Define the goal and be honest about it.  Is the goal to make sure every American has access to affordable health care or is the goal to make sure every American is paying premiums to an insurance company of some sort?  Have these nitwits stopped to consider what the general state of health care of those over 65 would be if Medicare had been structured the way these contortionist legislators are proposing we reform the system for the rest of us?  Oh, sure, there's Medicaid, which varies from state to state, but that's not the best example, since there are clearly differences in the quality and extent of coverage from state to state, and corresponding differences in the health of those it is serving, with poorer states not funding commensurate with need, and cutting already whittled budgets.

What do the American people want?  They want to be able to take care of themselves without having to go broke.  Most of them would like to know that no matter where they work, or if they are working, their insurance coverage goes with them.  Everyone I know is hacked off that if their employer offers marginal coverage, they would be prevented from signing on to a better and less expensive plan administered through the government.  They want to stop paying more and getting less.  They want their doctors to decide on the care they need not some clerk in an insurance company office who is getting a bonus based on how much money was saved through denial of care.  They're even more hacked off that so little effort was made to just put together the best plan possible - the dream plan - from Day One, and go with the strength of the majority.  

I feel like I am watching the "hey, kids - let's put on a show!" portion of an old Judy Garland-Mickey Rooney movie, except it's not Judy and Mickey, it's the losers from the American Idol auditions, and it's so bad we all know it's doomed to fail.

"In July, 60 Democrats in the House signed a letter saying they would vote against any bill that does not have a robust public option.  The news broke last night that the number is down to 46.  It takes 39 stop a bill without a public option from passing".

The Carper amendment wouldn't permit anything which is not currently allowed but it would impose more stringent requirements.

The amendment says:

This would allow a state to offer a state public option; however, both the executive and state legislature would have to agree.

Most states (I believe every state) allows a law to be passed over the veto of the governor if it can get a super majority in the state legislature.....

The amendment would place restrictions how the public plan could be run.

Regardless of the mechanism chosen, the state would be bound by the same insurance regulations and benefit requirements as private plans in the exchange. The mechanism would have to be completely self financed, aside from initial seed funding, and would be required to have a reserve fund in the same manner that private plans have. The mechanism could not explicitly require doctors to participate, nor use provider participation in Medicare or other public programs to force participation. Additionally, the state could not use Medicare or Medicaid style price controls or rates - they would have to negotiate rates.

If a state started a public plan today, they would not be required to follow all of these restrictions. FDL

It also would only be open to individuals who were eligible to acquire coverage through the exchange. States currently can set up insurance programs like co-ops and not restrict who may participate.

If each state then goes for it's own program and sets it's own guidelines, won't this actually increase the problem?