By John Brummett

Because he believes Democrats must somehow straddle the Grand Canyon that is their caucus and pass something, or anything, on health care reform, Senate Majority Leader Harry Reid apparently has made a plan.

First he intends to push the bill he’s put together himself and which, rather impressively, the Congressional Budget Office says would actually reduce the deficit over 10 years.

You’re wondering how that could possibly be so considering that the bill extends health insurance to an estimated 94 percent of the population and subsidizes a great many of those people.

First you raise taxes — on high-income persons’ Medicare payroll deductions and some of the highest-end insurance plans offered by employers. You mix in a little excise tax on elective cosmetic surgery.

Then you make cuts — mostly in Medicare, through government payments to the private Medicare Advantage program and in the growth curve of general administrative costs, but not, everyone promises, in benefits.

Then you design your bill to take effect in 2014, rather than 2013 like the House bill, which keeps your 10-year cost estimate below the limit the president set, you see.

To pass this bill, Reid must secure 60 votes to end a Republican-led filibuster. Apparently he cannot achieve that so long as the bill contains something he was obliged to insert to assuage his liberal base. That would be a public option government insurer that would take effect nationwide and that states would have to take affirmative action to opt out of.

But Blanche Lincoln, Joe Lieberman, Mary Landrieu, Ben Nelson, Evan Bayh and Kent Conrad are disinclined or wholly averse. All are Democrats except Lieberman, an independent who caucuses with the Democrats. Sixty votes can’t be achieved without all of them, since Republicans number 40.

So for a fallback position, Reid has assigned Delaware’s Tom Carper to come up with something. That’s because Carper, for weeks, has demonstrated a willingness to try to work something out and a propensity for incremental ideas.

Carper has been meeting with balking Democratic moderates. He says this is what he tends to hear from them consistently: They don’t like a government insurer.

Either they think their constituents abhor it and will punish them for supporting it or they fear it will cost more in truth than anyone says and explode the deficit. Or, as in Lincoln’s case, and perhaps others’, they think and fear both.

What Carper has been working on, then, is a hybrid of a hybrid. He has taken as a foundation the idea of Maine Republican Olympia Snowe to create a public option government insurer to be triggered and take effect only in limited areas where there were insufficient affordable private options available through a new health care exchange the government would create.

But since many of these centrist Democrats eschew a government insurer, Carper has talked about adapting the trigger idea to make it not a public agency but a private nonprofit cooperative, as Lincoln and Conrad and others have discussed.

Carper would require the affected states, not the feds, to set up the nonprofits once they were triggered by federal law. The federal government would provide seed money to be repaid from actual receipts of the state-created regional nonprofit.

Reid has not wanted to talk about this because (1) you don’t negotiate well by announcing your fallback position, and (2) liberals think this is so lame as to be nigh unto worthless. They’ll swallow it only if they absolutely must, and they’re not to that point yet.

They wanted single-payer government insurance. They’ve already been forced to retreat to a weak public option. Ordering a few states to set up backwoods health care nonprofit cooperatives — that’s one of the last things they had in mind when Barack Obama got elected promising universal health care.

We have an arduous process to endure before they’ll settle for it.

But then there’s this, which is Reid’s card in the sleeve: The House has passed a public option already. A nonprofit cooperative trigger passed by the Senate would provide the countering boundary for negotiation.

A public option trigger might be the logical middle ground in conference committee. A public option trigger might actually be worthwhile if the terms of its triggering weren’t so restrictive as to be unachievable.

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John Brummett is a columnist for the Arkansas News Bureau in Little Rock. His e-mail address is jbrummett@arkansasnews.com; his telephone number is (501) 374-0699.