The other Nelson

THE OTHER NELSON…. Generally, when supporters of health care reform express concerns over Senate Democrats, they point to Sen. Ben Nelson (D) of Nebraska. But it’s worth remembering that the other Nelson is worth keeping an eye on.

Sen. Bill Nelson (D-FL) said on MSNBC a few moments ago that he prefers a “trigger” option on health care reform — of the sort favored by Sen. Olympia Snowe (R-ME) — to the new “opt-out” compromise — which would allow states to individually opt out of a public health insurance option — that is gaining favor with some Democrats.

“I think it ought to be available in all markets, each of the states,” Nelson said. “The idea is, let the free market competition really determine what the rates are.”

Nelson said the “trigger” plan “would be more important” than the “opt-out” compromise, saying that “otherwise you could have a state (that) would say, well, the insurance companies lobbied that state and they just completely did what the insurance companies wanted and took away the public option.”

Now, Nelson’s concerns about the main drawback of the opt-out compromise are entirely fair. If you’re in, say, South Carolina, it’s likely state policymakers would remove your state from the national public plan, and South Carolina’s consumers would be at a serious disadvantage. Reform advocates can hope that South Carolinians would, in time, demand the public option that would exist in other states, but it’s far from a guarantee and would probably take quite a while.

But to argue that a trigger is preferable to the opt-out seems entirely wrong. With the latter, there would be a national public plan that gives consumers a choice. With the prior, there would be no public option at all until some arbitrary point in the future, when private insurers have failed by some arbitrary measurement.

Or put another way, with the opt-out, it’s possible that some states would refuse to let residents have a choice between competing public and private plans. With the trigger, it’s definite that everyone would be denied a choice between competing public and private plans for some indefinite period of time.

Ideally, there’d be no need for these new compromise measures. Both chambers would vote up or down on a sound, responsible reform bill that includes a popular and robust public option.

But if a compromise measure is necessary, the choice between these two should be obvious. Asked last week about the opt-out compromise, Richard Kirsch, executive director of the group Health Care For Americans Now, said, “It is clearly much better than triggers.”

Someone needs to let Bill Nelson know.