U.S. Rep. Tammy Baldwin (D-Madison) told a small group of people at a meeting Thursday that she still believes a public health plan is possible, but is not as optimistic as she once was.
"I really think [a public plan] is essential and it's going to be a big fight to keep it in," Baldwin told the group of about 20 people. "It's getting tougher and tougher. If it were easy, we would have done it decades ago."
Baldwin spoke and answered questions in an informal meeting at the office of Access to Independence, a group that advocates for the disabled. She described the proposal that the House Energy and Commerce Committee, which she sits on, passed. She also talked about the political dynamics in Washington.
Baldwin said the plan that her committee passed, America's Affordable Health Choices Act, would allow people who have insurance to keep their plans, if they like them. "Sixty percent of everyone in America won't be affected at all," she said.
(This isn't entirely true, as an article in The New York Times recently pointed out. With a public plan, an employer could decide to pay a fee to the government, rather than offer its own health insurance - in such a scenario, you could lose the health insurance you have. There's also no guarantee that your plan won't change.)
The proposal also would set up an insurance exchange, which people could shop for and compare health plans on. "I think 'insurance exchange' is the strangest name," Baldwin said. "We'll give them an F for marketing."
Several people in the audience were curious about how this exchange would work. Baldwin explained that consumers in every health care market would be able to go to an office or someplace online to see what health care plans are available in the area. And consumers will be able to compare the benefits and costs of each plan side by side.
The legislation will also include insurance reform, so that people can't be denied coverage because of a pre-existing condition. "If you can pay, they have to accept you." And the government will subsidize health insurance for the poor.
Baldwin admitted that the resistance from Republicans and the so-called "Blue Dog Democrats" has become fierce. "We have a for-profit health system and a lot of people don't want to see that change and they're fighting tooth and nail to see it doesn't ever change."
But she said the changes the conservatives are demanding would hinder meaningful reform. "They shouldn't allow people to destroy it just to say it's bipartisan."