Some of Senate Majority Leader Harry Reid's colleagues were surprised by his decision this week to include a government-run health-care plan in the Democrats' bill.
But the mathematics of the Senate suggest the motives for the Nevada Democrat's gamble: While a handful of Democratic moderates don't like the so-called public option, the liberals who support it easily outnumber them -- and at least some of them warned Mr. Reid they would oppose a bill that didn't include the option.
[Reid] European Pressphoto Agency
President Barack Obama talks with Senate Majority Leader Harry Reid on Wednesday at a Capitol ceremony.
Democratic centrists such as Sen. Ben Nelson of Nebraska have expressed reservations about creating a government-administered health plan to compete with private insurers. So has Sen. Olympia Snowe of Maine, the lone Republican who has signaled possible support for a Democrat-led health overhaul.
Senate Republicans are united in their opposition to a public option, and Minority Leader Mitch McConnell (R., Ky.) reiterated Wednesday his view that it would drive private insurers out of business. "Supporters of the government-run plan say they're only advocating one more option among many," he said on the Senate floor. "What they don't say is that the option they're advocating would soon be the only option."
But liberals are insisting with equal force on a public option. And they are more numerous among Mr. Reid's caucus of 60 votes -- made up of 58 Democrats and two independents usually aligned with them.
Earlier this month, 30 senators sent Mr. Reid a letter saying "a strong public option has resounding support among Senate Democrats." and urging that any bill include one.
At a recent private meeting of Senate Democrats, Sen. Bernie Sanders (I., Vt.) argued that polls show strong and growing support for the public option. Mr. Sanders also organized a get-together between Mr. Reid and liberal senators.
"What we said is, 'Look, the overwhelming majority of the people want the public option,'" Mr. Sanders said. "How are we going to tell people they must get insurance, and then force them into a private insurance company and not give them a public option? Who wants to defend that?"
Ultimately, Mr. Reid, who has met with virtually all Senate Democrats and some Republicans in recent weeks, decided to go with a public option that allows individual states to opt out.
"In the last week or so, he detected a willingness on the part of the progressives to move more to the center, while detecting a similar willingness among some moderates to make some concessions as well," said Reid spokesman Jim Manley.
Mr. Reid needs the support of 60 senators twice -- first in a vote to consider the health bill, then later to approve it. Even some Democrats who oppose the bill in its current shape may support the leader in the initial vote just to get it to the Senate floor. If so, it will kick off a weeks-long debate, including votes on numerous amendments and horse-trading to address the concerns of particular senators.
Democratic leaders hope that at the end of that process, even some who oppose Mr. Reid's bill, like Sen. Joseph Lieberman (I., Conn.), will be on board. Mr. Lieberman has suggested he might support the initial vote on the bill.
"We all know that the bill that emerges after weeks of debate will not be the same one that leader Reid presented," said Sen. Chuck Schumer (D., N.Y.).
So far, Mr. Reid's approach appears to be paying off, as some of the centrist Democrats are expressing a willingness to compromise.
"I don't favor a government-run national public option," said Sen. Mary Landrieu (D., La.) a couple of days before Mr. Reid's announcement.
But she added, "I could be open to either a fallback, or a public option that plays on the same playing field as private business....Something like that I could maybe consider if it meant a deal at the end. But we'll have to see."