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Health care ‘trigger’ idea gains

Insurance companies would face benchmarks

Peter Nicholas And Christi Parsons Tribune Washington bureau

WASHINGTON – Looking to break the logjam on health care legislation, the White House and Democrats in the Senate are increasingly placing their hopes on the idea of a “trigger” that, if set off, would allow the government to offer health insurance to many Americans.

Advocates believe the “trigger” idea could win over several moderate Republican and wavering Democratic senators, who do not want to give the government blanket authorization to enter the insurance market and compete with private companies.

“This is the best shot we’ve got for getting a public option,” said one House Democratic adviser. “It’s better than nothing.”

Under a trigger, private insurance companies would be told to meet benchmarks for improving the health system, such as insuring more Americans and reducing health care costs. If they failed to do so by a certain deadline, a government-run program would begin offering health insurance.

The proposal has long been part of the health care discussions in Congress. But it has drawn new attention, because it has become a central focus of negotiations between President Barack Obama’s staff and Sen. Olympia Snowe of Maine, a moderate Republican.

If Snowe supported a health care overhaul bill, she potentially could bring a patina of bipartisanship to the measure, providing political cover to other moderate Republicans and conservative Democrats who have thus far withheld their support.

Suggestions that Obama might support a trigger were welcomed by the influential, 52-member coalition of “Blue Dog” House Democrats – conservatives who generally are not sold on Obama’s health care plans.

“The trigger is something the Blue Dogs have supported from the beginning,” said Brad Howard, spokesman for Rep. Mike Ross, D-Ark., who heads the Blue Dogs’ health care task force. “We’ve been talking about this for a while as a compromise, as a middle-of-the-road and moderate alternative.”

By supporting a trigger, Obama could still make the argument to liberal Democrats that he has not abandoned the prospect of a government-run plan, also called a “public option,” which labor unions and much of the House Democratic leadership have said must be part of any health care legislation.

They argue that a government-run plan is needed to inject competition into the insurance industry, which might lead to lower costs and give the public more choices among insurance plans.

Talks between the White House and Snowe have focused on what developments would set off the trigger and begin the government’s entry into the insurance market. Private insurers could keep the government out of the market if they met benchmarks in several areas. Those might include expanding the number of Americans who have health insurance coverage and reducing health care costs.

If the White House manages to come up with numbers that satisfy both moderate Republicans and liberal Democrats, the Snowe proposal could end the stalemate.

The White House declined comment on the negotiations with Snowe.

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