Public option still the big issue in health care reform

As the White House and Congressional leaders turned in earnest on Wednesday to working out big differences in the five health care bills, perhaps no issue loomed as a greater obstacle than whether to establish a government-run competitor to the insurance industry.

One day after the Senate Finance Committee approved a measure without a “public option,” the question on Capitol Hill was how President Obama could reconcile the deep divisions within his party on the issue. All eyes were on Senator Olympia J. Snowe, the Maine Republican whose call for a “trigger” that would establish a government plan as a fallback is one of the leading compromise ideas.

Two senior administration officials, speaking on condition of anonymity, said the White House looked favorably on the Snowe plan. But liberal Democrats were maneuvering against it Wednesday, arguing that Ms. Snowe, the lone Republican to vote in favor of the Finance Committee’s bill, was gaining undue influence over the talks.

“It’s one vote, she won’t make the commitment on the final product, and she says she’s got to have the trigger,” said Representative Raúl M. Grijalva, Democrat of Arizona, who is leading an effort in the House to round up votes for a government plan akin to Medicare. “I think the administration has put her in the driver’s seat; it’s very disconcerting.”

Of the many difficult decisions remaining — including how to pay for an overhaul and how many people will be left uninsured — few carry as much political weight for the president as the public option. The plan, which would be for people who do not get health care through their employers, has become a proxy for a larger debate over where Mr. Obama is taking the country.

“What’s going on here is not simply health care and the public option,” said Kenneth M. Duberstein, a chief of staff in the Reagan White House. “In light of the auto bailout, the bank bailout, the stimulus package, the public option fight is a surrogate for how much government is too much.”

With Democrats split, an array of compromises are being floated — including the nonprofit cooperatives in the Finance Committee bill and the latest idea to capture some Democrats’ fancy, leaving the public option to the states. But economists say few would fulfill Mr. Obama’s stated goal of injecting “choice and competition” into the marketplace.

Full Story in The New York Times