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By David Dayen

By now you've probably heard about Nancy Pelosi's decision to include the more liberal version of the public option in the final House bill, the one that includes Medicare + 5% rates, as the Progressive Caucus has sought, instead of negotiated rates. This may be slightly premature. Whatever bill she releases will be guaranteed to get 218 votes, and right now the process to round up those votes is ongoing – her Majority Whip Jim Clyburn will seek the necessary votes within the next 24 hours. But she's nearing that count for the "robust" version, leading her to side with House liberals on this question.

"We are very close and I count tough," Pelosi said, according to a senior Democratic staffer at the caucus. She added that passing a strong public option will give the House negotiating leverage in conference negotiations with the Senate.

She has asked House Majority Whip Jim Clyburn (D-S.C.) to have his operation survey all House Democrats starting Wednesday to see if they will support the Medicare-based option.

Democratic leaders are planning to roll out the bill next week, and are hoping to vote the first week in November.

Pelosi wants to back the so-called fiscally responsible Blue Dogs into a corner by giving them a bill that the CBO scores well and includes a robust public option as well as bills with a trigger or a weak public option that score worse, so that to reject it, they would have to actually accept a larger price tag. The reports have this new bill coming in at an $870 billion dollar cost to the government over 10 years (the total health care expense for individuals et al. is uncertain at this point). The bill won't add to the deficit in the first 10 years, though it may further out – although gimmicks keep the Senate Finance Committee version looking artificially like a deficit reducer outside the budget window (such as not including the Medicare doctor fix inside the bill, and assuming that policymakers would allow the excise tax on insurance plans to capture 40% of all plans by 2019). Pelosi reportedly wants to come in LOWER than the SFC bill, which seems like chasing a white whale to me, at the expense of affordability for people who need help purchasing insurance. Right now the House bill covers more people than Baucus-care, and by obsessively lowering the cost, Pelosi could threaten that.

http://news.firedoglake.com/2009/10/21/pelosi-to-include-medicare-5-public-option-in-house-bill/