Lieberman and the Public Policy

Sen. Joseph Lieberman, speaking in that trademark sonorous baritone, utters a simple statement that translates into real trouble for Democratic leaders: "I'm going to be stubborn on this."

Stubborn, he means, in opposing any health-care overhaul that includes a "public option," or government-run health-insurance plan, as the current bill does. His opposition is strong enough that Mr. Lieberman says he won't vote to let a bill come to a final vote if a public option is included.

Probe for a catch or caveat in that opposition, and none is visible. Can he support a public option if states could opt out of the plan, as the current bill provides? "The answer is no," he says in an interview from his Senate office. "I feel very strongly about this." How about a trigger, a mechanism for including a public option along with a provision saying it won't be used unless private insurance plans aren't spreading coverage far and fast enough? No again.

So any version of a public option will compel Mr. Lieberman to vote against bringing a bill to a final vote? "Correct," he says.

This is, of course, more than just one senator objecting to one part of health legislation. This is the former Democratic vice presidential nominee, now an independent, Joe Lieberman, still counted on to be the 60th vote Democrats will need to force a final vote on health legislation. In opposing a public option, he is opposing the element some Democratic liberals have come to consider the cornerstone of a health-care bill.

Maybe the Lieberman stance is posturing, or a maneuver to force a watering down of the public option into something he and like-minded Democratic conservatives can swallow. In any case, as Senate Majority Leader Harry Reid tries to solve the Rubik's Cube that is health legislation, Mr. Lieberman just might represent the hardest piece to flip into place.

In spite of that, Mr. Lieberman insists he wants a bill. He voted with Democrats over the weekend on a procedural motion to let debate begin on a version that definitely includes a public option, albeit one states could choose not to join. "I want to get to the health-care debate, and I want to be part of creating, working on and passing health-care reform," he says. "I've been working on it for years, so that's my goal. But I'm not going to vote for anything and everything called health-care reform."

He says he wants the government to help uninsured Americans get coverage, as the bill envisions, and likes the provisions designed to bring down overall health costs. And he favors the consumer protections it would impose on private insurers, including one that bans insurance companies from denying coverage to those with pre-existing health conditions.

But none of that trumps his opposition to a public option, Mr. Lieberman says. And he insists his objection isn't based on the oft-expressed conservative fear that a public option would lead to a government takeover of health care. He says he doubts this or any subsequent Congress would allow that.

Rather, his objection is based on fiscal risk: "Once the government creates an insurance company or plan, the government or the taxpayers are liable for any deficit that government plan runs, really without limit," he says. "With our debt heading over $21 trillion within the next 10 years...we've got to start saying no to some things like this."

Mr. Lieberman also notes that the public option wasn't a big feature of past health-overhaul plans or the campaign debate of 2008. So he says he finds it odd that it now has become a central demand -- which it has, he suspects, because some Democrats wanted a full-bore, single-payer, government-run health plan, and were offered a public option as a consolation.

Critics, of course, think Mr. Lieberman is merely protecting insurers from his home state of Connecticut. He, of course, insists otherwise, arguing that regulation and litigation are the traditional and more appropriate ways to keep the private market honest. The real risk he sees, he insists, is government debt.

Yet he still thinks that, somehow, health legislation will get done, probably not by Christmas but early next year. "At the end of the day," he says, "I feel strongly health-care reform will pass the Senate and the Congress."

How? Mr. Lieberman says he has made his position absolutely clear to Mr. Reid. And Mr. Reid, all agree, is a wily tactician. So does he think Mr. Lieberman, and the two or three conservative Democrats who share his inclination, will give in at the end? Or is there some artful compromise that can be seen as including and not including a public option at the same time?

Here's another possibility: Maybe Mr. Reid plans to push as far as he can with a bill including a public option, to show his party he has done all humanly possible, before yanking the public option just before the whole effort goes off a cliff. We've proven that a bill is possible, he might say then, but also that a public option isn't.