Several leading Democrats voiced concern Monday about an apparent White House shift on health-care reform, objecting to signals from senior administration officials that they would abandon the idea of a government-run insurance plan if it lacked the backing to pass Congress.
In the Senate, where negotiations are now focused, John D. Rockefeller IV (W.Va.) said that a public option, as the plan has become known, is "a must." Sen. Russell Feingold (Wis.) said that "without a public option, I don't see how we will bring real change to a system that has made good health care a privilege for those who can afford it."
House Speaker Nancy Pelosi (Calif.) said that the plan will be included in whatever bill is voted on in the House. "There is strong support in the House for a public option," she said, though she did not demand that the administration express support for the idea.
One Democrat predicted that without the provision, the bill could lose as many as 100 votes in the chamber.
President Obama had pushed a nonprofit, government-sponsored insurance plan as an alternative to existing insurance companies, saying that a public program would compete with the industry and help reduce costs. Over the weekend, he minimized the importance of a public option, saying at an event in Colorado on Saturday that it was "just one sliver" of his overall effort to reduce health-care costs and expand coverage.
Two of his top advisers on Sunday reiterated that he is open to alternatives to a government plan, setting off a wave of reports about a White House shift and frustrating senior advisers.
White House press secretary Robert Gibbs, speaking to reporters returning to Washington from Phoenix, said Obama has not shifted his position, suggesting that the president's support for a public option had never been absolute. "The goals are choice and competition. His preference is a public option. If there are other ideas, he's happy to look at them," Gibbs said. White House officials repeatedly denied that there was any new positioning on the provision, accusing the media of fabricating developments.
Three House committees and one Senate panel have passed versions of health-care legislation that contain a public option.
White House officials sought to reassure Democratic groups and activists that they did not intend to rule out the public option, a position they are able to maintain, for now, because no final version of the bill exists. White House Deputy Chief of Staff Jim Messina told some groups involved in the effort that the administration's positions have not changed.
Democrats close to the White House said there is increasing pessimism about getting two Republicans who have been at the center of Senate Finance Committee negotiations -- Charles E. Grassley (Iowa) and Mike Enzi (Wyo.) -- to back the compromise measure that is expected to emerge from that panel. Those Democrats noted that dropping the public option may be necessary simply to win the votes of conservative Democrats such as Sen. Ben Nelson (Neb.), who has been wary of the provision.
John Sweeney, president of the AFL-CIO, said the union will continue pressing House and Senate negotiators to keep a public plan. "The only way to force real competition on the insurance companies is a strong public plan option," he said.
Rep. Anthony Weiner (D-N.Y.), a member of the House Energy and Commerce Committee, said Obama could lose up to 100 Democratic votes in the House by abandoning the option.
"I know the trade the administration made is they have gotten two or three senators, but they have lost dozens of House members," Weiner said.
Democracy for America, a grass-roots group started by former Vermont governor and 2004 presidential candidate Howard Dean and now run by his brother Jim, sent an e-mail to its supporters declaring "a healthcare bill without a public option is D.O.A. in the House. Period." The Congressional Progressive Caucus, a group of the most liberal House members, threatened to oppose the bill if it does not include a public option.
Conservative Democrats in the House and Senate have been vague about whether they will support such an option, and the office of Senate Majority Leader Harry M. Reid (Nev.) made a statement Monday that largely echoed the White House language.
Reid "supports a public option in part because of the necessity to keep insurance companies in check," said spokesman Jim Manley. "However, he recognizes there are different proposals on the table that could accomplish that goal."