Last night on Countdown, James Clyburn said the House was considering a public option trigger, but before you jump out of your chair, the trigger Clyburn was talking about is a trigger with a twist -- and it might actually be a good thing.
Unlike the Snowe Trigger, which would trigger the public option itself, Clyburn's trigger (he called it a "hybrid trigger") was a trigger to go from a public option with negotiated rates to a public option with Medicare + 5. With a hybrid trigger, you'd have a public option from day one -- the thing that would be triggered would be its reimbursement mechanism.
Clyburn said that there are four forms of the public option being considered in the House. Two of them have a form of the hybrid trigger, listed above. Clyburn said that the White House "seemed" to support that hybrid trigger. If Clyburn is correct, that would mean the White House wasn't supporting the Snowe Trigger, but rather the hybrid trigger, which is far more palatable, because we'd have a public option from day one. Obviously, it would be a huge coup if the Senate passed anything with Medicare + 5 in it. Also, apparently, the House is not putting an opt-out on the table, at least not now.
Here's a transcript of Clyburn's portion of the interview:
People are very passionate about this issue. There are those who feel that a robust public option, that is Medicare + 5, which really, when you look at it, it saves $118 or $119 billion dollars would be the best way to go because that would allow us to make the whole thing more affordable with subsidies, and that sort of thing, for other people.
But there are others who feel that there are three other forms of the public option that ought to be given consideration.
One is the so-called negotiated rates, and then there are two what I call hybrids of the two, that is negotiated rates with a trigger that seemed to be favored by some people, including the White House, and then there's negotiated rates with the 150% poverty that would allow about 3 to 7 more million people to come into Medicaid.
O'Donnell explained that negotiated rates means the rates are negotiated with providers instead of dictated to them, as with the case of Medicare + 5. Clyburn continued:
That's where we are having the debate, because there are those people who feel that the Medicare reimbursement rates in many parts of the country are just too low, and they feel that even if you do a + 5, that will not do their providers justice. And others feel that the negotiated rate would be better so that all these providers can negotiate with the powers that be for what the rate terms would be.
O'Donnell then asked if polls showing the popularity of the public option were being taken into account by members of Congress. Clyburn:
Absolutely. Remember, when we came back after Labor Day, there were people who thought that the whole health reform bill was dead for the year. About 2 or 3 weeks later, after we had an opportunity to explain to people what we were doing, they said, "well, okay, we got a good plan, but the public option is off the table."
Now, we are debating what form of the public option. There are those that said that the Senate had absolutely no way of passing a public option. Now they are saying there may be a form of the public option that the Senate will consider. That's all because the public has dialed in and they are in fact very much for some form of a public option. We're not saying it won't be. We're just saying "what form will take it?"
Next, O'Donnell asked about the Snowe Trigger and whether it could pass the House. Clyburn:
Well, the trigger that's been discussed in the House is a trigger that would allow for negotiated rates up front and then the trigger would kick in after two or three years if the negotiated rates do not produce the result that we would like to see produced. And so that's the only one that's been discussed.
As I understand it, what's being discussed over in the Senate is that the trigger, it would just sit there and we are not to sure how that will ever kick in. And so, I don't believe there is real strong support in the House for that kind of a trigger.
There is a significant amount of support in the House for another hybrid, that is negotiated rates plus 150% of poverty to allow more people to kick in from Medicaid, so we have all four of these plans, and I really believe that sometime by the end of next week, we'll see the House rolling something out, with a public option. I just don't know which one of the four forms will be laidout.
This interview is far from definitive, but it does put a new wrinkle into the trigger debate because, as Clyburn makes clear, there is more than one kind of trigger under consideration.