Health care: Obama likely to focus on conference report

The key players in the health reform debate are already moving beyond the incredibly slow Baucus committee. Both Baucus and his Republican buddies have come off looking pretty terrible, and public support for the public option is actually increasing. Now everybody is preparing for the next act. It is generally believed that the Baucus bill (if any) will be heavily edited by the 77 Senators who were NOT on the Finance Committee. Schumer is confident that the bill will become more liberal on the Senate floor and again in the bicameral conference committee, and he’s right on both counts.

And the White House is watching too. It sounds as though the White House will wait until the bill goes through Finance, out to the Senate floor, and is voted on, and then jump in when the conference process begins. If Obama goes that route, then there are still multiple options.

Option 1. If the first Senate bill has the public option (which they could get if they succeed with the “commit to cloture” gambit), they could ask the House to vote on that bill as is, with no changes, so they needn’t hold a conference and then go back to the Senate for a second vote.

If the first Senate bill does not have the public option, Obama can do one of several things:

Option 2. Accept the final Senate bill as is, presumably a slightly less terrible version of the Baucus bill. Unlikely.
Option 3. Alter the Senate bill in the bicameral conference, to include a strong national coop with guaranteed federal funding, or a trigger that is a real hair-trigger, destined to take us straight to the public option with little delay. (In other words, Public Option Lite, or Public Option in a year or two)
Option 4. Add the public option in the conference, and get all the Democrats to “commit to cloture” even if they don’t like the bill. Thus Obama needs only 50 votes to win.
Option 5. Add the public option in the conference, and go for reconciliation. Again Obama only needs 50 votes, but he must make the bill confirm to reconciliation rules, which would be rather complicated.

So for all supporters of real reform, Options 1, 4 and 5 get us a pure public option, and Option 3 gets us close enough. Only Option 2 is a stinker.

I think Obama is gunning for Option 4, with Option 5 as his emergency backup.

Pelosi is helping to set up Option 4 by pushing the House bill hard to the left, to give herself – and Obama – more leverage when the conference process begins.

And that’s what people forget: Obama has four routes to getting a good bill, and the Republicans must block all four of them, to win.