Harry Reid won a compromise between Senate Centrists and Senate Liberals: centrists killed the public option and liberals get the privilege of voting for something that they could argue resembles a public option, sort of.
Reid refuses to release any details of the plan, but Senators have been leaking the results of each compromise as it was made, so a basic picture of the new Senate plan has emerged. Instead of a weak, opt-out public option (which, we remind you, was already a compromise made to "moderates") there will be a "triggered" federally-run public insurance option, and the Senate will obviously make sure that trigger is never pulled.
One nice aspect of the new plan is allowing people aged 55-64 to buy into Medicare, which is an actual public option that exists and is very successful. This will keep costs down and help a group that is typically under-insured. Medicare expansion will begin in 2011, though it will probably look expensive and not worth it until the "exchanges" open in 2014 and the federal subsidies kick in.
As usual, the middle-aged and old come out pretty well! The same cannot be said of poor people, as the proposal to expand Medicaid eligibility to 150% of the poverty line died rather quickly. Sorry, poors! No money for you!
Instead of the public option the government will ask insurance companies to create "nationally-based non-profit insurance plans that would be offered on the exchanges in every state." The federal public option "trigger" will be pulled if they don't do this. And, shit, we are sick of the compromises but heavily regulated non-profit insurance options with national price-bargaining power are basically an ok deal, fine, whatever.
Now, the future of this current compromise: it will go back to the CBO to be scored, again. At that point, they will attempt to vote to close debate. That will take 60 votes, again, because the Senate is broken. Seriously, it's not supposed to work this way. At all. But it does, so how are we doing on those 60 votes? Well...
Kent Conrad, moderate Democratic Senator from North Dakota and enemy of the rest of America, hates the Medicare buy-in option because it is too fiscally responsible. Ben Nelson is also being a dick about stuff, and now that his "no abortions for anyone" amendment is dead, he may attempt to kill the bill. And he might be joined by Joe Lieberman, who did vow to filibuster any bill with a public option, even if it is a triggered public option that will never be triggered, like this one.
So, following this lengthy and tenuous compromise, expect another one or two or three.
Meanwhile: public opinion! Did you know that 10% of Americans oppose the House health care bill because it is not liberal enough, which means 56% of Americans would like a public option? Did you know that more people support the "public option" when it's specifically compared to Medicare? Did you know (and this is the best statistic) that 3% of Americans support health care reform because they think the bills are so crippled that they successfully prevent actual health care reform? Joe Lieberman should sign up with that contingent!