Editorial: Full circle on 'public option'

Maybe the latest predictions for the Senate's pivotal health-care reforms will prove too good to be true.

How could any overhaul of the $2.5 trillion health-care economy drive down the growing cost of care, shave the federal deficit by $81 billion over a decade, and yet still bring 29 million Americans to the rolls of the insured?

But that was the judgment made last week by the nonpartisan Congressional Budget Office on the Senate Finance Committee legislation. The bill being put together by the committee chairman, Sen. Max Baucus (D., Mont.), is headed for a final vote before Baucus' panel on Tuesday.

Even after spending $829 billion over 10 years to expand health-insurance coverage, the budget office said that savings and new taxes provided by the Baucus bill would cover the cost, and then some.

The fiscal vote of confidence by the budget office is a positive move in the right direction on the road to reform.

Although the latest Quinnipiac University poll suggests that Republicans' reflexive opposition to any Democratic-backed reform is damaging the GOP, the chances for bipartisan action appear slim. So it's even more significant that the budget office report gives Senate moderates every reason to be reassured that the Baucus bill won't break the bank.

The CBO report also provides potentially better leverage to wage a floor fight over the so-called public option. That's good news for the more liberal members of Congress who understand the need for a government-run alternative to private insurers.

The argument for the public option could be that its likely added costs are more affordable, given the deficit-reduction estimates by the budget office.

Of course, much depends on whether Congress can fill out the picture with regard to the actual costs of a Medicare-like health plan for the under-65 population. The idea has been vehemently opposed on ideological grounds by Republicans in league with insurers and, because of its possible cost, by some Democrats.

What's already evident, though, is that the Baucus bill's middle-of-the-road approach will fall short, inasmuch as the budget office estimates that 25 million people still would be without insurance.

Instead of a government-run plan, Baucus would establish insurance cooperatives to compete with private insurers. Yet the CBO threw cold water on that idea, saying the co-ops wouldn't make a dent in many regions.

So that should bring the debate full circle on whether the Senate has no choice but to embrace a public option, as no doubt will be the case in whatever health-care reform the House approves.

The good news is that both the Senate and House appear to be determined to begin full-fledged debates in the coming weeks that could yield legislation to safeguard the nation's health as never before.