The Right Prescription

The “Public Option” Trap

Obama is damned if he does, and damned if he doesn't.

By 8.24.09

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Last Thursday, President Obama tried to contain a backlash among liberals concerned that the administration was wavering in its support for creating a new government-run health care plan, telling volunteers at his Organizing for America group that the uproar was a "manufactured" controversy.

"I think a public option is important," he said. But he was also sure to emphasize that "There are a whole bunch of other aspects to health insurance reform."

With opposition growing to Democratic health care legislation, it's understandable that the administration wants to keep its options open so that it can declare victory by signing any bill that is able to get through Congress, even something far less ambitious than what Obama wants. But it is surprising that the White House wasn't prepared for the passionate response to Health and Human Services Secretary Kathleen Sebelius's statement that a government-run plan was not an "essential element" of health care legislation.

The Washington Post quoted an anonymous senior White House adviser as saying, in reference to the creation of a new government-run plan, "I don't understand why the left of the left has decided that this is their Waterloo." The adviser added, "We've gotten to this point where health care on the left is determined by the breadth of the public option. I don't understand how that has become the measure of whether what we achieve is health-care reform."

It's perplexing that the White House was caught off guard given that liberal activists were essential to helping Obama organize a successful presidential campaign. Anybody who has kept half an ear to the progressive community for the past several years knows how essential the creation of a new government-run plan is to liberals.

"It's not like a decal on a car," Jacob Hacker, a professor at the University of California at Berkeley and the intellectual architect of the idea, said at the March 2008 conference of the Campaign for America's Future. "It's the engine of the car."

Throughout the health care debate a majority of the members of the 80-member House Progressive Caucus have maintained that they would not vote for any bill that did not include a "robust" government plan.

And during a conference call last Thursday, Arizona Rep. Raul Grijalva, a co-chair of the group, said that he had commitments from more than 60 members of the House that they would not vote for a bill that did not include a strong government plan, enough to block its passage. "That’s the understanding: no public option, no support," he said on the call, sponsored by the Campaign for America's Future.

Rep. Keith Ellison of Minnesota, who was also on the call, explained the opposition to a bill without a government plan: "We meant that not just in getting it through committees, but we mean it for the House floor, and we mean it when it comes back from conference (with the Senate).”

But North Dakota Sen. Kent Conrad, a Democrat who has been deeply involved in health care negotiations, has said that "It's very clear that there are not the votes in the United States Senate for a public option."

Taken together, this means that health care legislation cannot get through the Senate with a government plan, but it can't pass in the House without one.

Recent polling on the issue reinforces how difficult it will be for Obama to resolve this issue in the coming months. An NBC news poll found that a plurality of 47 percent of Americans opposed the creation of a new government-run plan to be offered on a government-run insurance exchange, compared with 43 percent who support it. Yet at the same time, a Rasmussen poll found that if a government plan is not included, support for health care legislation actually drops -- to 34 percent. The explanation is that a majority of independents and Republicans don't support legislation either way, but ditching the government plan means an erosion of support among the Democratic base. 

Another problem Obama will face is that right now, many of the liberal activists fighting for health care legislation are doing so because they want a government plan. If that is tossed aside, it will deprive Obama -- at a crucial time -- of an army of people who are writing and calling their members of Congress, while opponents remain unified. Rasmussen found that without the government plan, just 9 percent of people said they "strongly support" legislation while 37 percent were "strongly opposed." So in other words, among the most passionate people on the issue, the ones most likely to lobby Congress, opponents could outnumber supporters by more than 4 to 1.

Obama is trying to keep his options open by arguing in favor of a government plan while refusing to draw a line in the sand, but eventually he will be forced to decide whether he will stand with or against his core supporters. It's a trap that Obama created for himself by campaigning as a post-partisan president while promising to be a transformational liberal leader, and it's one that he won't be able to escape with lofty rhetoric.

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About the Author

Philip Klein is The American Spectator's Washington correspondent. You can follow him on Twitter at: http://twitter.com/Philipaklein