The President's Health Care Plan: No Public Option, Lots of Compromise

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For more than a year, President Obama remained on the sidelines of the health care debate -- chiming in now and again with sometimes-inspired, sometimes-disappointing rhetoric about broad values while members of Congress did the heavy lifting.

Now, the president has finally weighed it with "a plan."

But it is not enough.

The White House is making a big deal about what's being labeled "The President's Proposal," which the administration announced with much fanfare Monday.

According to the White House, the Obama plan does a lot:

• It makes insurance more affordable by providing the largest middle class tax cut for health care in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today. This helps over 31 million Americans afford health care who do not get it today – and makes coverage more affordable for many more.

• It sets up a new competitive health insurance market giving tens of millions of Americans the exact same insurance choices that members of Congress will have.

• It brings greater accountability to health care by laying out commonsense rules of the road to keep premiums down and prevent insurance industry abuses and denial of care.

• It will end discrimination against Americans with pre-existing conditions.

• It puts our budget and economy on a more stable path by reducing the deficit by $100 billion over the next ten years – and about $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.

But the real news is what it does not do.

Despite urging from House leaders and a growing number of senators, "The President's Plan" does not include a public option.

Nor does it bow in any meaningful way to progressive proposals to expand access to Medicare and Medicaid.

In other words, the president has opted for the Senate's exceptionally compromised approach, rather than the bolder bill produced by the House. This is not exactly shocking. The president abandoned serious discussion of the public option several months ago. But the failure to even reference moves to develop a federally-funded alternative to private insurance represents a clear embrace of the Senate stance.

Obama does tinker with some of the worst elements of the Senate bill. For instance, he proposes eliminating the special deal regarding Medicare spending in Nebraska that was cut to win the vote of Senator Ben Nelson, D-Nebraska.

Obama also proposes to delay until 2018 the tax on high-end insurance plans that was passionately opposed by organized labor.

One place where Obama's embrace of the Senate bill is good news is on the issue of reproductive rights.

The president's plan retains Senate language that is less restrictive regarding the use of federal money for abortion than what is contained in the House bill.

When all is said and done, however, "The President's Plan" is the Senate bill with the rough edges shaved off.

That's not exactly great news, as the Senate bill was not exactly a great bill. In fact, it has been condemned by serious reformers as a huge payoff for existing insurance and health-care industries that contains no real mechanism (in the form of a public option) for holding then to account.

So: Is "The President's Plan" the final bill?

No.

The president's aides admit that this "plan" is really just a framing document for the bipartisan, televised health care summit where Obama will meet with Democratic and Republican leaders in the House and Senate to discuss reform.

"This is the opening bid for the health meeting," says White House Communications Director Dan Pfeiffer. "We took our best shot at bridging the differences. It makes some strong steps to improving the final product... The president is coming to the meeting with an open mind."