Public Option: Win or Lose, Little Down Side for Senate Democrats

It's now settled that the health reform bill coming to the Senate floor will include a public insurance option, supported by premiums and run by the government, with states permitted to opt out if they don't want to offer it. And for the life of me, I can't find much of a down side for Democrats.

The public plan -- conceived as a cost-effective choice to be offered alongside private plans -- may or may not survive the Senate. But in making it part of the official Senate bill, Senate Majority Leader Harry Reid has aligned himself with frustrated liberals and majority public opinion, and he has given President Obama and other Democrats an opportunity to do the same.

Minutes after Reid's announcement, I received e-mails from the liberal group Americans United for Change (headline: "Reid Decision on Health Insurance Reform Bucks Big Insurance, Sides With Americans") and from the White House. The administration, which has been nominally in favor of a public option but worried about its Senate chances, was not equivocating Monday.

Obama is "pleased that the Senate has decided to include a public option for health coverage, in this case with an allowance for states to opt out," White House press secretary Robert Gibbs said in a statement. "As he said to Congress and the nation in September, he supports the public option because it has the potential to play an essential role in holding insurance companies accountable through choice and competition."

If the public option dies in the Senate, it will now be despite having first been given a fair shot to make it. Conservative Democrats in endangered seats, meanwhile, will be able to brag about helping to kill it. This seems like heads-I-win, tails-you-lose.

And there's always a chance the public option will survive. Reid appears to have adopted what might be called the Olympia Snowe leap-of-faith approach. As the Maine Republican said before voting yes on what she viewed as a less than perfect bill in the Senate Finance Committee, "When history calls, history calls."

Reid declined to say whether he has 60 votes in favor of the public plan or even the 60 needed to break a filibuster and move on to an up-or-down vote on the plan or a bill that contains it. But there will be pressure on the 60-member Democratic caucus to at least get past a filibuster. And those with reservations would be free at that point to vote against the public option or the whole bill -- you only need 50 votes plus Vice President Biden on an up-or-down vote.

You could argue that the potential loss of Snowe over a public option is a down side. But who really thinks one Republican equals a bipartisan bill? And isn't it crazy to give her veto power over what's in it? It really makes you wonder why this was such a hard decision.

Tuesday update: Joe Lieberman steps up to the plate. The Democrat-turned-independent, who caucuses with his former party and chairs the Homeland Security Committee, says he would filibuster a final health care bill if it has a public option. Liberals are beside themselves, but Democratic elders aren't panicking yet.