The Carper compromise

THE CARPER COMPROMISE…. The Wall Street Journal reports today that a public option compromise measure crafted by Sen. Tom Carper (D) of Delaware seems to be gaining steam. The piece noted that Carper’s measure “won praise from some in his party Tuesday as a way of bridging differences among them.”

Sen. Kent Conrad (D) of North Dakota, for example, called the Carper proposal was “very constructive.” And Sen. Ben Nelson of Nebraska, Congress’ most conservative Democrat, seems amenable, too.

At least one opponent of a public option, Senator Ben Nelson, the Nebraska Democrat, said Tuesday that he was warming to a compromise proposal floated last week by another Democrat, Senator Tom Carper of Delaware.

Mr. Carper has suggested leaving it to the states to decide whether to offer government-sponsored insurance plan, the so-called public option. Details are scant — Mr. Carper circulated a one-page proposal, not a fully fleshed-out legislative plan — and it is unclear whether the idea will gain enough traction to be included in a final Senate bill. But Mr. Nelson said he had been discussing it with colleagues.

“It all depends on the details,” Mr. Nelson said. “But I think there is a legitimate argument for giving the states an option to solve this problem, which is essentially an insurance problem.”

Nelson added that Carper idea start gaining some momentum last week “and it seems not to have lost any momentum since then.”

So, is Carper’s measure any good? We’ll have a better sense as it’s fleshed out in more detail, but Ezra Klein gave it a fairly positive review last week, and sketched out the general outline:

1) Participate as grantees in the CO-OP program and apply for seed funding.

2) Open up that state’s employee benefits plan.

3) Create a state administered health insurance plan with the option of banding together with other states to create a regional insurance compact.

Each state would, in other words, be allowed to create a public option. And states could band together to give their public options more bargaining power and efficiencies of scale. This would do a couple of things. First, it would give residents access to a public competitor. Second, it would provide an acid test of whether a public competitor substantially changes an insurance market. Does it force private insurers to bring their prices down? Does it create more competition and transparency? Are consumers more satisfied? And if all that happens, will other states really resist adopting the public option?

Jonathan Cohn had a slightly more skeptical take, but still called it “an interesting idea.”