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White House Is Seeking to Repair Intraparty Rift About Public Option

President Obama has said that he would not
President Obama has said that he would not "draw a line in the sand" about having a public plan be part of final health-care reform legislation. (By Ed Andrieski -- Associated Press)
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Since lawmakers left Capitol Hill for their August recess, the national conversation about health care has bounced from talk of "death panels" to insuring illegal immigrants to an outright government takeover of the system, GOP pollster Bill McInturff said.

"Those are bad questions to spend weeks litigating in the public," he said. "They have spent weeks talking about negative premises about the plan."

The president has maneuvered gingerly around the issue of a public plan, largely maintaining that he prefers to include the public option in a new insurance marketplace. He often argues that competition from a government plan -- without high executive salaries and the need to post profits -- could keep big insurance companies "honest."

But Obama and White House Chief of Staff Rahm Emanuel have also signaled a willingness to consider other avenues. Addressing a joint session of Congress in February, the president made no mention of a public insurance plan.

At a White House summit in March, he said: "If there is a way of getting this done where we're driving down costs and people are getting health insurance at an affordable rate and have choice of doctor, have flexibility in terms of their plans, and we could do that entirely through the market, I'd be happy to do it that way."

When the Obama campaign first crafted its health-care proposal, the creation of a government-sponsored insurance option "was not the most important thing," said David Cutler, a Harvard University economics professor and campaign adviser on health-care issues.

Obama, like Cutler, embraced the concept because it would afford consumers more options, Cutler said.

But while the idea has given conservatives an opening to attack Obama for allegedly supporting government-run health care, "to the left it's become this unholy grail" without which any reforms would be inadequate, Cutler said.

Richard Kirsch of Health Care for America Now said the idea was destined to become a flash point for the Obama administration as it began the health-care debate.

"They couldn't have avoided it," said Kirsch, an early proponent of the public option idea. "It was impossible. It was always going to be something that progressives really cared for."

Kirsch said early criticism of the concept by conservatives and insurance industry groups helped solidify liberal support for it.

"The right went on the attack," he said. "As a result, the issue got tremendously elevated. Because the right attacked it aggressively, it became a centerpiece of the battle."

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