[Readers, please add updates and your thoughts in posts or comments here as more of whatever these guys are doing leaks; RL has called me away from the keyboard. More from Ezra, WKJM, BooMan, McClatchy, Dean, Pravda and Izvestia below, as the stories appeared. -- lambert]

AP:

Democratic senators say they have a tentative deal to drop a government-run insurance option from health care legislation. No further details were immediately available.

But liberals and moderates have been discussing an alternative, including a private insurance arrangement to be supervised by the federal agency that oversees the system through which lawmakers purchase coverage. Additionally, talks centered on opening up Medicare to uninsured Americans beginning at age 55, a significant expansion of the large government health care program that currently serves the over-65 population.

Sen. Tom Harkin of Iowa told reporters he didn't like the agreement but would support it to the hilt in an attempt to pass health care legislation.

Depends on how Medicare is "opened up," eh?

Leave it to the Dems to fuck that up, too. After all, it's an "entitlement."

NOTE Assuming they do fuck up Medicare, which is almost a given at this point, the fallback position is still pass only that which helps people right away, shitcan the rest, declare victory, reboot, and start over.

Actually, I should probably thank the administration, the press, the Democratic leadership, and especially the "progressive" access bloggers for kicking single payer away from the table entirely, and keeping us well away from the shit sausage making area. We're the only ones who fought for what we believed in throughout, and we're also the only ones with a solution that works. Not to mention being the ones with the solution the American people want.

NOTE Now I understand Jane's sudden enthusiasm for single payer! It's the only show in town! No doubt there will be considerable disappointment, possibly even anger, when and if the Dems are seen not to deliver on health care. Whether "progressives" and access bloggers can morph into populists, get to the head of the crowd, and capitalize on that anger remains to be seen. (a) They've just spent the last year sucking up to the Dems, (b) they were the architects of the public option bait and switch FAIL to begin with, as anybody who can use Google will be able to see, and (c) the people who are the most pissed off are probably the 40% of Dems who aren't going to vote anyhow. I guess I should never underestimate the ability of shameless opportunists to seize an opportunity, but another way of looking at a purist is thinking of them as somebody who fights for the best policy, period. Maybe the country could use more purists, not fewer. And less shit sausage, while we're at it.

UPDATE Pravda has more, 8:59PM. Their version doesn't involve Medicare:

Senate leaders said they had reached a "broad agreement" late Tuesday on a compromise to replace the government-run insurance plan in the chamber's health-care package, but they declined to release details, pending analysis by congressional budget analysts.

Over the weekend, the outlines of a compromise emerged that would replace the public option with national plans that would be offered by private insurers but negotiated by the Office of Personnel Management, which administers coverage for federal employees. That idea has broad appeal among Democrats in both camps, as well as with Sen. Olympia J. Snowe (Maine), the only Republican who has so far voted to support the Democrats' health initiative. Negotiators are also looking at additional insurance regulations, such as a plan that would require private companies to spend 90 cents per dollar they collect in premiums on medical services.

Why would something called the "the Office of Personnel Management" be negotiating a national health plan? Weird. FDL earlier today on the suck. Bowers tries to salvage the public option semantic.

UPDATE Izvestia, 9:10PM:

The Senate majority leader, Senator Harry Reid of Nevada, said Senate leaders “have a broad agreement” on dropping a government-run plan from the health care bill, and that the Congressional Budget Office would review the implications of such a move on the budget.

“I told head of C.B.O. we would send him something he would have to score,” Mr. Reid said. He added that he had asked Senators Charles E. Schumer and Mark Pryor to work together with a group of liberals and moderates on making sure the health care bill has a vehicle to expand coverage to achieve the aims of the so-called public option.

Before and after the vote on Mr. Nelson’s amendment, a team of 10 Democrats worked furiously to broker a deal over the proposed creation of a government-run health insurance plan, or public option, to compete with private insurers.

The emerging deal would remove the public option [or plan] from the bill, setting up yet another conflict with the House measure, which includes a public plan [or option]. But Senate Democrats seem unable to muster the 60 votes needed with the public option [or plan] included.

