Nate Silver says that momentum is shifting in favor of some sort of public option, and lists his reasons why. At the top of the list:

The tireless, and occasionally tiresome, advocacy on behalf of liberal bloggers and interest groups for the public option. Whatever you think of their tactics — I haven’t always agreed with them — the sheer amount of focus and energy expended on their behalf has been very important, keeping the issue alive in the public debate.

The public option was never the best solution to the health care crisis, but it was something that Obama campaigned on, and using his own momentum was critical to the effort to forstall something much worse. If there’s even a small chance that people won’t be forced to buy junk insurance they can’t afford to use, “tedious” is a small price to pay.

I think most of the other valid reasons he gives grew out of this effort. Dogged activism kept pushing members of Congress to keep it alive, discredited the “bipartisan” fetish, fueled constituent letters and emails and caused the White House to start questioning whether it could live up to the deals struck by Rahm and Baucus without paying a huge political price. Which made AHIP hinky, and caused them to overreact. The polling done by Markos and the work done by Nate himself on the popularity of the public option in Blue Dog districts was also incredibly important in dismantling the ConservaDem argument that they were “voting their districts.”

One of Nate’s commenters says something interesting:

The political calculus has changed. Centrist Dems were worried that a public option would anger conservatives and drive them out to the polls. They now realize that almost no matter what they chose to do conservatives will be in angry up rise against them. Thus the strategy has shifted to how do they energize progressives without pissing off moderates.

Notice the major shift, they realize conservatives are pissed off no matter what, so this is becoming a base election scenario. Having some sort of public option is a huge rallying cry. Dems can claim they stood up to “big business” and “the right wing” and “prevailed”.

The teabaggers rallied in response to health care, but in reality it didn’t matter what the issue was — the GOP is doing a good job of rallying their base. No matter what the Blue Dogs and other ConservaDems do, Republicans are going to clutch their steering wheels and drive through sleet and rain to vote against them. Appeasement isn’t a reasonable strategy.

Rahm and Obama felt that they could make the medical industrial complex happy and then sell it to the progressive base as “health care reform” just like they jammed progressives in Congress while catering to the Blue Dogs. And it appears they’re going to try it again with the “opt-out.” Nate says it has more “liberal ‘street cred’ than co-ops or triggers,” but it also threatens to touch off a war with red state Democrats who aren’t keen on being thrown at AHIP like red meat.

Here’s Debbie Wasserman-Schultz, not exactly a flaming liberal, who as a member of House leadership never speaks out like this:

CENK UYGUR: The opt out idea is pretty simple. You get the public option by the federal government, but different states can opt out of it, but they have to actively, proactively opt out of it, either through their state legislator, or maybe even a referendum, or act of the governor, or combination thereof. And then that gives red state senators, whether they’re Democrats or Republicans….

DEBBIE WASSERMAN SCHULTZ: Then we’re not providing the necessary competition and choice for Americans in those states.

CENK UYGUR: That’s definitely a downside of it. The upside of it is it takes away all excuses. If you say, “Hey listen, I’m not comfortable with the public option.” Great then your state doesn’t have to have it.

DEBBIE WASSERMAN SCHULTZ: No, but we have mixed delegations Cenk, where we have Republicans… I don’t know… I have to spend some more time hearing about that. In my state we’ve got 10 Democrats and 15 Republicans and a split on our Senators. I wouldn’t want to be duking it out with the rest of my delegation on who wins, on whether or not we do or don’t participate in the public option. And I certainly wouldn’t want Charlie Christ to be able to make the decision. And he is our governor.

Despite the myth that Rahm promotes that he’s some kind of electoral genius solely responsible for the Democratic majority, he’s got an electoral tin ear. As head of the DCCC he wouldn’t let candidates oppose the war in 2006. He made freshmen sign on to the SAVE act to protect themselves from attack for being “soft on immigration” in 2008, only to provoke an angry protest from the Hispanic caucus on the floor of the House (not to mention the fact that he Hispanic vote put Obama over the top). As the architect of NAFTA in 1993, he was oblivious to its effect on depressing the base in 1994 which helped fuel the GOP’s 54 seat House swing.

From the start, Rahm has calculated that a political “win” was the most important objective of health care reform, and that what was good for Democratic campaign coffers was good for the country. He might want to have a word with Harry Reid, who’s sitting on a record haul and a 38% approval rating going into his 2010 race.

With a sluggish economy, 2010 may be brutal. Jamming progressives and red state Democrats with “opt-outs” just so Evan Bayh can make Wellpoint happy may provoke the very electoral massacre Rahm fears.