WASHINGTON — With prospects fading that the Senate will include a government-run insurance option in healthcare reform legislation, congressional Democrats and Republicans are already sparring over an alternative -- a series of private regional cooperatives that advocates say could achieve the goals of a public plan without the potential for government interference.
The key negotiators in the Senate -- the so-called Gang of Six of three Republicans and three Democrats from the Senate Finance Committee -- are scheduled to meet today by teleconference to discuss prospects for keeping a bipartisan health plan alive, which could hinge on the acceptability of co-ops to both sides.
One of the six -- Democrat Kent Conrad of North Dakota -- is the leading Senate proponent of co-ops. He and others point to cooperatives in Seattle and Minnesota that employ doctors and own their own healthcare facilities, giving them more control over costs and the quality of care. Conrad says that under his plan, the federal government would play no role in managing the co-ops, but would only provide seed money to help them get started.
Sen. Michael B. Enzi of Wyoming, a Republican member of the negotiating team, says he supports a co-op provision in the bill as long as it is not "hijacked" to get a "government-run program in place."
The White House has been adamant that healthcare reform legislation needs to create more competition in the health insurance marketplace, expand insurance to millions who do not have it, and drive down costs.
President Obama's favored mechanism is a federal insurance plan -- the so-called public option -- which could give consumers an alternative to private insurers and put pressure on the industry to reduce costs. Bills passed by committees in the House of Representatives contain that option.
But conservative opposition, based on arguments that a federal plan would have unfair advantages and ultimately drive private insurers out of business, has risen sharply. The chances of a public option emerging from the Senate Finance Committee are now considered almost zero.
Senators seeking a compromise hope that the White House, its liberal allies and Republicans might find common ground in co-ops. Supporters say co-ops offer improved service and are cheaper because they don't have to turn a profit. They would return revenue to their members in the form of lower premiums and be self-governed by elected boards. And the co-ops might help the White House achieve its goal of providing competition to private insurance companies.