Istead of a public plan [or option], the Democrats’s team of 10 propose creating a new menu of national, private insurance plans modeled after the Federal Employee Health Benefits Program, which covers more than 8 million federal workers, including members of Congress, and their dependents.

The plans would be overseen by a federal agency, the Office of Personnel Management, which would negotiate rates and coverage terms.

In addition, the Democrats are discussing a proposal that would allow Americans between the ages of 55 and 64 to purchase coverage under Medicare, which now covers Americans age 65 and over. The deal might also include a two-year extension of the Children’s Health Insurance Program, which was reauthorized earlier this year, and is set to expire in 2013.

UPDATE Then again, access bloggers TPM on an "impromptu news conference":

Late Update: We've now got a report from the press conference. The AP and NYT are both reporting that the Public Option [Ha ha! Initial caps! A proper name for something that never existed! WKJM is such a kidder... ] is gone. And it may well be. But Sen. Reid just said unequivocally that that's not true. Said Reid: ""All the things you've read in the newspapers...'the public option is gone,'--it's not true."

Which is what the access bloggers would like to believe. Then again, didn't Obama define co-ops as public option? Maybe that's what Reid's doing. As TPM notes "it looks like we'll know definitively by the end of the week--and maybe sooner. "

UPDATE Oh, Fuck. The exchanges are back. Online WSJ:

Capping several days of high-stakes negotiations, a group of ten Democratic senators – five moderates and five liberals – decided to turn away from the plan put forward initially by Senate Majority Leader Harry Reid (D., Nev.). Instead, the senators embraced a much more limited proposal that would empower the government's Office of Personnel Management to implement a new low-cost national health plan akin to the one now offered to federal employees and members of Congress, congressional aides said.

That plan would be run by nonprofit entities set up by the private sector, and would be available to the public on the new insurance exchanges that would be created by the sweeping bill.

So broadband access is part of the bill, then?

The arrangement is attractive to Democratic centrists who worry about the government's growing footprint in the private market. But in nod toward Democratic liberals still intent [ha ha ha] on expanding coverage, the group agreed to a proposal that would open Medicare, the health insurance program for the elderly, to Americans age 55 to 64. The proposal would benefit an estimated two to three million Americans, many of whom lost jobs and are having difficulty obtaining insurance. These people would be would be allowed to buy into Medicare at subsidized rates, but would likely pay more than retirees 65 and over.

UPDATE BooMan never fails:

A Grand Compromise on Health Care ReformIt's too early to say whether the bill will be good at expanding access to affordable health care or help the budget deficit. But it will be a very good bill for health insurance reform. And that is something.

And won't be an apple. But it will be an orange. And that's something.

UPDATE People are talking to Ezra (they would):

The team of 10 reaches a deal on the public option

But, err, they won't tell anyone what it is. At least not until they hear back from the Congressional Budget Office. The most telling tidbit so far has come from Sen. Jay Rockefeller, who said, "I've got a smile on my face. I don't smile naturally."

Rockefeller has been pushing to open Medicare to people between 55 and 64 years old. If he's got a smile on his face, that probably means he managed to shove hard enough. More tomorrow, when this thing begins to leak.

Update: The specifics are beginning to leak. The deal looks pretty much like it's looked for the past few days: The Office of Personnel Management will shepherd national, non-profit [like Blue Cross?] plans into existence [breaking regional oligololies how?]. Medicare will open to folks between 55 and 64 who are eligible for the exchange*

So it's a load of crap. Still. And the Democrats just managed to attach eligibility requirements to Medicare, turning it into a welfare prgram. GENIUS! I'm sure that will come in handy when it's time for entitlement reform.

If the national non-profit plans don't materialize [why would they not?], then there appears to be a trigger [great!] that will call a public plan into the market, but that seems pretty unlikely. All of this, of course, is contingent on CBO giving it a good score.

So, the fucking exchanges are still there. Hence the excuse to talk 'til 2014 to set them up, the discrimination against those who aren't wired, the obfuscation, and so forth. Lots of contracts for "creative class" "wellness consultants," PR operatives, contract analysts, IT people, though. Lots of fees. Yay!

The details will be important here.

Understatement of the century.

In fact, it's like we split the strong public option into two parts.

