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White House appears ready to drop 'public option'

WASHINGTON — Bowing to Republican pressure, President Barack Obama’s administration signaled on Sunday it is ready to abandon the idea of giving Americans the option of a new government-run insurance program as part of an overhaul of the U.S. health care system.

Facing mounting opposition to the overhaul, administration officials left open the chance for a compromise with Republicans that would include nonprofit health insurance cooperatives instead of a government-run plan. Such a concession would likely enrage his liberal supporters but could deliver Obama a much-needed win on a top domestic priority opposed by Republican lawmakers.

Officials from both political parties reached across the aisle in an effort to find compromises on proposals they left behind when they returned to their districts for an August recess. Obama had sought the government to run a health insurance organization to help cover the nation’s almost 50 million uninsured, but he never made it a deal breaker in a broad set of ideas that has Republicans unified in opposition.

Reforming the U.S. health care system is arguably Obama’s most challenging political fight yet as president, in no small part because of the vast number of diverse stake-holders involved. His goal is to ensure health care for everyone in a country with the world’s costliest system.

It’s an issue that touches everyone in the United States. There are thickets of competing interests among patients, doctors, drug makers, insurers, labor, businesses and others.

Any plan must get through a Democratic-controlled Congress, where many lawmakers are up for re-election next year. Also, there’s an ideological fault line between Democrats and Republicans, and liberals and conservatives over the level of government involvement in health care.

“I am confident that when all is said and done, we can forge the consensus we need to achieve this goal,” Obama wrote in an opinion piece published Sunday in The New York Times. “We are already closer to achieving health-insurance reform than we have ever been.”

Obama cited support for reforms from the American Nurses Association; the American Medical Association, which represents many doctors, and the influential seniors’ advocacy group AARP, among others.

“We have broad agreement in Congress on about 80 percent of what we’re trying to do,” he added.

Health and Human Services Secretary Kathleen Sebelius said that a new government alternative to private health insurance is “not the essential element” of the administration’s health care overhaul. The White House would be open to co-ops, she said, a sign that Democrats want a compromise so they can declare a victory.

“I think there will be a competitor to private insurers,” Sebelius said. “That’s really the essential part, is you don’t turn over the whole new marketplace to private insurance companies and trust them to do the right thing.”

Obama’s top spokesman refused to say a public option was a make-or-break choice for the administration.

“What I am saying is the bottom line for this for the president is, what we have to have is choice and competition in the insurance market,” White House press secretary Robert Gibbs said.

On Saturday, Obama himself appeared to hedge his bets.

“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 Grand Junction, Colo. “This is just one sliver of it, one aspect of it.”

Lawmakers have discussed the co-op model for months although the Democratic leadership and the White House have said they prefer a government-run option.

Democratic Sen. Kent Conrad of North Dakota, chairman of the Senate’s budget committee, has pushed the co-op alternative. He called the argument for a government-run public plan little more than a “wasted effort.” He added there are enough votes in the Senate for a cooperative plan.

“It’s not government-run and government-controlled,” he said. “It’s membership-run and membership-controlled. But it does provide a nonprofit competitor for the for-profit insurance companies, and that’s why it has appeal on both sides.”

As proposed by Conrad, the co-ops would receive federal startup money, but then would operate independently of the government. They would have to maintain the same financial reserves that private companies are required to keep to handle unexpectedly high claims.

Sen. Richard Shelby, an Alabama Republican, said Obama’s team is making a political calculation and embracing the co-op alternative as “a step away from the government takeover of the health care system” that the Republicans have pummeled.

“I don’t know if it will do everything people want, but we ought to look at it. I think it’s a far cry from the original proposals,” he said.

Republicans say a public option would have unfair advantages that would drive private insurers out of business. Critics say co-ops would not be genuine public options for health insurance.

But Rep. Eddie Bernice Johnson, a liberal Texas Democrat, said it would be difficult to pass any legislation through the Democratic-controlled Congress without the promised public plan.

“We’ll have the same number of people uninsured,” she said. “If the insurance companies wanted to insure these people now, they’d be insured.”

Republican Rep. Tom Price of Georgia said the Democrats’ public option would force individuals from their private plans to a government-run plan, a claim that the nonpartisan Congressional Budget Office supports.

“There is a way to get folks insured without having the government option,” he said.

Obama, in his opinion piece, said that the status quo is unacceptable when millions of Americans are struggling “with a system that often works better for the health-insurance companies than it does for them.”

“In the coming weeks, the cynics and the naysayers will continue to exploit fear and concerns for political gain,” he wrote. “But for all the scare tactics out there, what’s truly scary — truly risky — is the prospect of doing nothing.”

Congress’ proposals, however, seemed likely to strike a proposal to provide reimbursement to doctors for end-of-life counseling sessions. Former Alaska Gov. Sarah Palin has called the sessions “death panels,” a label that has drawn rebuke from her fellow Republicans as well as Democrats.

Sebelius said the end-of-life proposal was likely to be dropped from the final bill.

On Saturday, Obama invoked his own anguish over the death of a loved one as he challenged as “simply dishonest” arguments by some Republicans that Democratic reform proposals would include “death panels” that decided who would get care and who wouldn’t.

“I just lost my grandmother last year. I know what it’s like to watch somebody you love, who’s aging, deteriorate and have to struggle with that,” an impassioned Obama told the meeting in Grand Junction, as he spoke of Madelyn Payne Dunham. He took issue with “the notion that somehow I ran for public office or members of Congress are in this so they can go around pulling the plug on grandma.”

Obama’s grandmother died of cancer at age 86 on Nov. 2, two days before he won election to become the nation’s first African-American president.

Sebelius spoke on CNN’s “State of the Union” and ABC television’s “This Week.” Gibbs appeared on CBS’ “Face the Nation.” Conrad and Shelby appeared on “Fox News Sunday.” Johnson and Price spoke with “State of the Union.” Hatch was interviewed on “This Week.”

AP Writers Philip Elliott in Washington and Liz Sidoti in Grand Junction, Colo., contributed to this story.

(Associated Press)

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