How Harry Reid reached the public option compromise

By Lisa Mascaro

Tuesday, Oct. 27, 2009 | 2 a.m.

Senate Majority Leader Harry Reid did not look especially tired, although his shaggy hair, usually neatly trimmed but now in need of a cut, suggested a man who has been working for days, through the weekend even, preoccupied.

As he stepped up to the podium Monday afternoon, alone, he announced a decision that would be pivotal in the history of health care reform, define his legacy as Senate leader and shape his chances for reelection in 2010.

The Senate health care bill that will be brought to the floor, he said, will include the much-debated public option — the government-run insurance plan, like Medicare, that supporters believe will provide needed competition for private insurers.

But it comes with an asterisk: States can decide to opt out if they wish — meaning the government-run policy would not be offered within a state’s boundaries if a state chooses not to participate.

For the majority leader who has been under great scrutiny for the past two weeks as he forged a bill to bring to the Senate floor, the proposal is a potentially skilled compromise as Reid tries to keep the unruly 60-member Democratic caucus moving forward in the face of seemingly immovable Republican opposition.

The opt-out provision would shift the burden of decision-making onto the states — potentially making state legislators and governors ultimately responsible for choosing whether their residents who are now without insurance will be able to buy a policy from the government-run insurance plan.

This allows Reid’s conservative Democratic senators, who have openly announced their reluctance, if not downright opposition, to the public plan, political cover: No one is forcing the public option on anyone.

Even more, by putting the public plan in the bill, Reid wins a reprieve from the political left, which counts the public option as its highest priority in health reform.

Liberal and progressive groups have been hounding Reid for the past week over his failure to do more than profess his own preference for the public option. One progressive group has been running TV ads in Nevada asking if he’s tough enough to include it.

On Monday, Reid won rounds of praise from the White House, which thanked him for his work, and various health care advocacy groups.

“Thanks to their efforts, we’re closer than we’ve ever been to solving this decades-old problem,” White House Press Secretary Robert Gibbs said in a statement immediately following Reid’s announcement.

Princeton professor Julian Zelizer, who writes widely on American politics, said Reid’s plan “could be a shrewd move. Give liberals the public option they want but force states to fight out battles over whether it will actually go into effect.”

The danger, Zelizer notes, is if the public option becomes too diluted to accomplish its goal — to provide a lower-cost option for the uninsured to obtain health coverage.

One of Reid’s great skills as majority leader is the underappreciated art of vote counting. This is not simply an ability to count to 60 — the number of votes needed to move controversial legislation. It is an ability to mind-meld with his senators and understand what they need to vote yes.

One hones this skill slowly, one senator at a time, by talking and listening, which Reid has been doing for several days.

All last week Reid invited senators who oppose the public option to his office to see where they stood. He worked long evenings and continued working the phones over the weekend from his home.

Reid indicated in a meeting at the White House on Thursday with President Barack Obama that this was the direction he was heading, but kept calling senators.

Reid’s visit with Obama came the day after the Progressive Change Campaign Committee released a poll showing 54 percent of Nevadans support the public option — including 55 percent of the independents Reid will need to win a difficult reelection in 2010.

The poll also showed that one-third of Nevadans would be less likely to vote for Reid next year if Congress fails to pass a public option — among Democrats, the number less likely to vote for him is even greater, nearly half.

Both Nevada and nationally, where polls show even stronger majorities for a public option (61 percent in last week’s CNN poll), the momentum has been building. Reid will certainly help shore up his own base for reelection with Monday’s decision.

“Obviously a public option is something that has been talked about a lot,” Reid said Monday. “It’s something I believe in. ... All the national polls show a wide majority of Americans support the public option. I think it’s important that the matter that we work on, in the Senate, have a public option in it.”

Progressives will take great credit for nudging Reid toward the public option, but for nearly two weeks it has become clear the debate was shifting away from whether the public plan would be included but what shape it might take.

Various provisions for the public option had been considered, including the so-called trigger — which would launch a public plan only if private insurance policies remained unaffordable. It had been backed by the one Republican still negotiating with Democrats, Sen. Olympia Snowe of Maine.

But for all the conservative Democrats that Reid could pick up if he included the trigger, he would lose progressive senators who believe it does not go far enough to ensure affordable coverage. In opposing a trigger mechanism, Democratic Rep. Shelley Berkley, who represents Las Vegas, has asked: What are we waiting for?

Another provision, which would allow states to opt in to the government plan, pleased neither liberals nor conservatives.

Reid settled on the opt-out provision, first floated by Democratic Sen. Charles Schumer of New York, as middle ground.

In announcing his choice, Reid appeared confident he would have support from his senators — yet it remains unclear whether he actually has the 60 votes needed to move a plan forward with the opt-out option.

Once the final details are presented, he said, “I believe clearly we’ll have the support of my caucus.”

If it passes, Reid shifts the burden to Carson City and state capitals elsewhere across the country to decide whether the government-run insurance plan would be offered.

If it fails, Reid has other options that might look more appealing to liberals than they do now.