White House: Public option "a means," not an end

A senior administration official says President Obama will argue for, but not insist on, a healthcare public option

Published September 9, 2009 8:10PM (EDT)

President Obama still thinks a government-run public insurance option would be the best way to make private health insurance companies lower their prices and compete fairly, but his speech tonight will "make clear" that he sees it as "a means to an end, not an end in and of itself," a senior administration official told reporters this afternoon.

Previewing Obama's speech to a joint session of Congress, the senior official -- who the White House insisted remain anonymous -- said the talk was an attempt to shift the focus of the national debate about healthcare back to the goals behind reforms and the concrete improvements reform legislation should bring. People have been "very focused on the trees, and not the forest," the official said. "Tonight's the night when he can describe the forest."

Obama will lay out what he thinks on some of the contentious issues in the healthcare fight, from the public option -- which he'll argue for, but not insist on -- to how to pay for the estimated $900 billion cost, over the next decade, of the reforms. The White House's advance spin was clearly aimed at assuaging the fears of any voters who worry that the reform will mean worse coverage for their own families. "He's proposing a plan that will bring security and stability to people who have health insurance, in the form of insurance reforms that have been long overdue and very much the object of contention in Congress for decades, and will help those who don't have coverage get it at a price they can afford," the official said.

The question of whether the public option will survive the legislative process has consumed liberal activists lately, and the notion of a government-run health insurance program was a GOP boogeyman earlier this summer. But now the White House is emphasizing that most people in the country wouldn't even have the chance to buy into the public option, which -- even if it passed unanimously -- would only be available as part of an exchange system where small businesses and people who don't have insurance through their jobs can purchase plans.

"This is not a national debate about whether we have a public option for the tens of millions who are uninsured," the official said. "It's about how we bring security and stability for hundreds of millions of Americans -- most of whom won't be affected one way or the other; they won't be participating in this marketplace that we're talking about, the insurance exchange."

That was just the latest signal that the White House is ready to drop the public option -- or phase it in under a delayed "trigger" system -- if that's what it takes to get the rest of the legislation through Congress. The Senate Finance Committee, the last of five panels with jurisdiction over healthcare legislation, is planning to move ahead with a bill in the next couple of weeks, whether Republicans sign on to a deal or not. But forget the GOP -- enough conservative Democrats, like Ben Nelson of Nebraska, Kent Conrad of North Dakota and Blanche Lincoln, have said they won't support a public option that it looks like the Senate won't be able to pass a bill that includes it. In the House, meanwhile, leaders are slowly shifting away from flat declarations that a bill without the public plan wouldn't be able to pass.

The White House line is, basically, we'll take it if we can, but we'll leave it if we have to. "What's apparent to everyone now is that something has to get done, and it would be a failure, a political failure, not just for the president but for the Congress, not to respond to what is a widely perceived problem in people's lives," the official said.

By Mike Madden

Mike Madden is Salon's Washington correspondent. A complete listing of his articles is here. Follow him on Twitter here.

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