October 21, 2009

Jacob Hack, the policy wonk who was the architect of the public option idea, talks about opening Medicare instead.

It's a concept that many people in the netroots resist on the basis that Medicare is a public insurance system, and the public option... isn't. (They point to Medicare Advantage as the perfect example of misleading branding.)

But the idea is picking up steam because it solves several problems. It offers political cover for Blue Dogs and even Republicans who want to support the plan. It also makes it more likely that at some point, the public option will be rolled into the traditional Medicare plan:

House Democrats are looking at re-branding the public health insurance option as Medicare, an established government healthcare program that is better known than the public option.

The strategy could benefit Democrats struggling to bridge the gap between liberals in their party, who want the public option, and centrists, who are worried it would drive private insurers out of business.

While much of the public is foggy on what a public option actually is, people understand Medicare. It also would place the new public option within the rubric of a familiar system rather than something new and unknown.

The idea has bubbled up among House Democrats and leaders in the past week, most prominently in a caucus meeting last Thursday.

Rep. Mike Ross (D-Ark.) spoke out last week in favor of re-branding the public option as Medicare, startling many because he has loudly proclaimed his opposition to a public option.

[...] Speaker Nancy Pelosi (D-Calif.) planned to unveil a proposal to her caucus Tuesday night that would include the public option favored by liberals in the healthcare bill Democrats want to bring to the floor, according to two House sources.

The plan, called the “robust” option or “Medicare Plus 5” in the jargon that has emerged on Capitol Hill, ties provider reimbursement rates to Medicare, adding 5 percent. Leaders are planning to roll the bill out next week, and are hoping to vote the first week in November

Some Democrats say there’s no need to rename a legislative concept that’s gained steadily in support since being lambasted as a “government takeover” in August. A Washington Post-ABC poll published Tuesday showed 57 percent of the public supports the idea — up five points since August — while 40 percent opposes it.

“It keeps polling better and better as a public health insurance option,” said a senior Democratic aide. “I don’t think it’s changing.” Polling experts, however, have documented that many people don’t know what a public option is, and that small changes in language can cause poll results to vary widely. An August poll by Penn, Schoen and Berland Associates showed that only 37 percent of those polled correctly identified the public option from a list of three choices.

“Before this year, few people had ever heard of the term ‘public option,’ ” Ross said last week.

It’s not clear exactly how the new Medicare idea would work. Some want to expand Medicare itself to uninsured people under 65. Others want to simply rename what is now called the public health insurance option.

Lots more, go read and tell me what you think.

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