a public plan is likely to be included. Legislative text for the House bill may be released as early as next Tuesday and will likely head to the floor as soon as leadership is sure 218 votes are secured.