Greg Sargent's numbers are right: "47 House Dems are committed No votes, and eight are Leaning No," on a health care bill if it includes a public option, preferred by reformers, that pays providers Medicare rates plus five percent.
House Speaker Nancy Pelosi can only afford to lose a maximum of 38 votes in her own party, and she's still well over that. Nobody I've asked has gone so far as to say this is the end of the road for the so-called "robust" public option, but it's certainly not a good sign.
This morning, House Majority Leader Steny Hoyer said he was fairly confident a more modest public option, using negotiated rates, would win out in a vote count.
For her part, Pelosi asked CBO to score three versions of a public option: the two described above, and a hybrid public option that would start out using negotiated rates, but set them at "Medicare +5" rates after a number of years if the negotiated rates don't realize sufficient savings on their own. That may still be an option for House Democrats, but at this point the purest form of public option is looking like a reach.
The Senate's public option proposal uses negotiated rates, too, so if the House can't force through a more maximal measure, it's difficult to see how reformers and liberals will get the public option they've been fighting fore.

TPM Stories Now Surging on Digg.com

tosh
October 27, 2009 6:11 PM
Read Chris Bowers for a closer look at the "internals" of the Whip Count:
http://openleft.com/diary/15717/house-still-short-for-medicare-5-but-within-striking-distance
No knock on Greg, who does great work. But I think that even Greg would admit that Chris has been closer to the various whip counts on this topic (going back to when the Progressive Caucus was doing one) than probably anyone. He's also not one to be myopic on this topic, and is far from a pom-pom guy for House Leadership. Instead, he's been rather critical of how things have gone this year. So he's a good one to keep an eye on with this topic.
John
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
Overreach THIS!
October 28, 2009 12:54 AM in reply to tosh
Nice link! Thanks a lot for that!
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
Indie Pro
October 27, 2009 6:15 PM
The Doors, Who Do You Love? keeps coming to mind. We'll see who the Democrats love: lobbyists and industry or people, trapped by a mandate.
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
mans_best_friend
October 27, 2009 6:19 PM
In practice, the difference between Medicare+5 and negotiated rates may not be that large. Big insurers routinely negotiate steep discounts (30% or more) from providers in their networks. I see no reason to think that a PO negotiated rate will be any higher. The difference is that instead of the discount going into the insurance company's profits, it will go toward reduced premiums. Couple that with lower overhead costs and the PO will still be MUCH cheaper than private insurance.
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
bluebell
October 27, 2009 6:29 PM
The ought to be arrested for cruelty to animals. They keep dangling a bone here and there in front of progressives just to snatch them away.
Not good enough.
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
FreeRider
October 27, 2009 6:48 PM in reply to bluebell
As if anything they did would ever be good enough for you. LOL.
Hey, you heard that Pilot Sully is a Republican, didn't you? You know him. He's guy you said you'd vote for (without knowing anything about his politics) because he safely landed a plane.
Proof positive that you are waiting for a political knight in shining armor. Hint: politics and governing is not a fairy tale.
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
Cal Gal
October 27, 2009 11:26 PM in reply to FreeRider
WTF are you talking about? Try to keep on point, would you? I know ad hominem attacks can be attractive to some people with obsessive disorders, but you really aren't making sense to those of us just trying to follow a thread and have a conversation.
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
FreeRider
October 28, 2009 10:22 AM in reply to Cal Gal
It's not my fault that you're an idiot and can't keep up. Sit and spin.
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
Walter Mitty
October 27, 2009 7:13 PM
From what I can understand Pelosi shunned a less robust option that had more support to try and force through her robust plan and is facing a backlash because of it. Her strategy was to have the strongest PO possible so when it's watered down in the combining process there would still be something on the other end.
She doesn't seem to realize that every rep doesn't represent a San Francisco district. She shot herself in the foot on this one.
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
_jonny_5_
October 27, 2009 8:17 PM in reply to Walter Mitty
and at this point the house might be smarter politics to pass something closer to the senate bill and have a clearer picture going into conference.
kind of a united front thing...
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
Cal Gal
October 27, 2009 11:30 PM
Still watching that sausage, aren't we?
Obama. Calling President Obama. Obama to the white telephone, please.
Sure wish I was a fly on the Oval Office wall and knew where the H he really stood.
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
willia451
October 28, 2009 6:24 AM
This is a mess. And I'm not sure if its even of that much value.
Watered down individual mandates, weakened employer mandates, negotiated rates PO with an opt out / opt in / trigger ??? that may or may not be administered by HHS, no choices for those that already have crappy private plans, won't kick in until 2013, inadequate subsidies for the middle class, taxes on the rich and "Cadillac insurance plans (or not?), opt out for self-insured employers, no re-importation of prescription drugs, no "fix" for Medicare re-reimbursement, no negotiations with Pharma on drug prices for current govt run plans.
I could go on and on.
How much better for the American People Medicare for all, opt in, would have been.
How we got to THIS abomination I'll really never know. But I have my suspicions.
Oh well. It is what it is.
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
Indie Pro
October 28, 2009 9:37 AM in reply to willia451
I share alot of your frustration, as far ss, how did this become the reform?
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?
Tanjaoui
October 28, 2009 7:06 PM
Someone, please, get the CBO to score HR 676, fast!
Reply | Flag Abuse
Are you sure this comment violates TPM's Terms of Service?