Real health care reform is threatening to emerge from the ashes of the Massachusetts special election that exploded the effort in January. A growing movement in the Senate to urge Majority Leader Harry Reid (D-Nev.) to reinsert the public option into a health care reform package that would move through the chamber under majority-only rules depends on just how many votes backers can muster.
"Senator Reid remains a strong supporter of the public option, but it's always a question of where the votes are," Reid spokesman Jim Manley told HuffPost.
There's one tried and true way to find out if the votes are there: Hold a vote.
Because of the rules surrounding budget reconciliation, the process that would allow health care reform to move through with 51 votes, any Senator may bring up an amendment to the package. An opponent of the amendment will then likely make a point of order and argue that the amendment violates the "Byrd Rule" and is out of order. If the parliamentarian sustains the point of order, the amendment would need 60 votes to pass. But if he deems that it complies with the rules of reconciliation -- that it has a substantial effect on the budget and is germane to the legislation -- then the amendment passes with a majority vote.
Chris Bowers, who has been counting votes based on public responses and private correspondence, counts at least 45 votes for a public option. Democrats would need to find five more, with Vice President Joe Biden breaking the tie. The new movement for the public option began with a letter sent from progressive House freshmen Jared Polis (D-Colo.) and Chellie Pingree (D-Maine) and picked up speed when freshman Sen. Michael Bennett (D-Colo.) organized his colleaguesaround it. (Read the letter here.) Meanwhile, outside progressive organizations have been flooding Congress with calls from constituents, asking members to sign on to the effort.
[UPDATE: Bowers sends in a more recent item of his putting the number at 51; without then-Sen. Paul Kirk (D-Mass.), who has since been replaced by Republican Scott Brown, the number would still hit the 50-threshold.]
Including the public option, they argue, would make the Senate legislation much more politically popular in the House and, polls show, with the nation at large.
If a public option falls short, backers could bring up a Medicare expansion as an alternative. The Medicare buy-in, which would allow those 55 and over to purchase the government plan, was enormously popular before it was unilaterally killed by Sen. Joe Lieberman (I-Conn.), who said he would filibuster any bill with such an expansion.
But there is no filibuster under reconciliation rules. No other Democrat had opposed the Medicare expansion, indicating that there may be as many as 58 votes for it.
The Senate bloc pushing for a stronger reform package is drawing the lesson from Massachusetts that voters want Democrats to use their majority to pass strong reform, rather than rely on backroom deals and capitulation to the GOP. And that's just what the polling shows.
During his State of the Union address, Obama urged his fellow Democrats not to "run for the hills" in the face of the electoral challenge facing them in November. Democrats are taking his advice, and charging directly at the GOP instead. The public option or the Medicare buy-in just may be popular enough to save the Democratic Party from its own worst instincts.
UPDATE: The Las Vegas Sun reports that while Nevada voters are opposed to the previous health care bill, they support moving it through by using reconciliation.
See the poll here.