Agreement to drop public option pushes health bill 'way down road'

NEW YORK To paraphrase a quote often attributed — but probably incorrectly — to 19th century German Chancellor Otto von Bismarck, if you like either laws or sausages, it’s best not to watch them being made.

That maxim could certainly apply to the seemingly endless bickering over the details of the health-reform debate in Congress. But in an era of constant Internet news feeds, blogging and instantaneous, on-the-spot reporting and analysis, it’s virtually impossible to avoid the spectacle.

Since the spring, the give-and-take over health reform and the public rancor it’s generated have dominated the airwaves and print media. And, given the almost unanimous opposition of House and Senate Republicans and the apprehension of some centrist Democrats regarding issues like the so-called public health-plan option and public funding for abortion, the odds against passage of any health reform legislation this year have seemed at times almost insurmountable.

But those odds went up dramatically on the evening of Dec. 8. A breakthrough on negotiations over the Patient Protection and Affordable Care Act came when Democratic leaders in the Senate indicated their willingness to compromise on the issue that posed perhaps the biggest single impediment to passage — the public option. Senate Majority Leader Harry Reid said the tentative agreement to drop plans for a government-managed health plan pushed the bill’s chances “way down the road.”

The Democrats could still end up with half a loaf, since the agreement includes a plan to create a network of nonprofit health plans — administered by the Office of Personnel Management — for Americans who lose their employer-sponsored health plans and others who find it difficult to get insurance through other means. What’s more, the bill, if reconciled in its current form with health reform legislation already passed by the House and signed into law, could boost the rolls of the insured through another means besides those already laid out in previous health reform proposals. To wit: The agreement hammered out Tuesday night includes a proposal to lower the age for Medicare eligibility to 55.