As official White House statements go, the latest on Senate Democratic leader Harry Reid's plan to tack a government-run insurance plan onto the Senate's health care reform bill was uncommonly enigmatic.
“As [President Obama] said to Congress and the nation in September, he supports the public option because it has the potential to play an essential role in holding insurance companies accountable through choice and competition,” said White House press secretary Robert Gibbs.
But even in that Sept. 9 address, Obama was hedging his bets on the public option, saying the ultimate goal is affordability.
“The public option is only a means to that end – and we should remain open to other ideas that accomplish our ultimate goal,” Obama told Congress and the nation.
The White House fervently denies it, but their statements on including a public option in health care reform have at times been contradictory, and often appear shifting.
June 2: In a letter to Congress, Obama wrote, “I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans.”
July 18: “Any plan I sign must include an insurance exchange — a one-stop shopping marketplace where you can compare the benefits, costs and track records of a variety of plans, including a public option to increase competition and keep insurance companies honest,” Obama said in his weekly radio address.
Aug. 15: “All I'm saying is, though, that the public option, whether we have it or we don't have it, is not the entirety of health care reform,” Obama said at a town hall meeting in Colorado. “This is just one sliver of it, one aspect of it.”
Aug. 15: Health and Human Services Secretary Kathleen Sebelius tells CNN's “State of the Union” that the public option “is not an essential element” of health care reform.
Aug. 17: Asked about an apparent shift or contradiction on the public option, White House press secretary Robert Gibbs said, “I challenge you guys all to go back and see what we've said about this over the course of many, many, many, many months, and you'll find a boring consistency to our rhetoric.”
Sept. 26: Obama addresses the annual dinner of the Congressional Black Caucus, talks at length about health care reform, but makes no mention of a public option.
Oct. 26: The president “supports the public option because it has the potential to play an essential role in holding insurance companies accountable through choice and competition,” said Gibbs.
Under pressure from labor and liberal interest groups determined to have a public option, the administration's fallback position is that Obama still wants a government-run, nonprofit plan.
But with Maine Republican Sens. Olympia Snowe and Susan Collins saying they won't support Reid's measure, and Connecticut independent Sen. Joe Lieberman also opposed, the White House lacks the 60 votes it needs in the Senate to pass reform.
Increasingly, the administration appears willing to sacrifice a public option in order to get a bill through — as long as it meets the newer, lower and politically less combustible standard of providing “choice and competition.”
“I think that's what their statements and body language have been saying for months,” said Michael Cannon, director of health policy studies for the Cato Institute. “And Obama knows it's not essential because if he gets an individual mandate included, then he has nationalized private health insurance anyway.”
A provision in the larger health care effort would require Americans to have health coverage or face a financial penalty.
The administration's confusing statements on a public option may have contributed to public confusion about the idea, as illustrated by a new NBC News/Wall Street Journal poll.
Seventy-three percent of Americans said it was important to give Americans the choice of a public option, 45 percent called it “extremely” important and 27 percent said it was “quite” important.
At the same time, only 48 percent said they support the public option, and 42 percent said they oppose it.