Snowe's Trigger Plan to Boost Insurance Competition

Janice Simmons, for HealthLeaders Media , September 4, 2009

A public insurance option as part of the healthcare reform measure has a number of friends on Capitol Hill—mainly Democrat. And the public option has number of foes as well—mostly Republicans.

But recently, one Republican senator's idea has re-emerged regarding a public option that she thinks might encourage opponents to change their minds—at least within the moderate ranks.

Sen. Olympia Snowe (R-ME) is one of the three Republican members on the six-members Senate Finance Committee panel that has been hammering out a health reform proposal during the summer congressional recess. It is known that the panel is looking at ideas besides the public option—such as state cooperatives—but are other ideas viable as well?

Snowe is pushing for a "trigger plan," which would feature nonprofit agencies offering health insurance only in instances in which private insurers could not cover 95% of the people in their regions with plans costing no more than about 15% of the individual's or household's annual income. She has explained earlier that her option could be made available in states from "day one in any state" where "affordable, competitive plans" currently do not exist.

Such a proposal might draw support from those Democrats—such as Sen. Tom Carper from Delaware or Ben Nelson from Nebraska—who are not satisfied going in the direction of a full-fledged public option as proposed in the Senate Health, Education, Labor and Pension bill.

However, some of the Democrats solidly behind the public option—such as Sen. Charles Schumer (D-NY) or Sen. John Rockefeller (D-WV)—may not support what they might view as a watered-down version of the option.

On the other side of the Hill, the Congressional Progressive Caucus, which is made up of 83 liberal lawmakers, sent President Obama a letter Thursday saying a health bill "without a robust public option" would not achieve the health reform "this country so desperately needs." They said they would not "vote for anything less."

So, which way will Congress turn? In recent weeks, interpretations have been bouncing back and forth on whether President Obama would consider signing health reform legislation with or without a public insurance option. Snowe's proposal could ensure that the option remains—but on terms that might be more compatible to lawmakers uneasy over full-fledged competition with health insurers.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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