The Public Option: Five Reasons Harry Reid Went For It

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Less than two weeks ago, Senate Majority Leader Harry Reid’s aides and colleagues were saying they were all but certain he would bring health care legislation to the Senate floor without a public option. Yesterday, as everyone who follows this issue now knows, he did the opposite. It’s a big gamble. While Reid will likely be able to hold his caucus together and get all 60 votes he needs for the procedural vote to bring the bill to the floor (known as a “motion to proceed”), he’s still at least three votes short on the more crucial vote of cloture–that is, cutting off a promised filibuster by Republicans.

So why did he go for it? There are some subtle shifts in the politics around public option on Capitol Hill that have given it a new–though still fragile–lease on life. Among them are these five:

1. The poll numbers. As Swampland readers know, the public option has enjoyed strong public support all year. But what surprised some on Capitol Hill was that it continued to do well in a more recent round of polls, even after the craziness of the August town hall meetings. What that says to politicians is that the sentiment for a public option is out there, and it’s resilient.

2. The CBO numbers. Another boost came from the Congressional Budget Office, which showed that a public option could save money, and that a strong public option could save even more. That puts conservatives in the unsettling position of standing for more spending.

3. The insurance lobby overplayed its hand. They had assumed that a consultants report warning of higher premiums under health reform would deal a crippling blow. But the methodology was so skewed that its main effect was to damage the insurers’ own credibility — and to diminish their goodwill on Capitol Hill. The argument that a public option might blow a hole in the insurance industry’s business model isn’t getting as much sympathy as it was a few weeks ago, when the insurers were considered a crucial ally to keep at the table.

4. More horror stories. Recent weeks have seen a spate of reports showing how badly insurance companies can act when they are left unchecked: one baby denied coverage because he was too big, another because she was too small, and a woman who couldn’t get health insurance because she had been raped and was taking anti-HIV drugs as a preventive measure.

5. Home-state politics. Specifically, Harry Reid’s poll numbers back in Nevada, where he faces a potentially difficult re-election fight next year. If Reid is to survive, he can’t afford a disaffected Democratic base. Win or lose on this one, he will at least be able to tell liberals he gave his best effort to a cause that has, for them, become the most important element of health care reform.