Cantwell offered her “basic health plan” amendment (described in further detail earlier). It would be a voluntary program that states would need to choose to opt in to. If states choose to create a “basic health plan,” their population between 133%-200% of the FPL would be covered through private insurers operating under the basic health program, and not through plans selected on the new exchange. During the debate, Cantwell called the idea a public plan (a point I strongly dispute). Interestingly, the amendment had not been scored by the CBO. It is expected to save money given the history of the program in Washington state, and because of how the amendment is designed.

The amendment passed 12-11. All ten Republicans, along with Democratic Senator Blanche Lincoln, voted against the amendment. All other Democrats voted in support. Chairman Baucus described it as a “great amendment.”

Committee Republicans such as Sen. Cornyn expressed serious concerns that removing such a large population from the exchange would weaken the exchange. He is worried that it could drive up prices for individuals who would still be buying coverage on the exchange. Cantwell argued that lower income Americans tend to be the least healthy individuals. She argued that removing them from the exchange would in fact reduce premiums for those still buying coverage on the exchange. There was no CBO analysis available to support either argument.