Senior Democrats have reached an agreement on one of the biggest hurdles for the Senate's health care reform bill: a public health insurance option.

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Senate leaders reach deal on health reform bill

December 9th, 2009

WASHINGTON – Senior Democrats have reached an agreement on one of the biggest hurdles for the Senate's health care reform bill: a public health insurance option.

Senate Majority Leader Harry Reid (D., Nev.) announced late Tuesday that a group of 10 moderate and progressive Democrats have come to a consensus on the Senate's health care overhaul proposal, the Patient Protection and Affordable Care Act.

"It is a consensus that includes a public option and will help ensure the American people win in two ways: one, insurance companies will face more competition, and two, the American people will have more choices," Reid said in a statement.

He did not disclose details of the agreement, saying it must first go before the Congressional Budget Office for evaluation.

However, published reports seemed to differ on whether the agreement indeed preserved the public option — at least in its initial form as a government-run health insurance plan, as envisioned by President Barack Obama. Some reports described the public option as having been "sidelined," while others said the Senate consensus included a "scaled back" plan.

According to reports, the "public option" in the Senate agreement includes nonprofit national health plans administered by the Office of Personnel Management (OPM), which runs the federal employee health plan, and a program that would allow uninsured Americans to "buy-in" to Medicare starting at age 55, beginning in 2011.

"I know not all 10 senators agree on every single detail of this, nor will all 60 members of my caucus," Reid commented. "But I know we all appreciate the hard work that these progressives and moderates have done to move this historic debate forward."

Senate Democrats involved in the agreement included Charles Schumer (New York), Mark Pryor (Arkansas), Sherrod Brown (Ohio), Tom Carper (Delaware), Russ Feingold (Wisconsin), Tom Harkin (Iowa), Mary Landrieu (Louisiana), Blanche Lincoln (Arkansas), Ben Nelson (Nebraska) and Jay Rockefeller (West Virginia).

The consensus ostensibly removes a key stumbling block for the health reform package as the Senate enters its second week of debate on the legislation, which would cost the nation nearly $1 trillion over 10 years.

Reid has been pushing the Senate to act on the bill by Christmas. However, more challenges are expected this week as lawmakers propose additional amendments to the legislation.

In response to news reports about the possibility of an OPM-administered public insurance option, the National Community Pharmacists Association has urged lawmakers to favor a pharmacy benefit administrator (PBA) for managing drug coverage under such a plan rather than a pharmacy benefit manager (PBM).

"A PBA, such as those employed by Medicaid and the Pentagon, would give patients and taxpayers the best bang for their buck by passing through all rebates, discounts, and price concessions," Bruce Roberts, NCPA executive vice president and chief executive officer, said in a statement.