« TDS Co-Editor William Galston: Obama Needs Fear As Well As Hope | Main | TDS Co-Editor Ruy Teixeira: Conservatives Fear Clarity on Health Reform »

ShareThis

The Problem With a Public Option "Trigger"

The other day J.P. Green published a good summary of initial reactions to Sen. Olympia Snowe's reported proposal of a "trigger" to resolve the gap between proponents and opponents of a "public option" in a competitive health insurance system. To put it simply, no one much likes it, and there are growing pressures in both parties to rule it out in advance.

But is the "trigger" one of those "centrist" compromises that don't really make sense, or is something else going on here? In an important post last week, Ezra Klein may have put his finger on the problem:

The concept of a trigger for the public option is actually pretty savvy if the two sides were fighting over the empirical question of "can the health insurance industry control costs and increase competition in a constructive fashion?" If conservatives are right that a restructured market would compel insurers to cut costs and increase competition and generally clean up their behavior, then that's good enough. But if liberals are proven right that a handful of new regulations isn't sufficient to create a working insurance market, then the public option would "trigger" into existence and we'd give that solution a try.

The problem is that there's no real constituency for that compromise: Liberals want a public plan because they want a public plan. Conservatives don't want a public plan because they don't want a public plan. Moreover, conservatives don't just oppose the public plan, but most of them actually oppose passage of a bill. The number of additional votes you can get by making substantive concessions is thus much smaller than the number of additional votes you could get if substantive concessions were actually the sticking point.

Ezra goes on to say that maybe a "constituency of one" is enough to carry the day given Snowe's pivotal positiion in the Senate (particularly if she can bring along fellow Maine Republican Susan Collins, and provide "cover" to a few Democrats).

But in case the "trigger" does fly, it's worth noting that the idea is by no means absurd, and could be, if properly designed (a big "if"), entirely consistent with progressive demands for a public option. In the end, the viability of Snowe's idea will probably come down to a decision among Democrats as to whether they want to cobble together a 60-vote coalition in the Senate and then try to maintain it through a conference committee, or instead go the reconciliation route and hope that Blue Dog defections in the House and a variety of procedural and political obstacles in the Senate don't doom the legislation. Denunciations of the "trigger" by progressives, mainly in the House, should be understood as an effort to dictate the latter strategy, or perhaps some variation like a full-court press for Senate Democrats who oppose the legislation to vote for cloture and allow a bill to come to the floor. And most Republicans will denounce anything that makes passage of any bill possible.