Apparent shift riles proponents of public health plan

Several leading Democrats voiced concern Monday about an apparent White House shift on an overhaul of the health-care system, objecting to signals that senior administration officials were open to abandoning the idea of a government-run insurance plan.

In the Senate, where negotiations are ongoing, Jay Rockefeller of West Virginia said a public option, as the plan has become known, is "a must." Sen. Russell Feingold of Wisconsin said that, "without a public option, I don't see how we will bring real change to a system that has made good health care a privilege for those who can afford it."

House Speaker Nancy Pelosi of California said the plan will be included in whatever bill is voted on in the House. "There is strong support in the House for a public option," she said.

President Obama had pushed a nonprofit, government-sponsored insurance plan as an alternative to existing insurance companies, saying a public program would compete with the industry and help reduce costs. He minimized the importance of a public option over the weekend, saying at an event in Colorado on Saturday that it was "just one sliver" of his overall effort to reduce health-care costs and expand coverage.

Two top advisers reiterated Sunday that he is open to alternatives to a government plan, setting off a wave of reports about a White House shift and frustrating senior advisers.

White House press secretary Robert Gibbs, speaking to reporters returning from Phoenix, where Obama spoke to a Veterans of Foreign Wars convention, said the president has not shifted his position, suggesting his support for a public option never had been absolute.

"The goals are choice and competition," Gibbs said. "His preference is a public option. If there are other ideas, he's happy to look at them."

White House officials repeatedly denied there was any new positioning on the provision, accusing the media of fabricating developments.

Three House committees and one Senate panel have passed versions of health-care legislation that contain a public option.

White House officials sought to reassure Democratic groups and activists that the public option has not been ruled out.

Democrats close to the White House said there is increasing pessimism that Republicans who have been at the center of Senate Finance Committee negotiations — Chuck Grassley of Iowa and Mike Enzi of Wyoming — will back the compromise measure that is expected to emerge from that panel.

Those Democrats noted that dropping the public option may be necessary simply to win the votes of conservative Democrats such as Nebraska Sen. Ben Nelson, who has been wary of the provision.

John Sweeney, president of the AFL-CIO, said the union will continue pressing House and Senate negotiators to keep a public plan. "The only way to force real competition on the insurance companies is a strong public-plan option," he said.

Rep. Anthony Weiner, D-N.Y., a member of the House Energy and Commerce Committee, said Obama could lose up to 100 Democratic votes in the House by abandoning the option.

"I know the trade the administration made is they have gotten two or three senators, but they have lost dozens of House members," Weiner said.

Democracy for America, a grass-roots group started by former Vermont governor and 2004 presidential candidate Howard Dean and now run by his brother Jim, sent an e-mail to supporters declaring "a health-care bill without a public option is D.O.A. in the House. Period." The Congressional Progressive Caucus, a group of the most liberal House members, threatened to oppose the bill if it does not include a public option.

Conservative Democrats in the House and Senate have been vague about whether they will support such an option, and the office of Senate Majority Leader Harry Reid of Nevada made a statement Monday that largely echoed the White House language.

Reid "supports a public option in part because of the necessity to keep insurance companies in check," spokesman Jim Manley said. "However, he recognizes there are different proposals on the table that could accomplish that goal."