The Public Option In Obama's Platform

"I didn't campaign on the public option," President Obama told The Washington Post in an interview in the Oval Office, when asked about criticism of the health care plan being shepherded through the Senate this week--a plan that has drawn fire from liberals for not including the type of government-run insurance plan that Obama pushed for repeatedly in 2009.

"Every single criteria for reform I put forward is in this bill," Obama said.

Liberals have disputed the claim today, citing the official Obama-Biden health care platform, available here in .pdf thanks to Ezra Klein's Google skills (Klein posted a comparison of the current plan and the platform a few days ago).

So who is right?

The public option was not a focal point of the 2008 campaign. Obama's disputes with Hillary Clinton focused on the individual mandate; his prime spat with McCain was over whether to tax employees' health benefits. Despite its prominence in '09, and Obama's public efforts to create one, the public option didn't get mentioned very often in 2008.

The Obama-Biden platform clearly does include mentions of a new public health insurance plan, but it is by no means trumpeted as a central facet of reform.

The document is 7 1/2 single-spaced pages (plus citations at the end), and the public option doesn't even get its own bullet point. It's never the lone subject or object of a declarative sentence. Given the public option's prominence this year, it's actually surprising to read the document and see it referenced so passingly.

Here are the only points at which the public option is mentioned (references bolded by me):

Providers who see patients enrolled in the new public plan, the National Health Insurance Exchange, Medicare and FEHB will be rewarded for achieving performance thresholds on physician-validated outcome measures.
The Obama-Biden plan provides new affordable health insurance options by:  (1) guaranteeing eligibility for all health insurance plans; (2) creating a National Health Insurance Exchange to help Americans and businesses purchase private health insurance; (3) providing new tax credits to families who can't afford health insurance and to small businesses with a new Small Business Health Tax Credit; (4) requiring all large employers to contribute towards health coverage for their employees or towards the cost of the public plan; (5) requiring all children have health care coverage; (5) expanding eligibility for the Medicaid and SCHIP programs; and (6) allowing flexibility for state health reform plans.
Through the Exchange, any American will have the opportunity to enroll in the new public plan or an approved private plan, and income-based sliding scale tax credits will be provided for people and families who need it. Insurers would have to issue every applicant a policy and charge fair and stable premiums that will not depend upon health status.  The Exchange will require that all the plans offered are at least as generous as the new public plan and meet the same standards for quality and efficiency.

This is an explanation of insurance exchanges, but sounds like an articulation of what the public plan will entail:

The Exchange will have the following features: 
  • Comprehensive benefits.  The benefit package will be similar to that offered through the Federal Employees Health Benefits Program (FEHBP), the program through which Members of Congress get their own health care. Plans will include coverage of all essential medical services, including preventive, maternity and mental health care.  
Barack Obama and Joe Biden will ensure that all Americans are empowered to monitor their health by ensuring coverage of essential clinical services in all federally supported health plans, including Medicare, Medicaid, SCHIP and the new public plan.

Firedoglake's Jane Hamsher finds this video (below) of Obama telling Planned Parenthood that "essentially what we're doing is to say that we're going to set up a public plan that all persons and all women can access if they don't have health insurance."

Salon's Alex Koppelman notes that a Lexis-Nexis search for "Barack Obama" and "public option" yields only 46 results between Jan. 1, 2008 and Oct. 31, 2008. Sam Stein has a rundown of news clips and concludes that candidate Obama spoke "remarkably infrequently" about the need to create a government-run plan.

So it comes down, in essence, to how one interprets the verb "campaign"--a discussion that Political Animal's Steve Benen calls "annoying." And annoying it may be, but it's important.

Obama didn't campaign on the public option too actively. He didn't talk about it much, and it wasn't a prominent part of his campaign's health care platform--at all. He did support it, and he did include it in his platform, albeit in a back-bench way.