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Senate may cut public option

Medicare buy-in also under consideration

WASHINGTON – Racing to complete work on health care legislation before Christmas, Senate Democrats worked Monday on a compromise that could leave their health care bill without a new government insurance plan.

Instead, Democratic lawmakers are exploring an alternative that would authorize the federal government to contract with a commercial insurer to offer benefits to millions of Americans who don’t get insurance through work.

The compromise could include an expansion of the Medicare insurance plan that would allow some Americans as young as 55 to buy into the program, according to lawmakers and others involved in the discussions. That element is an effort to mollify liberal lawmakers who have been demanding that the government set up its own insurance plan, or “public option,” to compete with private insurers.

Other issues that figure to be part of a final deal include the size of subsidies that the government would offer to low- and middle-income Americans, as well as restrictions on federal funding for abortion, which the Senate may vote on as soon as today.

The closed-door negotiations have yet to produce a deal that could bring together 60 senators, the number needed to ensure passage of the bill.

Sen. Ben Nelson, D-Neb., a key swing vote on the issue, cautioned Monday that negotiators were “a long way” from a final compromise.

And several leading supporters of a public option in the Senate and elsewhere reiterated their demands Monday.

“Congress must enact a strong public plan if we want to create affordable, accountable coverage options for all Americans,” said Sen. John D. Rockefeller IV, D-W.Va., who filed an amendment to bolster the version of a public option that is currently in the Senate bill.

The compromise under discussion would allow the federal Office of Personnel Management, which administers health plans for federal employees, to contract with a commercial insurer for a new plan that would be available to people who do not get insurance at work.

The idea is that with federal oversight on behalf of consumers, the new plan would be more responsive to the needs of beneficiaries than are the private plans that would be offered by competing insurance companies.

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