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Demonstrators rally in favor of a public health insurance plan Thursday outside the downtown Fargo Post Office. (Carrie Snyder/The Forum)

Sen. Conrad's co-op plan a target for criticism from left and right

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FARGO - A liberal activist group organized rallies across North Dakota on Thursday to protest the plan that U.S. Sen. Kent Conrad hopes will draw bipartisan support for health care reform.

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Conrad has been a vocal proponent of nonprofit, user-owned cooperatives as an alternative to a new public health insurance plan, the most controversial aspect of the reform bills that have cleared committees in the House and Senate.

At rallies Thursday in Fargo, Grand Forks and Minot organized by left-wing advocacy group MoveOn.org, backers of a publicly owned health plan spoke out against the proposal Conrad has likened to agricultural co-ops.

"It wouldn't work. It wouldn't sustain itself," said George Barnes, vice president of the Northern Plains United Labor Council. "You can't compare health care to grain elevators."

"In the richest country in the world, there's no reason for this," said Trana Rogne of Kindred, N.D., who wore a button that read, "Get a spine."

Conrad said Thursday that he understands the appeal of a public plan competing with private insurers, but that doesn't have the 60 votes it needs to pass in the Senate.

Plus, he said that a public option that pays doctors 5 percent more than Medicare reimbursement rates, which is what the House plan calls for, would be bad for North Dakota hospitals because the state has some of the lowest levels of Medicare reimbursement.

"It's like so much else in life: The devil's in the details," Conrad said.

Andrew Lindner, an organizer of the noon-hour rally in front of the federal building in downtown Fargo, doesn't think co-ops will be more politically palatable than the public option he prefers.

"It's kind of a fringe plan," he said.

Conrad sits on the Senate Finance Committee, which is trying to negotiate a health care bill to draw at least some GOP support. The senator said he's not positive co-ops will be part of the finance bill, but he thinks there's still a reasonable chance.

He called the finance bill still under negotiation the "only bipartisan vehicle" in the reform debate.

That might explain why Conrad has landed in the political crosshairs aimed from both sides of the aisle. North Dakota is the only state besides Arkansas in which both national parties have bought television ads in the past two weeks to push their reform goals.

Organizing for America, a vestige of Obama's campaign now run by the Democratic National Committee, started airing a commercial here last week that argued it's time for health care reform of some sort.

A commercial backed by the Republican National Committee hit airwaves in North Dakota beginning on Monday, calling the reform efforts expensive and risky.

Asked why he figures he is being targeted from both his political flanks, Conrad didn't offer a guess. He just chuckled and said, "Welcome to my world."

House Democrats Health Bill Details

Below are details on the health care overhaul bill introduced last week by Democrats in the House.

Under the idea proposed by Sen. Kent Conrad, D-N.D., the public health plan in this bill, and a similar one approved by the Senate health committee, would be scrapped in favor of private nonprofit cooperatives

* Who's covered: Around 94 percent of nonelderly residents (those not covered by Medicare, which kicks in at age 65) would be covered, compared with 81 percent today. Nearly half of the 17 million nonelderly residents who remain uninsured would be illegal immigrants.

* Cost: About $1.5 trillion over 10 years.

* How it's paid for: Revenue-raisers include: $544 billion from a new income tax surcharge on single people making $280,000 a year and households making $350,000 and above; $37 billion in other tax adjustments. About $500 billion in cuts to Medicare and Medicaid. About $200 billion from penalties paid by individuals and employers who don't obtain coverage.

* Requirements for individuals: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5 percent of income.

* Requirements for employers: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt.

* Subsidies: Individuals and families with annual income up to 400 percent of poverty level ($88,000 for a family of four) would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

* How you choose your health insurance: Through a new Health Insurance Exchange open to individuals and, initially, small employers; it could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.

* Benefit package: A committee would recommend an "essential benefits package" including preventive services, mental health services, oral health and vision for children; out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange and over time would become the minimum quality standard for employer plans. Insurers wouldn't be able to deny coverage based on pre-existing conditions.

* Government-run plan: A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. On average it would pay Medicare rates plus 5 percent to doctors.

* Changes to Medicaid: The federal-state insurance program for the poor would be expanded starting in 2013 to cover all non-elderly individuals with incomes up to 133 percent of the federal poverty level ($14,404).

Sources: AP research; Congressional Budget Office; House Ways and Means Committee.

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