The Senate could hold its first procedural vote on health care reform as early as Friday or Saturday, although conservative Democrats have still not committed to allowing an up-or-down vote on a bill that contains a public option.

According to The New York Times, Harry Reid believes he has the votes to bring the bill to the floor to begin debate. Still, a number of Senate Democrats have begun to publicly question whether a bill with a public plan in it s current form could ever garner 60 votes.

Tom Carper believes he has a compromise that may appease Democratic skeptics: a public plan that would go into effect immediately on the day the exchanges open — but only in states that fail to meet affordability requirements. The exchanges are not scheduled to go into effect until 2013, so states would have four years to bring down costs.

There are essentially two major criteria a public plan needs to meet to be deemed effective: it needs to give consumers a place to go if they are priced out of the private insurance market, but also use its bargaining power to lower costs across the board. Carper’s proposal seems to meet the first criteria, but not the latter. Since his proposal is not national in scope, it seems unlikely that it could achieve the market share necessary to lower costs. To be fair, the opt-out public option that’s mostly limited to the unemployed and self-employed would also fail the “market share” test. But Carper’s proposal would seem to further defang the plan.

From a political standpoint, one would think that any compromise would be aimed mainly at Joe Lieberman. To my knowledge, is the only non-Republican who has unequivocally vowed to filibuster a bill that contains a new government plan.

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