The Congressional Budget Office has estimated that the new version of the Senate Finance Committee’s health bill “will result in a net reduction in federal budget deficits of $81 billion over the 2010-2019 period.” The Committee’s deficit neutral proposal will cost approximately $829 billion, about $55 billion more than the original pre mark-up version, but about $71 billion less than President Obama’s $900 billion target. The full Committee is expected to vote on the final bill sometime next week.

During 7 days and more than 80 hours of mark-up, the Committee considered over 140 different amendments and voted on 103. In fact as Chairman Max Baucus (D-MT) pointed out throughout the hearings, “it has been 15 years since this committee has held mark-up that took five days.” “Since then we have held more than 150 mark-ups and most of those took one or two days.” Baucus reminded Republicans that “the 2001 tax cut bill was a $1.3 trillion bill, we spent, I don’t know how many days on that, not too many days. This is a $900 billion bill…this committee hasn’t spent actually more than two days in mark-up for ten years. But this is a big bill and we’re just trying to find away to find the right balance here, the balance between understanding the bill on one hand, and acting on the other,” Baucus said.

Per the Chairman’s instruction, the committee’s health care bill had to remain deficit neutral and cost less than $900 billion over 10 years. Today, the CBO concluded that the committee met its goal. Here is a comparison of how the bill evolved during mark-up:

Despite the positive CBO score and the bipartisan nature of the bill, it incorporates many conservative ideas, Republicans are still dismissing the legislation. In fact, during the last few minutes of mark-up, Sen. Chuck Grassley (R-IA), the ranking member on the committee conceded that regardless of the CBO score, “There is a product here that all of the people on my side may not vote for.”

The Wall Street Journal reports that Sen. Tom Carper’s (D-DE) state-based public option compromise is gaining steam among moderate Sens. Ben Nelson (D-NE) and Kent Conrad (D-ND):

The Delaware Democrat’s plan won praise from some in his party Tuesday as a way of bridging differences among them. “Conceptually, having the states take responsibility makes a great deal of sense,” said Nebraska Sen. Ben Nelson, a key voice for moderate Democrats. “It is important that we really take a close look at this.” He noted that states are already in the health-insurance business because they administer Medicaid and other federal-state programs. Mr. Nelson said state health plans could compete alongside the nonprofit cooperatives. Another Democratic centrist, Sen. Kent Conrad of North Dakota, said the Carper proposal was “very constructive.”

The compromise may make “constructive” short term political “sense”, but cutting a public option 50 different ways won’t lower health care premiums or change delivery patterns. Carper’s proposal would “allow states to individually decide whether to create a private-insurance competitor such as a government plan and a nonprofit insurance cooperative, or to open up state-based insurance pools for government workers to every resident.” But in the 30 states that already provide their employees with coverage through so-called mini public options or co-operative options, health care costs have not decreased. They’ve increased. The coverage may be good, but the price is still unaffordable.

The problem is, when you slice a robust Medicare-like public option 50 different ways, you rob the plan of any real ability (i.e. market clout) to lower health care spending or change the way care is delivered. For instance, if you replaced the national Home Depot corporation with a network of 50 loosely connected stores and then forced those individual businesses to negotiate independently with suppliers and develop their own delivery systems, costs would only increase. It’s by banding together as a single entity that large corporations are able to deliver services more efficiently and pass on the savings to their consumers. The same is true of Medicare and the national public option: its national structure is essential to delivering quality care more efficiently and streamlining delivery-system reforms.

Stripping the national public option of its national structure establishes a mere shadow of a public plan. Replacing a national public plan with a network of state-based options isn’t a compromise that sacrifices the means to achieve the same ends. It’s a compromise that sacrifices the ends.