LEWISTON — What they agree on: cutting costs by increasing competition among insurance companies and reducing the total number of uninsured without adding to the federal deficit.

What they disagree on: whether creating a government-run health care plan, known as a ‘public option,’ is the best or only way to achieve the outlined goals.

The differences of opinion among Maine’s federal delegation — two Democrats and two Republicans — reflect the debate that has dominated kitchen tables, town halls and Washington, D.C., in recent months.

As Congress inches toward reforming the health care system, the debate over whether to add a public option has overshadowed the fact that there’s bipartisan consensus that the status quo of rising costs for diminished outcomes is considered unacceptable.

“That trend is not going to change unless we begin to grapple with reforms in the insurance system, like not denying people coverage or rescinding it when a major medical illness strikes or putting caps on lifetime benefits,” said Republican Sen. Olympia Snowe, adding that between 10,000 and 14,000 people lose their health insurance every day.

Snowe, who is working with a bipartisan group of senators to produce a compromise health care bill, said her group’s proposal would not include a public option, but would include other means of creating more competition.

“We have the exchanges, the co-ops, and hopefully we’ll get the fall-back too, at some point,” said Snowe, who has been promoting a ‘fall-back’ pubic option that would take effect immediately if private health insurers could not meet affordability and coverage standards established by the government. The exchanges and cooperatives, she said, would allow individuals or small businesses to work together and bargain for plans nationally or regionally.

“(The Congressional Budget Office) has estimated costs could be reduced up to 10 percent if we went with exchanges on a national basis; on a regional basis, it could bring down those costs up to 15 percent,” she said.

Rep. Chellie Pingree, a Democrat representing Maine’s 1st District, said she thinks a public option is the only way to guarantee the kind of competition necessary to make health insurance more affordable for everyone.

“Maine is certainly a state where we’ve seen what happens when we don’t have enough competition,” she said.

Rep. Mike Michaud, a Democrat representing the 2nd congressional district in Maine, also supports a public option.

“The issue for me right now is what exactly will that public option look like, and how is the whole thing going to be paid for?” he said.

Michaud said he had heard from constituents concerned about government intervention in health care, even though government health care programs such as Medicare, Medicaid and the VA system have been around for decades.

“One woman used the argument that they don’t like the government taking over, and actually, this individual was on Medicare. I asked her how she likes it and she said, ‘It’s great,'” he said.

Michaud said politicians on both sides of the aisle have contributed to confusion among the public.

“I know Republican leadership has been using a lot of rhetoric, as well as (House Speaker Nancy Pelosi), and I think health care is really important; at the very least, public officials need to try and hold down the amount of rhetoric and focus on moving forward with the most positive health insurance reform bill that we can,” he said.

Republican Sen. Susan Collins has said she is concerned about how much reform will cost, as well as how effectively it will ‘bend the curve’ of rising health care costs.

“We should focus on holding on to what is good about our system and improve what is not working,” she said “It is especially important that high-quality, low-cost states like Maine are not harmed by reforms.”

Congress is expected to continue to work on health care legislation when members return from recess in September.

rmetzler@sunjournal.com