WASHINGTON — As President Barack Obama prepares to tell the nation Wednesday night how he wants to revamp the country's health care system, key congressional Democrats on Tuesday signaled a growing willingness to give up or at least postpone creating a "public option" government-run system to compete with private insurance.
Obama will address a joint session of Congress at 8 p.m. Wednesday. He's hoping that by offering more details of how he wants a plan crafted, he can break the months-old congressional deadlock on the issue.
One key choke point is whether the legislation should include a "public option" alternative to private insurance. Liberals insist on one, while moderates and conservatives are wary. Obama has said he prefers one, but hasn't demanded it.
Obama "will not abandon the public option" on Wednesday night, but will make clear that he sees it as "the best mechanism, but not the only mechanism," according to a senior administration official who spoke on the condition of anonymity Tuesday because he wasn't authorized to speak in advance of the speech. The official said that Obama wants "to break the logjam between the progressives and the centrists" inside the Democratic Party.
White House Press Secretary Robert Gibbs was coy when asked Tuesday about the public option, but he, too, suggested a push for compromise by the liberal wing of the party. "The president continues to believe that increasing choice and competition through additional options for people to get health insurance is tremendously important," Gibbs said.
Leading lawmakers spoke carefully Tuesday, refusing to offer explicit assurances that they'd approve a plan that puts government into competition with the private sector.
"We're going to do our very best to have a public option or something like a public option before we finish this work," said Senate Majority Leader Harry Reid, D-Nev., after he and House Speaker Nancy Pelosi, D-Calif., met Tuesday with Obama.
The House of Representatives, where three committees have voted to back legislation including a public option, is expected to approve legislation with one, perhaps later this month.
"I believe that a public option will be essential to our passing a bill in the House of Representatives . . . ." Pelosi said after the White House meeting.
The Senate, however, is unlikely to accept it, and Pelosi wouldn't rule out accepting alternatives once the two chambers pass different bills and final House-Senate negotiations begin. "This . . . is the legislative process. And right now, we will have a public option in our bill," she said.
Gibbs said he didn't expect Obama to use the speech to unveil formal legislation of his own, but that by the end of the roughly half-hour address, Americans — and Congress — would have a more detailed sense of what the president wants Congress to pass.
"The president continues to believe that increasing choice and competition through additional options for people to get health insurance is tremendously important," Gibbs said.
He said that Obama would offer some concrete assurances that people with private insurance through their jobs wouldn't suddenly be dumped into a public option, and that those on Medicare or other government benefits wouldn't be adversely affected by any overhaul.
Gibbs also used compromise language, saying Obama is "focused on the end, and he's focused on results" and said that Obama would outline "what he thinks can get done this year."
That seemed to be on the minds of members of Congress as they returned Tuesday from their summer recess, when many were confronted by angry, confused constituents at town hall meetings.
A Pew Research Center poll taken Sept. 3-6 illustrated the difficult job that Obama and Congress face. While 56 percent of Americans said they planned to watch Obama's speech, 73 percent said the debate affected them personally, 93 percent said it was important, and fully two-thirds said the health care debate is difficult to understand.
House Majority Leader Steny Hoyer, D-Md., said that lawmakers heard the voters' message.
"If the public option weren't in there, I still could support a bill, because there's a lot in there that's good," said Hoyer, who's closer to moderate and conservative Democrats than Pelosi is.
He said he'd spoken to Democratic members of Congress in recent weeks and that they had similar findings: People want changes in health care policy, but many lawmakers are wary of a government-run insurance plan that would compete with the private sector.
That was the message that Rep. Mike Ross, D-Ark., a leader of the 52-member "Blue Dog" coalition of moderate-to-conservative House Democrats, got back home. Ross, whose July support for a public plan was crucial, said Tuesday that after listening to constituents, he could no longer support the public option.
Hoyer listed several points of agreement among Democrats: Restricting insurers from denying coverage because of pre-existing conditions, barring lifetime limits on consumers' health care benefits and help for small businesses.
Hoyer said he'd try to "come to agreement on what can garner a majority. I believe this bill has many component parts that are important."
In the Senate, the Health, Education, Labor and Pensions Committee has approved legislation that contains a public option, but the Finance Committee has yet to vote on any plan, and six members, three from each party, continue to discuss alternatives.
Sen. Max Baucus, D-Mont., the panel's chairman, this weekend proposed a $900 billion, 10-year "framework," Kaiser Health News reported.
Baucus proposes to create nonprofit health care insurance co-operatives instead of a government-run program, and is floating the idea of a tax on high-cost health insurance policies as a way to raise revenue. Insurers would be prohibited from denying coverage based on pre-existing medical conditions.
His measure also would expand Medicaid coverage to 133 percent of the federal poverty level — currently $22,050 a year for a family of four — provide tax credits for people with incomes up to 300 percent of poverty and establish a series of health insurance exchanges to help individuals find affordable coverage.
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