Obama Administration Voices Support for Public Health Plan
On Monday, the Obama administration restated its support for a public insurance plan within health reform legislation, after some officials over the weekend indicated that President Obama might be willing to sign a bill without such an option, the Wall Street Journal reports.
HHS Secretary Kathleen Sebelius on Sunday said on CNN that a public option was not an "essential element" of health reform (Bendavid, Wall Street Journal, 8/18).
In addition, Obama on Saturday said that a public plan is "not the entirety of health care reform," adding that it is "just one sliver of it" (Norman, CQ HealthBeat, 8/17).
However, in an e-mail sent to members of Congress and other supporters, Obama said that he wants a public insurance option as part of the overhaul but that he is willing to consider other alternatives (Wall Street Journal, 8/18).
Linda Douglass, communications director for the White House Office of Health Reform, said in a statement, "Nothing has changed. The president has always said that what is essential is that health insurance reform must lower costs, ensure that there are affordable options for all Americans and it must increase choice and competition in the health insurance market. He believes the public option is the best way to achieve those goals" (CQ HealthBeat, 8/17).
On Monday, White House press secretary Robert Gibbs said that the comments made by Sebelius and others were misinterpreted. He said, "If there are other ideas" to achieve "choice and competition" in the health insurance market besides through a public option, Obama is "happy to look at them" (Kornblut/Bacon, Washington Post, 8/18).
White House aides said that the president will not commit to a public option or not-for-profit cooperatives until at least next month.
Administration officials have said that they increasingly believe they will have to rely almost entirely on the support of congressional Democrats to push through health reform legislation.
According to the New York Times, "Navigating the acrimonious debate among Democrats -- between a public option and a health care cooperative -- presents a significant challenge" to the Obama administration (Zeleny/Hulse, New York Times, 8/18).
A Democratic Senate aide said that Obama's shift was intended "to relieve pressure to get the bill out of the Senate Finance Committee" where a discussion is ongoing about the more bipartisan proposal to establish co-ops. "He's trying to get things moving. Then there will be another discussion about public option," the aide said (Soraghan, The Hill, 8/17).
Democrats React to Administration's Retreat on Public Plan
A number of Democrats on Monday reacted negatively to suggestions from the administration that it would be willing to forgo a public plan as part of health reform legislation, Roll Call reports (Drucker, Roll Call, 8/17). According to the Washington Post, some Democrats insisted that a public plan is necessary to pass health reform legislation in the House.
On Monday, Sen. Jay Rockefeller (D-W.Va.) said that a public option "is a must" (Washington Post, 8/18).
House Speaker Nancy Pelosi (D-Calif.), whose chamber's health reform bill (HR 3200) includes a public plan, said, "A public option is the best option to lower costs, improve the quality of health care, ensure choice and expand coverage," adding that there is strong support for the provision in the House (Whitesides, Reuters, 8/17).
Sen. Russ Feingold (D-Wis.) said, "Without a public option, I don't see how we will bring real change to a system that has made good health care a privilege for those who can afford it" (Roll Call, 8/17).
According to Politico, many Democrats have indicated that that it would be difficult to pass health reform legislation in the House without a public plan.
In a letter sent Monday to Sebelius, leaders of the Congressional Progressive Caucus and the Congressional Black Caucus wrote, "To take the public option off the table would be a grave error; passage in the House of Representatives depends upon inclusion of it." The letter included a list of "60 members of Congress who are firm in their position that any legislation that moves forward through both chambers, and into a final proposal for the president's signature, MUST contain a public option."
Rep. Anna Eshoo (D-Calif.) said that it "would be very tough" to pass health reform without the public option because many Democrats "view themselves as having already compromised on single-payer" (Martin/Budoff Brown, Politico, 8/18).
Rep. Anthony Weiner (D-N.Y.) said that without a public option, the legislation could lose up to 100 Democratic votes in the House (Washington Post, 8/18).
