Health Care: Of Triggers and Timing

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As Kate notes in her story today, yesterday’s defeat of the public option by the Senate Finance Committee has focused a lot of attention on the next big test, which is Senator Olympia Snowe’s amendment to put the public option on a “trigger“–that is, to establish one only as a fallback if private insurance companies fail to create a market for affordable coverage.

However, I am told the Snowe is considering the possibility of withdrawing that amendment from the Finance Committee deliberations, and waiting instead to offer it when the bill reaches the Senate floor. Here’s why:

Given the intensity of yesterday’s debate, both sides are pretty entrenched at the moment. However, outside the heated atmosphere of the committee room, there have been some tentative signs of growing support for the trigger proposal. As we noted last week, Senate Majority Leader Harry Reid has called it a “pretty doggone good idea”–albeit insisting that his preference remains a public option. And over the weekend, former President Bill Clinton also praised it on “Meet the Press,” saying: “Now, the one Republican who’s come up with a good idea is Senator Snowe.”

The staunchest advocates of a public option continue to insist that a trigger is a bad idea, because it would never be pulled, or even constitute a serious threat to the insurance industry. Speaker Nancy Pelosi has said that in her caucus, a trigger is viewed as merely “an excuse for not doing anything.”

But the Obama White House has made no secret of its belief that the trigger could be the compromise on the public option that the President has been looking for. And should the public plan be defeated on the Senate floor–as now appears likely–some of its supporters may be willing to give the trigger idea another look, especially if President Obama decides to explicitly support it. (In his health care speech before Congress, he cited it as one of several “constructive ideas worth exploring.”)

One thing to watch closely: The Congressional Budget Office has yet to weigh in with its appraisal of the trigger idea. It’s “score” would give us not only an idea of the costs, but also some independent appraisal of the likelihood that (1) a trigger might actually be pulled, resulting in the creation of public plans in some states and (2) whether the trigger would be a credible enough threat to private insurance firms to assure that they engage in geniune competition in places that now lack it.

In politics and legislating, timing can be everything. It may well be that by waiting, Snowe would give her “trigger” a better shot.

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