Pressure from constituents and activists, targeted advertising from interest groups and questions from the media, though, have forced these officials to speak publicly about health care policy. Here are a handful of examples of members of the Senate, who have tried to position themselves on multiple sides of the health care debate.
-- Sen. Maria Cantwell (D-Wash.) has downplayed the importance of health reform legislation with a public insurance option, while arguing for health cooperatives as an alternative and changes to the Medicare reimbursement formula. Since 1991, Cantwell has collected $584,300 from the health sector, with the bulk of that ($351,735) coming from health professionals, many of whom believe the Medicare reimbursement rates are unfair. Health professionals are also her No. 9 contributor over her career. Last month, Cantwell told a Washington public radio station that health reform legislation with a public insurance option wasn't feasible. "I don't think that's something we can get through the United States Senate," she said at the time. A week later, however, she had changed her tune. "There can be a bill with a public option that can pass," she told a newspaper in the state. In response, one of Seattle's weekly newspapers criticized her for changing the definition of "public plan" to include the "co-op compromise." Yet her office insisted to the newspaper that the senator's position is clear: "She could support a federally run health plan or a nonprofit co-op plan."
-- Sen. Arlen Specter (D-Pa.), who switched party allegiances earlier this year, has also recently switched his stance on the importance of a public health insurance option. Specter has received more money from the health sector than any sitting senator who has not been his party's presidential nominee in the last five years — since 1989, more than $4 million has gone to Specter's campaign committee and leadership PAC. More than $1.5 million of that take comes from health professionals, who are Specter's No. 3 career campaign contributor. He has also raised more than $1 million from pharmaceutical and health products companies, which are his No. 7 all-time industry backer. Immediately following his party switch, Specter appeared on NBC's Meet the Press and maintained his opposition to his new party's public insurance goal. "I did not say I'm a loyal Democrat," Specter declared. When asked by host David Gregory if he would "not support a public plan," Specter said, "That's what I said, and that's what I meant." Two months later, at the end of June, Specter told a crowd of union activists he now stood with one of the Senate's leading advocates for a government-administered health insurance plan. "[Sen.] Schumer has it right about having a public component," he said.
-- Sen. Mary Landrieu (D-La.) has received $1.3 million from the health sector since 1995. Her campaign committee and leadership PAC have also collected more than $155,150 from health insurers. Last November, Landrieu, in a letter to the advocacy organization Health Care for America Now, signed a pledge to support health care reform that includes a public insurance option. By May of this year, however, her support seemed to be withering. "I am actually not sure," she told the Huffington Post in reference to a public option. "I don't think I am [for it], but I told the folks that are promoting it that I would talk with them… I'm not going to shut the door on anything right now." Yet by June, she told the online news organization that she had changed her mind. "I'm not open to a public option," she said. "Public option is not something that I support. I don't think it's the right way to go." Liberal groups, including Democracy for American and MoveOn.org, are now pressuring her with TV ads to again change her mindand re-support the public option.
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-- Sen. Joe Lieberman (I-Conn.) is one of the Senate's top 10 recipients of health industry campaign cash. The former Democratic vice presidential nominee, who backed Republican John McCain for president last year, has collected more than $2.5 million from the health sector since 1989 for his campaign committee and leadership PAC, and more than $455,000 from health insurers. Lieberman has said he supports universal health care, but he has now cooled to the idea of a government-backed public insurance plan. On the campaign trail in 2006, Lieberman said he backed legislation to "allow anybody in our country to buy into a national insurance pool like the health insurance pool that we federal employees and members of Congress have." (And he also championed this idea in 2004 as a Democratic presidential candidate.) Many activists and bloggers have said this sounds like an endorsement of a new public health insurance option, yet this summer, Lieberman said he has cooled to the idea of a public plan. "I don't favor a public option," he told reporters in June. "And I don't favor a public option because I think there's plenty of competition in the private insurance market."
-- Sen. Blanche Lincoln (D-Ark.) has not only earned her ire from liberal bloggers for her fence sitting on a public insurance plan. It also prompted these liberal bloggers' Blue America PAC to fund pro-public option TV ads in her state. Lincoln has raised $1,953,400 from the health sector since 1989, counting money going to her campaign committee and leadership PAC. This places her among the top 18 senators who have accepted money from this industry. Health professionals are also her No. 2 campaign contributor over time, giving more than $701,000. During mid-June, Lincoln told the Arkansas News that she was apprehensive of a public plan and preferred private insurance co-ops as a mechanism for health care reform. "One of our biggest concerns is that it doesn't need to be a government plan that usurps that ability to compete in the marketplace, which I'm concerned that a totally government-run option would do," she said at the time. On Wednesday, she overcame some of that apprehension in a column in the Arkansas Democrat-Gazette that reportedly stated she would be open to a public option being part of the solution. "Individuals should be able to choose from a range of quality health insurance plans," she said. "Options should include private plans as well as a quality, affordable public plan or non-profit plan that can accomplish the same goals as those of a public plan."
-- Sen. John Kerry (D-Mass.) is on the record in support of a public insurance option. He has also collected more than $8 million from the health sector since 1989, with more than half of that coming from health professionals, who are his No. 8 all-time campaign backer. As a member of the Senate's powerful Finance Committee, which is crafting a portion of the chamber's reform proposal, he has also been considering other fallback options. When the Huffington Post blasted the headline "Kerry Pushes For Public Option Trigger In Closed-Door Meeting," his office issued a rapid clarification. "Let's be clear, if Sen. Kerry had his way, there'd be no debate: we'd have universal coverage tomorrow with a strong public plan at its core," his spokesperson said. "Sen. Kerry strongly supports a robust public option and has been pushing for it since day one of this debate… But it's no secret that the Finance Committee is looking at a whole range of progressive options with an eye on what can make its way to the president's desk to become law, and obviously if it's the only way to get universal health coverage then people will consider a trigger that ultimately guarantees a strong public option."
-- Sen. Kay Hagan (D-N.C.) has raised $181,125 from health sector since 2007, for her campaign committee and leadership PAC, including $86,375 from health professionals. Her committees have also collected $22,600 from health insurers alone since 2007. At the end of June, her press office told a North Carolina newspaper that the first-term senator was not yet on board with a public option and she wanted "to ensure private health insurance isn't going to be destabilized" by any public insurance plan. She didn't want to see millions of people dropping their existing private health insurance and flock to a public option provider, leading to a collapse of the private health insurance market, according to her spokesperson. In response, MoveOn.org and others criticized her for holding up the Senate Health, Education, Labor and Pensions Committee's health reform proposal, which included a public option. Then, at the beginning of this month, she endorsed her committee's bill. "We have crafted a plan that will stabilize health care costs and includes a Community Health Insurance Option, which I support," she said.
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-- Sen. Byron Dorgan (D-N.D.) reportedly doesn't want any health care reform to put the private insurance companies out of business. Democracy for America, the advocacy group run by former Democratic presidential candidate and Democratic National Committee chairman Howard Dean, which is tracking lawmakers' stances on the public option, lists Dorgan's position as undecided. Yet at least one North Dakota media outlet has gotten Dorgan, whose committees have taken $549,050 from the health sector since 1991, to commit. "I do believe that some sort of public option needs to be part of the proposal, along with a focus on bringing down health care costs and prevention," he told the blog NorthDecoder. "I do believe that a public option should negotiate for rates and drug prices."