The Senate Finance Committee voted in late September to reject an amendment including a public health insurance option in the healthcare reform bill.
This is not the committee's only opportunity to include the public option, but it indicates that battle lines drawn over the issue are not softening.
According to The Wall Street Journal, the panel voted 15-8 against an amendment introduced by Sen. John D. Rockefeller IV (D-W.Va.) to support a public health insurance option.
As negotiations continue in the committee, others may introduce similar amendments or amendments slightly altered to gain more votes.
The Rockefeller amendment lost support because some Democrats and all of the Republicans on the committee are opposed to a government-run health insurance option that would be provided to roughly 5 percent of uninsured Americans. Rockefeller's amendment would pay physicians in a public option according to Medicare rates, currently under harsh criticism by the physician community for being too low.
The Senate Finance Committee is the only committee with jurisdiction over healthcare that has not yet passed a health reform bill and the only committee that so far has not shown signs of supporting the public option, which is heavily favored by House Democrats and President Barack Obama.
The public health insurance option is one of several issues that has delayed the Senate Finance Committee's passage of a bill. Committee Chairman Max Baucus (D-Mont.) has said from the beginning of negotiations that he and several key Democrats on the committee would not support a public plan option. Without their votes, Democrats on the committee can't pass such a plan and a full Senate vote to pass the measure becomes more difficult.
Reform advocates have criticized Baucus as one of the Congressmen receiving the most funding from pharmaceutical companies and health insurance plans. Health insurance plans are opposed to a public option, claiming it would threaten their business model. Supporters of a public option say it will keep health plans "honest."
The Senate Finance Committee is debating an $885 billion reform bill introduced by Baucus that would, according to the senator, lower healthcare costs, provide quality and reduce the federal deficit over 10 years.
"America's Healthy Future Act" would, he said, make it easier for families and small businesses to buy healthcare coverage, ensure Americans can choose to keep the healthcare coverage they have and slow the growth of healthcare costs over time. It would bar insurance companies from discriminating against people based on health status by denying coverage because of preexisting conditions or imposing annual caps or lifetime limits on coverage.
The bill would improve the way the healthcare system delivers care by improving efficiency, quality and coordination, Baucus said.
Baucus was part of a bipartisan group of six senators who had worked over the past few months to design a bill that might gain support from Republicans. That bill left out the public health insurance option. House Democrats have said a public option is "non-negotiable."
Baucus and some Senate Democrats have said they would only support non-profit organizations called "co-ops," which are part of the Baucus package.
The new bill must gain approval from the Senate Finance Committee before it can be combined with a House bill and one sponsored by the late Sen. Ted Kennedy (D-Mass.) already passed by the Senate Health, Education, Labor and Pensions Committee.
Observers expect some battles ahead as Congress strives to gain some Republican support for health reform bills currently on the table. Obama has vowed to try and pass a health reform bill this year, and hopes to do so with some Republican support.