Maintaining the public option semantic is very important to access bloggers, so Ezra gives 'em a reacharound here.

The national non-profits are not exactly like, but not that far from [and here], the compromised public plan in the House version of the bill. They won't be publicly run, but with the OPM regulating them tightly and carefully choosing [and here] which offerings are accepted into the market, the impact might not be that different [and here] in practice. They have the advantages of offering a single product nationally and being freed from the profit motive, both of which were key to the theory of the weaker public option. Indeed, they're like publicly-regulated utilities [well, we'll need detail for that] more than private plans. These look a lot like the semi-private insurers that function well in Germany, Sweden and the Netherlands, among others.

No. You'd need detail on the regulation to know that. Ezra doesn't have the detail, so he's spinning fantasy, here.

Meanwhile, the Medicare buy-in lets people in the broader insurance market [Except those who are already insured, since the exchanges don't apply to them] see what national bargaining power can do for individual premiums. Right now, Medicare's rates are largely hidden, as no one pays the full premiums, and so no one can really compare it to private offerings. But if the premiums become visible...

If the premiums become visible, then the Dartmouth study boys can take an axe to the delivery of services. Notice how our GENIUS Dems have made Medicare transparent, but not the cost structures of the health insurance companies? (That's what would be needed to make the system more like Germany, Sweden, or the Netherlands....)

.... and Medicare's superior bargaining power is capable of offering rates 20 to 30 percent lower than its private competitors can muster, we'll see how long it is before representatives begin getting calls from 50-year-olds who'd like the opportunity to exchange money in return for insurance as good as what 55-year-olds can get.

Which, if they already have insurance, they will not be able to do. This is Obama's 2% of the population, the 10 million. How much bargaining power do they have?

Now, will the deal hold when Joe Lieberman and Olympia Snowe get a look at it? Stay tuned for more on that...

Back to personalities!

UPDATE Bowers has a good catch on the Franken Amendment:

Plus, the Franken amendment will be in the bill:

Additionally, there was consensus support for a requirement long backed by Sen. Jay Rockefeller, D-W.Va., and other liberals for insurance companies to spend at least 90 percent of their premium income providing benefits, a step that supporters argue effectively limits their spending on advertising, salaries, promotional efforts and profits.

Score! That is actually up from 85% in the House bill.  This is a major improvement.

Could be. Depending on how "premium income" is defined, of course.

UPDATE Dean lays hands on the sausage:

A staunch supporter of a public option to expand health care says he's encouraged by a Senate compromise on the troublesome issue.

Former Vermont Gov. Howard Dean, a physician, said Wednesday he believes opening up Medicare to people 55 to 64 years old gives momentum to the quest for a health care overhaul, putting it "on the right track."

The former Democratic presidential candidate and party chairman said on CBS's "The Early Show" that Medicare already is "a single payer run by the government. This moves things forward." Dean called it "real reform. Whatever we call it is irrelevant." Dean said he hopes [he doesn't know?] the final version of the legislation "involves expansion of care" in America.

Except it's only available to those eligible for the exchanges. So, no more than [a|the] [strong|robust]? public [health insurance]? [option|plan] does it bring pressure to bear on the insurance companies. Worse, as I argued above, because there are eligibility requirements for the 55-64s, it turns Medicare from single payer to an entitlement (and ripe for attack when Obama does "entitlement reform"). That said, I'd rather be fighting for expansion based on Medicare -- although even that depends on the real detail of the plan, and how shitty the FKDP sausage really is. Dean has played a mischievous role through this whole debacle, so it's hard to trust him now.

UPDATE AP has another round-up. Looks there's a trial balloon that Reid won't be able to get the bill done by Christmas. Good. Our "representatives" need to get an earful when they show up in the District again.

UPDATE Via the Agonist, Reuters:

“This has been a long journey. We have confronted many hurdles, and
tonight I believe we have overcome yet another one.

“I asked Senators Schumer and Pryor to work with some of the most
moderate and most progressive members of our diverse caucus, and
tonight they have come to a consensus.

“It is a consensus that includes a public option and will help ensure
the American people win in two ways: one, insurance companies will
face more competition, and two, the American people will have more
choices.

That was last night, though. Were there two impromptu press conferences????