Although the administration's comments over the weekend were seen by some as a means of gaining GOP support for health reform legislation, some Republicans have said that even if the public option were dropped from the health care overhaul and replaced with co-ops they would still not support the legislation, The Hill reports.
"We think [a co-op is] just another term for public option," a Republican aide said (The Hill, 8/17).
A House Republican leadership aide said, "It doesn't make a difference to us. This plan is so bad that changing one particular provision is not going to fix it" (Wall Street Journal, 8/18).
However, House Minority Whip Eric Cantor (R-Va.) on CNBC said that he's "heartened" by the administration's apparent willingness to compromise on a public plan (The Hill, 8/17).
Conrad Defends Co-Ops
On Monday, Sen. Kent Conrad (D-N.D.), the author of the co-op provision being considered by the bipartisan group working on the Senate Finance Committee health reform bill, defended his proposal, calling it "a nonprofit competitor to for-profit insurance companies in a proven business model" (Siegel, "All Things Considered," NPR, 8/17).
Conrad said that the co-op plan is the "only plan that has bipartisan support in the Senate," adding that it is "quite clear the public option does not have the votes."
According to Conrad, talks between the Finance Committee negotiators, actuaries and insurance market experts have convinced senators that the co-ops could work if they were first established with a minimum of 500,000 members to ensure bargaining leverage.
Conrad said that the startup costs would be about $6 billion and that it would enroll 12 million members (Weisman, Wall Street Journal, 8/18).
Editorial, Opinion Piece
- Wall Street Journal : While "it looks as if the public option has been sent to the death panel -- so to speak, ... dumping one of the most radical and destructive features of ObamaCare is best viewed as a tactical political retreat, not a surrender," the editorial states. The editorial suggests that the "best health care option now is to attempt a truly bipartisan reform, likely one built on individual tax credits for private health insurance. Or drop the scheme entirely and focus on improving the economy." It concludes, "The Democratic walk-back on the public option is just a few steps," adding, "This fight is a long way from over" (Wall Street Journal, 8/18).
- Robert Reich, Salon: There "hasn't been more support for universal health care coming from progressives, grassroots Democrats, and independents ... because the White House has never made an explicit commitment to a public option," writes Reich -- a professor of public policy at UC-Berkeley and former Department of Labor secretary in the Clinton administration. According to Reich, a health cooperative system -- which has been cited as an alternative to the public option -- "won't have the scale or authority to do what a public option would do," which is "why some Republicans say they could buy it." Reich writes that if Obama tells "Senate Democrats he will not sign a health care reform bill without a public option, there will be enough votes in the United States Senate for a public option" (Reich, Salon, 8/17).
- American Public Media's "Marketplace" on Monday reported on the prospects of passing health reform without a public plan. The segment included comments from Paul Ginsberg, president of the Center for Studying Health System Change (Keith, "Marketplace," American Public Media, 8/17). "Marketplace" also featured an interview with Christine Arnold, managing director at Cowen and Company, about health insurance co-ops (Radke, "Marketplace," American Public Media, 8/17).
- CBS' "Evening News with Katie Couric" on Monday reported that many U.S. residents do not understand the difference between a public plan and health care cooperatives (Cordes, "Evening News with Katie Couric," CBS, 8/17).
- NPR's "All Things Considered" on Monday featured a discussion about health insurance co-ops (Silberner, "All Things Considered," NPR, 8/17).
- KPCC's "Patt Morrison" included a discussion about the public plan with Rep. Henry Waxman (D-Calif.) (Morrison, "Patt Morrison," KPCC, 8/17).
- KPCC's "Air Talk" included a discussion of the debate over a public option in health care reform.Â Guests on the program were Gail Chaddock, Congressional Correspondent for the Christian Science Monitor; Shana Alex Lavarreda, director of Health Insurance Studies and research scientist at the UCLA Center for Health Policy Research; Rep. Brad Sherman (D-Calif.); and Rep. Adam Schiff (D-Calif.) (Mantle, "Air Talk," KPCC, 8/17).