Pelosi Steps Away from Public Option, Slightly

For the first time in the white-hot debate over national health care reform, House Speaker Nancy Pelosi spoke approvingly of a bill that lacked the so-called public option, the government-financed move into private insurance markets.

Until today, Pelosi has described the public option, backed aggressively by more than 100 liberal House Democrats, as a key ingredient to passage of any House health reform package. But today she acknowledged aggressive talks to substitute a "trigger" mechanism that would hold the public option in abeyance for several years so Congress could evaluate the performance of the insurance industry and its ability or willingness to expand coverage or lower premiums.

"That is true," Pelosi said of stepped up talks on a trigger mechanism as a replacement for the public option. "But I don't know what particulars are of the trigger. Here we have a situation where in the Kennedy bill in the Senate, there is a public option, it's not as strong as the public option in the House bill. If they want no public option, but a trigger, you can be sure that the trigger will bring on a very robust public option. So, if I were advising insurance companies, I'd tell them take this bill the way it is now."

The Senate bill Pelosi referred to was passed out of the Health, Education, Labor and Pensions Committee that the late Sen. Edward Kennedy chaired. It has not been formally named after Kennedy, but many Democrats, in honoring Kennedy's pursuit of health care reform, have come to call the bill by his name. Sen. Robert Byrd, D-W.V., has called for Congress to name the final health care bill after Kennedy to memorialize his contribution to health care legislation throughout his nearly 47-year Senate career.

Briefed on Pelosi's remarks, one White House aide involved in health care strategy said: "That sounds like a start. It sounds as if there are a lot of different options when it comes to a trigger."

The White House is eager for House Democrats to move away from the public option to give President Obama maximum negotiating room and to take one of the most contentious issues of the health care debate off the table. Pelosi's comments do not eliminate the public option entirely, but do give Democratic leadership voice, for the very first time, to a trigger as an acceptable alternative.

Pelosi also said Democrats are ready for a fight on behalf of health care and haven't been frightened by intense public reaction and skepticism evident in health care town halls across the country.

"The best preparation for combat is combat," Pelosi said. "Members have been engaged in the trenches on this issue and when they come back to Washington they're ready for the fight for us to pass this. The American people need it and they will get it, insurance reform. The other side showed the poverty of their ideas, they had nothing really to say except to shout down people from hearing the facts."