One of the most respected progressive voices on health care reform said on Thursday that he could live with and even support a compromise to the public plan that would grant states the right to reject the option entirely.
Former DNC Chair Howard Dean told the Huffington Post that the "opt-out" compromise that is being discussed by Senate Democrats was not his ideal conception of what a health care overhaul should be. But he granted that the proposal would produce "real reform" and said that, if there were no other vehicle for getting a bill through the Senate, he would support it.
"If I were a member of the U.S Senate I wouldn't vote for the [Senate Finance Committee] bill but I would vote for this," Dean said, "not because it is necessarily the right thing to do but because it gets us to a better conversation about what we need to do."
In a brief telephone interview, Dean stressed repeatedly that his preference remained, far and away, a national public option that was available to anyone -- regardless of state -- from the day of its conception. But in a wholly political context, he acknowledged, adding the opt-out option to the bill might be the best and only way to get something through the Senate.
"I would like to see that come out of the Senate because it is a real public plan," he said of the opt-out compromise. "Then they can negotiate it [with the House] in conference committee... And if this passes I won't say it is not reform because it is reform."
"If this is what it takes to get 60 votes I say go for it," said Dean
One of the loudest proponents of a national public option, Dean's support for an opt-out provision -- however qualified -- is sure to have ripple effects on Capitol Hill. Currently a group of Democratic senators, led by Chuck Schumer (D-N.Y.), are discussing the opt-out as a means of bridging the divide between progressive members of the caucus (who demand a public plan in the final product) and conservatives in the party (who are worried about the effect a government-run insurance provider would have on private markets). Dean's remarks on the compromise provision could help Schumer and company help bridge that divide, though the former Vermont governor himself predicted that conservative members would still fight it.
"Expect a rigorous fight in the [Democratic] caucus," he said.
A former governor, Dean said that he was fine with the idea of giving state legislatures the power to determine whether their states could be exempt from offering a public plan in their insurance polls. But he worried about the possibility that local governments would actually exercise that right and end up denying the uninsured access to affordable coverage. Health care, he stressed, needed to be thought of as an absolute right for people and not merely a privilege determined by the whims of local legislatures.
"What bothers me is the morality of it," he said. "Because it is a little like civil rights. If the states are making the case that you don't have to do things that are common decency... there are a lot of people who will end up suffering unfairly."