A new twist on a public option compromise

A NEW TWIST ON A PUBLIC OPTION COMPROMISE…. I’d much prefer a legislative landscape in which the search for a public option compromise was entirely unnecessary. Write up the reform bill with a robust public plan, get an up-or-down vote in the Senate, and send it to the president’s desk.

But if a compromise is going to be struck, lawmakers have several possible alternatives to consider, some of which are preferable to others. Tim Noah goes through some of the top contenders, including Kent Conrad’s co-ops, Olympia Snowe’s triggers, Maria Cantwell’s low-income state plan, and Tom Carper’s state-based, opt-in public options. All have advantages and disadvantages (mostly disadvantages).

Sam Stein, however, reports on a new compromise proposal that’s easily the best of the bunch.

Senate Democrats have begun discussions on a compromise approach to health care reform that would establish a robust, national public option for insurance coverage but give individual states the right to opt out of the program.

The proposal is envisioned as a means of getting the necessary support from progressive members of the Democratic Caucus — who have insisted that a government-run insurance option remain in the bill — and conservative Democrats who are worried about what a public plan would mean for insurers in their states.

“What folks are looking for is what gets 60 votes,” said a senior Democratic Hill aide. “The opt-out idea is very appealing to people. It has come up in conversations. I know personally that a handful of members have discussed it amongst themselves.”

This effectively takes Carper’s idea, and makes it better. Carper would let states create their own public options, and possibly increase their economies of scale by partnering with other states. This new alternative makes it an opt-out, instead of an opt-in — Congress would create the public plan, and if states didn’t want to participate, they wouldn’t have to.

As a rule, it’s tough to figure out what public option opponents will come up with in terms of rationales, but this really should satisfy the concerns of Ben Nelson & Co.

It’s not altogether clear who’s championing this approach, but if a compromise has to be part of the mix, this one has real promise.