Obama wants a public option

OBAMA WANTS A PUBLIC OPTION…. The White House, following up on yesterday’s discussions with lawmakers on health care reform, sent a letter today to Sens. Edward Kennedy (chairman of the Senate Health, Education, Labor & Pensions Committee) and Max Baucus (chairman of the Senate Finance Committee). President Obama has voiced tacit support for a public option before, but notice the renewed emphasis.

“The plans you are discussing embody my core belief that Americans should have better choices for health insurance, building on the principle that if they like the coverage they have now, they can keep it, while seeing their costs lowered as our reforms take hold.

“But for those who don’t have such options, I agree that we should create a health insurance exchange — a more market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that’s best for them, in the same way that Members of Congress and their families can. None of these plans should deny coverage on the basis of a preexisting condition, and all of these plans should include an affordable basic benefit package that includes prevention, and protection against catastrophic costs. I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.” [emphasis added]

Again, this isn’t new, but the more the president steps up and shows some leadership in support of a public option, the more likely it is the measure will be included in the final bill. Which is why I’m encouraged by this letter — Obama could have stuck to broad generalities about his core (but undefined) beliefs. Instead, the president reminded the senators, who are not entirely on the same page on the issue, what he wants to see.

Ezra Klein noted today that the White House “seemed relatively uninterested” in the public option as recently as a few months ago, but “has begun pushing hard for it.”

And that, in my reporting, is what seems to be underneath the change. A few months ago, most observers thought the public plan was a bargaining chip. It had a lot of public supporters but few real friends. In recent weeks, that’s begun to change. The White House seems genuinely intent on including a public plan — or at least some form of public competition — in the final bill. And that’s changed the incentives for senators down the line. The public plan was safe to oppose so long as the powerful players weren’t really interested in its survival. Indeed, when the policy was going to be bargained away anyway, the incentives were to try to convince the health industry that you’d been their key ally in that victory. But now that the White House has put some muscle behind the policy, opposition has potential consequences. And that’s making the policy’s opponents rethink their stridency.

Note to the White House: more of this, please.