WASHINGTON -- Sen. Olympia Snowe, the only Republican to support the Finance Committee's health care bill, said Wednesday she could foresee a government-run plan that would "kick in" if private insurers failed to live up to expectations.
Snowe emphasized that she still opposes the so-called public option, but said she also believes the private insurance market must yield a system in which health coverage becomes more widely accessible and affordable.
"I think the government would have a disproportionate advantage" in the event of a government-run option, the Maine Republican said in a nationally broadcast interview. Snowe said "at the same time, I want to make sure the insurance industry performs, and that's why we eliminate many egregious practices."
If the industry didn't follow through on congressionally-mandated changes aimed at overhauling the delivery of medical services, she said, "then you could have the public option kick in immediately."
Snowe previously had proposed using the public option as an incentive, or a threat, to private insurers who do not make their plans affordable by certain deadlines. This "trigger" option, or some version of it, has survived the bitter debate and scrutiny to remain a viable option for compromise.
Snowe broached this standby notion again as talks among lawmakers on health care were going back behind closed doors; Senate leaders are trying to merge two very different bills into a new version that can get the 60 votes needed to guarantee passage.
Such a statement from a Republican can be very influential in an environment in which GOP lawmakers almost universally have opposed any kind of government-run health care option to compete with private insurers. It represents a break in party solidarity, even if finite. Health care proposals advanced in the House mostly include such a government option.
Senate Majority Leader Harry Reid, D-Nev., has said he wants to complete the wedding quickly and get historic health care overhaul legislation onto the floor the week after next.
Both bills were written by Democrats, but that's not going to make it easier for Reid. They share a common goal, which is to provide all Americans with access to affordable health insurance, but they differ on how to accomplish it.
The Finance Committee bill that was approved Tuesday has no government-sponsored insurance plan and no requirement on employers that they must offer coverage. It relies instead on a requirement that all Americans obtain insurance.
The Senate Health, Education, Labor and Pensions Committee bill, passed earlier by a panel in which liberals predominate, calls for both a government plan to compete with private insurers and a mandate that employers help cover their workers. Those are only two of dozens of differences.
President Barack Obama acknowledges it's not going to be easy. Speaking Tuesday in the Rose Garden, Obama called the 14-9 Finance Committee vote "a critical milestone" toward getting a health care overhaul this year. The legislation won its first Republican support when Snowe broke ranks with her party, saying she was answering the call of history.
Obama wasn't ready to bask in the bipartisan glow.
"Now is not the time to pat ourselves on the back," he said. "Now is the time to dig in and work even harder."
There was no victory lap either for Finance Committee Chairman Max Baucus of Montana. "The bottom line here is we need a final bill, a merged bill, that gets 60 votes," he said. "Our goal is to pass health care reform, not just talk about it."
Aides say Reid has a keen sense of what the Senate will pass and he is focused on finding a solution that can get the 60 votes needed to overcome a Republican filibuster.
In general, bills moving toward floor votes in both houses would require most Americans to purchase insurance, provide federal subsidies to help those of lower incomes afford coverage and give small businesses help in defraying the cost of coverage for their workers.
The measures would bar insurance companies from denying coverage on the basis of pre-existing medical conditions and for the first time limit their ability to charge higher premiums on the basis of age or family size. Expanded coverage would be paid for by cutting hundreds of billions of dollars from future Medicare payments to health care providers. Each house also envisions higher taxes — an income tax surcharge on million-dollar wage-earners in the case of the House, and a new excise levy on insurance companies selling high-cost policies in the Senate Finance Committee bill.
Apart from Snowe, Finance Committee Republicans cited higher taxes, a greater federal role in the insurance industry and other concerns as they lined up to oppose the bill.
Sen. Charles Grassley, R-Iowa, said the legislation would place the nation on a "slippery slope to more and more government control of health care."
Snowe said there were problems with the bill but the risks of doing nothing were too great.
Across the Capitol, Speaker Nancy Pelosi and her lieutenants have been at work for weeks trying to blend legislation approved by three House committees. The eventual result is certain to include a government option, but the details of the plan have split the rank and file and leaders have spent days struggling with the issue.
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