Obama’s evolution on a public option in healthcare reform

It’s an article of faith among politicians that voters admire consistency as evidence of backbone. No leader, least of all a president, wants to be seen as flip-flopping.

So the White House is unhappy about recent news coverage suggesting that President Obama and his administration have changed positions on an important piece of the healthcare proposal: creating a government-run medical insurance plan that would compete with private insurers.

The issue flared over the weekend, when senior administration officials and the president himself gave what were widely seen as signals that they were prepared to jettison the “public option,” if that’s what it took to pass a healthcare overhaul.

Not so, the White House insisted Tuesday, pushing back against the idea that its position had changed.


White House Press Secretary Robert Gibbs, briefing reporters Tuesday, said that Obama’s position on a public option was the same:

“As I’ve said -- now, yesterday and earlier today -- the president, his position, the administration’s position, is unchanged: that we have a goal of fostering choice and competition in a private health insurance market. The president prefers the public option as a way of doing that. If others have ideas, we’re open to those ideas and willing to listen to those details. That’s what the president has said for months.”

Here is a look at what the Obama administration has said over the last few days, compared with what it said over the last few months:

* On Sunday, Obama’s secretary of Health and Human Services, Kathleen Sebelius, told CNN that a government-run health insurance plan was “not the essential element” of Obama’s program.

* On Saturday, speaking at a town hall meeting in Grand Junction, Colo., Obama said: “The public option, whether we have it or we don’t have it, is not the entirety of healthcare reform. This is just one sliver of it, one aspect of it.”

* In a news conference on June 23, Obama said: “As one of those options, for us to be able to say, ‘Here’s a public option that’s not profit-driven, that can keep down administrative costs, and that provides you good, quality care for a reasonable price, as one of the options for you to choose’ -- I think that makes sense.”

* On June 16, Gibbs briefed reporters and said: “If I understand the free enterprise system . . . increased choice in competition drives down the prices for other insurance. That’s why a strong public option is necessary to ensure that competition.”

* On June 15, speaking to the American Medical Assn. in Chicago, Obama said: “You will have your choice of a number of plans that offer a few different packages, but every plan would offer an affordable, basic package. . . . one of these options needs to be a public option that will give people a broader range of choices and inject competition into the healthcare market . . . [to] force waste out of the system and keep the insurance companies honest.”

* In an interview with CNN on June 14, Sebelius said: “The president feels that having a public option side by side, same playing field, same rules, will give Americans choice and will help lower costs for everybody. And that’s a good thing.”

* On June 11, speaking to an audience in Green Bay, Wis., Obama said: “If you’ve got a private plan that works for you, that’s great. But we want some competition. If the private insurance companies have to compete with a public option, it’ll keep them honest and it’ll help keep their prices down.”

Later in the same appearance, Obama said: “For people who are self-employed, for small businesses, for others, they should have an option that they can go to if they can’t get insurance through the private marketplace. That’s why I’ve said that I think a public option would make sense.

“What that then does is it gives people a choice,” he continued. “If they’re happy with what they’ve got, if they’re employed by somebody who provides them with good healthcare, you can keep it. You don’t have to do anything. But if you don’t have health insurance, then you have an option available to you.”