The Nationals may have never had a shot at the playoffs, but Washington's senators are still playing hardball in October.

Much of the action centers on the public plan, which has reemerged as one of the central issues in merging the Senate's HELP and Finance bills.

Senate Finance Chairman Max Baucus told reporters on Monday that he believed a "pure public option" did not have the votes to pass the Senate, but that there were many options on the table that could form the basis of a compromise.

One option is Sen. Tom Carper's (D-DE) idea of allowing states to decide whether to create a public health insurance option. Sen. Chuck Schumer (D-NY) supports the proposal, Sen. Evan Bayh (D-IN) seems interested and Sen. Ben Nelson (D-NE), long skeptical of a public option, says he's intrigued by the idea. And while the latest polls show a majority of the public favors a public option, NPR's Ron Elving cautions us on placing too much faith in polls because a lot depends on how you ask the question.

Two other issues are at the top of the docket in the Senate. One is finding a permanent fix to the Sustainable Growth Rate formula that threatens to cut Medicare payments to doctors by 21 percent in 2010 and by about 5 percent in each of the next few years.

The AMA and AARP sent a letter last week to Senate Majority Leader Harry Reid, urging him to repeal the SGR. The House included the so-called "doctors fix" in its legislation but exempted it from budgetary provisions that would require offsets. Reid's Democratic colleagues in the Senate have balked at such an exemption, which would cost around $247 billion over ten years, and Senate Budget Committee Chairman Kent Conrad (D-ND) is looking at potential ways to pay for the fix.

Meanwhile, Politico's Pulse reports that Reid, Schumer and Senate Judiciary Committee Chairman Patrick Leahy will "announce that legislation to repeal the health insurance industry's anti-trust exemption will be offered as an amendment during health reform." From a media advisory from Leahy's office:

The Health Insurance Industry Antitrust Enforcement Act of 2009, introduced in September by Chairman Leahy, would promote competition in the health insurance and medical malpractice insurance industries that will benefit consumers.  Providing antitrust exemptions for insurance companies has been anticompetitive and damaging to the American family and the American economy.

The three Senators will be joined by Jim Guest, president of Consumers Union, at 11:30 am for the announcement in the LBJ room of the U.S. Capitol. For more on the history and implications of the antitrust issue, check out this thoughtful post from our colleague Julie Barnes.

Meanwhile, in the other chamber of Congress, the latest leaked estimates put the CBO's preliminary score of the House bill at $871 billion, according the Associated Press. Speaker Nancy Pelosi continues to advocate for a strong public option and some of her colleagues are floating the idea of re-branding it as Medicare Part E (for everyone). While Speaker Pelosi looks to hold together the various factions of her Democratic caucus, she might check out  WhoRunsGov.com, which has a useful tracker of the reform positions of all 535 senators and House members, including a special section just for Blue Dogs.