Glimpse of gratitude

What public option are they fighting for, exactly?

Here's one small process note: You really can't start from scratch with items planned to go through the reconciliation process. Since the Senate bill, as passed by a supermajority, did not have a public option in it, that leaves the House version. So let's review what that was, exactly.

A new agency, required to be self-sustaining

Funded with $2 billion dollars of federal money to be repaid within 10 years.

It would be an option available only to individuals who did not have insurance available via their employers, offered on the national insurance exchange.

The government would be required to negotiate rates with providers in a similar fashion to the commercial carriers.

Policies would be subject to the same restrictions and regulations as any other policy on the exchange.

The government could hire contractors to administer the plan; that is, private insurers.

Under no circumstances could the public option be bailed out by the government. Premiums would have to reflect the actual claims experience and administrative costs associated with maintaining the plan.

The first issue that emerges is an important one, and probably why Senator Harkin is shying away: It assumes a national exchange. The Senate bill is based upon state exchanges or co-ops selling across state lines but subject to state regulation. It's not clear how a national public option that is supposed to be sold alongside private options on state-based exchanges could actually be done. But let's say that it can.