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One Step Forward, One Step Back

More news from Speaker Nancy Pelosi today: She indicated that the House might be willing to pass the Senate's latest public option proposal, which entails offering new non-profit plans across the country and making Medicare available to some workers over 55. If true, that would eliminate a major point of contention between the two chambers.

To be sure, first the Senate would actually have to pass the measure. And while Pelosi's endorsement might give it a little momentum, the latest pronouncement from Senator Olympia Snowe has taken away some. Via Politico:

Sen. Olympia Snowe (R-Maine) said Thursday that she does not support the Medicare buy-in because it would “aggravate an already-serious problem” with the program – the low reimbursement rates for hospitals and doctors.

“I have serious concerns,” Snowe told reporters. “I just think that is the wrong direction to take.”

Snowe said she could not see a way for Senate Democratic leaders to even tweak the proposal to win her vote.

“I can’t see it,” said Snowe, who met Wednesday with President Barack Obama. “I am talking to a lot of my providers this afternoon and I know they are mighty unhappy.”

Asked if it meant she would oppose the health care bill, Snowe said: "Among other issues. There would be other issues. That is part of it."

To pass a bill, the Democratic leadership doesn't need Snowe or her Maine counterpart, Susan Collins. But if it doesn't have Snowe and Collins, then it needs Joe Lieberman and Ben Nelson. Sure enough, Politico reports that Lieberman is also raising eyebrows at the deal, although he hasn't said "no" yet to the Medicare buy-in. Sources on the Hill have also been saying, for a while, that Lieberman seems closer to voting "yes" on reform than Nelson.

One interesting question is the extent to which Snowe's opposition depends on the program's use of Medicare payment rates. Nobody has said yet whether that's the case. If the Medicare buy-in for older workers operates separate from traditional Medicare--and if it pays doctors and hospitals more, as they'd like--then maybe Snowe would embrace the idea after all.

Of course, that'd make it a much less appealing option...