Health Care Bill Passes. No Public Option. Yet?

The plan endorsed on Capitol Hill and at the White House may not be the one that goes into effect across the U.S.

After five months of congressional debate and five hours of tense discussion, the Senate Finance Committee passed the makings of significant health care reform. Backed by 13 Democrats and Republican Sen. Olympia Snowe, the wide-ranging bill introduced by committee chairman Max Baucus will cover needed reforms on which there is almost no partisan disagreement—comparative effectiveness research for new drugs and generics, the computerization of medical records, and a ban on denying insurance coverage to Americans with preexisting medical conditions.

Underscoring the still-heated debate over how strong of a hand the federal government will play in regulating the health care industry, the bill does not include a “public option” of government competition with private insurance providers.

President Barack Obama cheered the passage Tuesday afternoon in the White House Rose Garden. “We are now closer than ever before to passing health reform, but we're not there yet,” he said. Still, Obama, as well as much of Washington’s Democratic leadership, is reportedly pleased about the appearance of bipartisan support in the committee. Senate Majority leader Harry Reid singled out the crucial Snowe vote, noting that “her courage to stick with her principles in the face of an increasingly partisan environment in Washington, D.C., is heartening and should serve as a reminder that health care is an issue that should defy party labels.” What remains to be seen, however, is if Republicans will continue to play nice—and if the bill will actually make an effective intervention in America’s thoroughly broken health care delivery system.

And it might be hard for Republicans to keep complaining that health care will break the U.S. piggy bank. The Congressional Budget Office, a nonpartisan entity that evaluates the fiscal outcomes of all of legislation that comes through the Congress, gave the Baucus bill a positive score earlier this month—estimating that the plan will reduce the federal budget deficit by $81 billion over time, and manage to cover 30 million uninsured Americans. CBO director Doug Elmendorf, testifying Tuesday before the finance committee, reaffirmed that the bill in question would be a significant change in the lives of the working poor, the sick and the uninsured.

Still, the plan, while endorsed Tuesday from the Hill and the White House, will not necessarily be the final version that goes into effect across America in the coming months and years. The Baucus bill will need to be merged with plans from the Senate Committee on Health, Education, Labor and Pensions. As well, there is a version, perhaps including the elusive “public option,” that is expected to pass the House of Representatives in the next week. Baucus, Reid and Sen. Chris Dodd are expected to lead those conferencing negotiations at the White House beginning Wednesday.

Some Republicans, like Senate Finance Committee members Jon Kyl and Jim DeMint, are still intransigent about any kind of reform. Many Democrats are still insistent that the public option, strongly supported by progressives in both houses (and, reportedly, by the president) should make the final cut. This faction critiqued the bill that passed. "The Senate Finance bill is a dream come true of the health insurance industry,” said Wendell Potter, a former health insurance executive, in an ad released by the progressive group MoveOn. “The finance committee bill falls far short of real health care reform,” wrote John Nichols at The Nation. “It steers billions of taxpayer dollars into the accounts of insurance companies while failing to provide a realistic, humane or fiscally responsible alternative to their profiteering.”

Despite the dissent from both wings of American politics, “doing nothing is not an option,” according to “Blue Dog” Democrat Kent Conrad. But the fact that so many details remain up in the air means that the partisan heat may only be starting. Sen. Joe Lieberman, who is not on the finance committee, is the first Democrat to come out officially against the Baucus bill. “There’s a danger that we’re trying to do too much here,” he said in a radio interview. “We’ve got to think about putting a lot of that off until the economy is out of a recession.” Democrat Bill Nelson, who did back the Baucus plan in committee, is another potential wavering vote, and Snowe warned Democrats against relying on a “one-vote margin” strategy, saying “my vote today is my vote today”—though rumors are circulating that her fellow Maine Republican Susan Collins may also back the Baucus plan on the floor.

Obama, for his part, applied as much pressure as he’s able to do from his perch on the other end of Pennsylvania Avenue—meeting one on one with moderate Democrat Evan Bayh and then reminding his caucus in his Rose Garden remarks that “now's not the time to pat ourselves on the back. Now's not the time to offer ourselves congratulations. Now is the time to dig in and work even harder to get this done.”

Dayo Olopade is Washington reporter for The Root. Follow her on Twitter.