Posted on 18 Aug 2009
Yesterday, in the aftermath of comments by Health and Human Services Secretary Kathleen Sebelius that seemed to contradict President Barack Obama’s desire for including a public insurance option as part of health care insurance reform, the White House attempted to reassure allies that its enthusiasm for a government-sponsored insurance plan remains strong.
The White House sent an email to members of Congress and other supporters reaffirming that President Obama wants a public insurance option as part of health care overhaul. Sebelius seemed to suggest otherwise on Sunday, saying a public option isn't an "essential element."
Yesterday’s message took the form of a Q-and-A. One question said, "It is pretty clear that you are backing away from the public plan. Right?" The answer: "Nothing has changed." Another asked, "The White House is saying that Secretary Sebelius misspoke. Did she?" The response was, "No. The secretary said what many people in the administration have been saying for months."
The flap illustrates the difficulty of communicating the President’s position on a public option -- he believes it is the best way to lower costs and increase coverage, but he is also open to alternatives.
That message is designed to appease two constituencies. Liberal activists say they will oppose any overhaul without a public option, while moderates worry it will pave the way for a government-run health system. The White House is trying to keep both factions at the table.
By backing away from a public health-insurance option, the White House appears to be showing how hard it is trying to make peace with Republicans who might support a health overhaul, says Naftali Bendavid of the Wall Street Journal.
Some liberals were alarmed by Sebelius's comments, and leaders of the Congressional Progressive Caucus and Congressional Black Caucus sent her a letter Monday in protest. "We stand in strong opposition to your statement that the public option is 'not the essential element' of comprehensive reform," it said. "We cannot rely solely on the insurance companies' good faith efforts to provide for our constituents."
Other progressives said they were placated by the White House's message. "I wanted a clarification, and feel confident that that's what we got," said Rep. Jan Schakowsky (D-IL). "I'm going to take them at their word that the administration still believes that this is the best way."
Republicans said that even if the public option is dropped, other aspects of the Democrats' plan -- such as the cost, estimated at close to $1 trillion over 10 years -- make it unworkable.
"It doesn't make a difference to us," said one House Republican leadership aide. "This plan is so bad that changing this one particular provision is not going to fix it."
The public option has emerged as the most contentious issue in the health-care debate, spurring heated exchanges at town-hall meetings this month. The House and Senate are taking different approaches.
Three House committees have approved health bills that include a public option, and it is likely to be part of any legislation that passes the House. Speaker Nancy Pelosi (D-CA) reiterated that Monday, saying, "We agree with the president that a public option will keep insurance companies honest and increase competition."
In the Senate, Republicans and Democrats on the Finance Committee are working to produce a bill that would feature a network of nonprofit health cooperatives, rather than a public option. It's unclear whether the Senate will pass a health bill, but if it does, it is unlikely to include a public option.
"The government-run plan does not have the votes to pass in the Senate, and it never has," said Michael Mahaffey, spokesman for Sen. Mike Enzi (R-WY), a Finance Committee member. "So while Sen. Enzi is pleased to see the White House backing away from its insistence on including a government-run plan, the fact is this doesn't change the dynamic in the Senate very much."
The final product may have to be crafted in talks between House and Senate negotiators. The White House email Monday was noncommittal on how President Obama would feel about the outcome of those talks.
Posing the question, "Would the President be willing to sign a bill without a public option?" it went on to respond, "We are not going to fast-forward the process and are not going to negotiate with ourselves in public."