Senate health bill will include public option

Harry Reid is planning to introduce health care legislation in the Senate that will include a public health insurance option, according to an aide.

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WASHINGTON (CNN) -- Senate Majority Leader Harry Reid, D-Nev., is poised to proceed with plans to introduce a Senate health care bill with a public health insurance option that would allow states to opt out, a senior aide to Reid told CNN on Sunday.

The aide, who did not want to be quoted by name when talking about private deliberations, said a final decision would be made Monday.

Reid is likely to make the move without having firm commitments of support from 60 senators, the number needed to break a filibuster, according to the aide. Describing the move as a "risky strategy," the aide said Reid believes including the public option is the right approach, and that the senator is "cautiously optimistic he can get the votes necessary."

The Senate fate of any bill with a public option is unclear, due to unanimous Republican opposition and concerns by some conservative and moderate Democrats.

Allowing states to opt out. A public option was considered virtually dead a few weeks ago, but Reid revived it last week by canvassing support for a plan that includes the public option while allowing states to opt out.

According to Reid's aide, the Nevada senator hopes to finalize the bill by Monday afternoon to send to the Congressional Budget Office for scoring -- an analysis of what it will cost. Reid then would present the bill to all Senate Democrats at their weekly policy lunch on Tuesday, the aide said.

Several Democratic sources acknowledged to CNN that Reid's decision to include a public option in the Senate health care bill reflects a desire to calm an increasingly angry Democratic base. According to the Democratic sources, the party's base is furious with President Barack Obama and congressional Democrats for moving slower than desired on issues such as closing the detention facility at Guantanamo Bay and reversing the military's "don't ask, don't tell" policy for gay soldiers.

Even if the Senate votes to drop the public option, Reid could still argue he tried to get it included, the sources noted.

Staunch opposition. Republicans oppose any form of public option, contending it would drive private insurers from the market and lead to an eventual government takeover of the health care system.

"I think 100% of Republicans have indicated they don't think having the government in the insurance business is a good idea," Sen. Mitch McConnell, R-Ky., the chamber's top-ranking Republican, said Sunday on the ABC program "This Week."

On the same show, Democratic Sen. Claire McCaskill, R-Mo., predicted the Senate will end up considering several versions of a public option during its upcoming debate on a health care bill.

"I think what we're going to end up with is having votes on a number of choices," McCaskill said.

Alternatives. Choices would include giving states the ability to opt out of a national not-for-profit public option, or reversing that dynamic by allowing states the choice of opting in to such a program, she said.

Another alternative would be the so-called "trigger mechanism," McCaskill said. That idea, originally proposed by moderate Republican Sen. Olympia Snowe of Maine, would mandate a public option in the future if specific thresholds for expanded coverage and lower costs go unmet by a certain time.

The goal is to come up with a plan that can overcome a filibuster in the chamber, said McCaskill, who supports including a public option in the health care bill.

"I'd be less than honest if I didn't say all of us were concerned about making sure we get the votes to move forward," McCaskill said. "But I remain pretty optimistic."

However, other Senate Democrats have concerns about a public option. Sen. Ben Nelson, a conservative Democrat from Nebraska, said Sunday on CNN's "State of the Union" program he had yet to decide on the issue.

"I've made no promise," Nelson said, adding he would need to see the contents of the bill being drafted by Reid before determining if he would help stop a likely Republican filibuster attempt.

Nelson questioned Reid's plan for a national public option that allows states to opt out, but indicated possible support for a plan in which states could opt in.

"Look, I'm a Jeffersonian Democrat," Nelson said. "I think states can make decisions on their own about their own citizens and so I certainly would look at that."

On the same program, liberal Democrat Sen. Sherrod Brown of Ohio said he could support a public option with the opt-out provision. Brown expressed concern about a trigger mechanism, but stopped short of calling it a deal-breaker.

"The trigger says, 'Let's give the health insurance companies another two years after they've had five decades since World War II to do things right,' " Brown said, adding, "We need the public option now. We need it in large part because it will inject competition into places where they don't have it."

Debate rages on. On "State of the Union," Republican Sen. Orrin Hatch of Utah rejected any form of a public insurance option.

"You're going to have a fiasco on your hands," Hatch warned, saying it would place additional financial burdens on states.

On CBS' "Face the Nation," both Republican Sen. John McCain of Arizona and Democratic Sen. Russell Feingold of Wisconsin said they expect some form of health care legislation to pass.

Feingold said the the public option matter could eventually be decided in negotiations to reconcile versions of the bill passed by each chamber.

"I'm frankly getting excited that we may have some momentum for something very positive," he said.

McCain, however, criticized Obama for allowing Democratic leaders and White House officials to craft the latest versions of a health care bill in private. Such closed-door talks violate an Obama campaign pledge to negotiate the health care bill on C-SPAN, McCain said.

Democrats respond that the bills passed in congressional committees include Republican amendments, and that floor debate in both chambers will be publicly televised.

--CNN's Martina Stewart contributed to this report. To top of page

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