White House Political Honcho Goes Mealy-Mouthed on Public Option

Just days before President Barack Obama is scheduled to deliver a major prime-time speech on health care reform, David Axelrod, the president's senior adviser, seemed to signal a willingness on the president's part to drop the public plan from legislation under discussion in Congress, in order to get a bill.

Yet even as Axelrod did so, White House Press Secretary Robert Gibbs indicated that the president would use the speech to make a case for including a publicly funded insurance option in any health care reform.

Axelrod downplayed the significance of a public health reform plan in his appearance this Sunday on NBC's Meet the Press, hosted by David Gregory. (Full transcript here; video and more from Axelrod's exchange with Gregory on the public option at the end of this story.)

Meanwhile, Gibbs, appearing on ABC's This Week, indicated that in the president's speech on Wednesday, he would state his support for a public health insurance plan.

David Gregory: This is what the House speaker says, Nancy Pelosi. She draws a line in the sand. She says the following, "Any real change requires the inclusion of a strong public option to promote competition and bring down costs. If a vigorous public option is not included, it would be a major victory for the health insurance industry. A bill without a strong public option will not pass the House. Eliminating the public option would be a major victory for the insurance companies. We have rationed care, increased premiums and denied coverage." Does the president agree with the House speaker?

David Axelrod: Well, he certainly agrees that we have to have competition and choice to hold the insurance companies honest. We have to have insurance protections for folks who have insurance, so they can't do the kinds of things that they've done in the past, arbitrarily throwing people off their insurance if they have a pre-existing condition or if they get seriously ill. He agrees with all of that.

The idea here is to bring more security and stability to people who have insurance and to help those who don't have insurance get it at a price they can afford. The public option within that exchange is certainly a valuable tool.

DG: The reality is as a political matter, you cannot get Republicans to sign on, nor can you get moderate Democrats, maybe 10 or 12 of them to sign on if the president fights for the public option. True or false?

DA: Look, why don't we let the president speak and make his case, and then we can have this discussion. I believe that there's enormous consensus around a broad number of issues that would make a great difference for people who have insurance and people who need insurance, and we have to build on that.

And I think the president will be able to do that on Wednesday night and we'll go from there.

One irony in this (and there are many when it comes to the current consternation over health care reform) is that in the districts of many of those conservative Democrats who oppose the public plan, either public sentiment remains in favor of the public option, or it appears to have little bearing on how constituents will vote in the upcoming midterm elections.

Take, for instance, the district of Rep. Mike Ross, D-Ark., spokesman for the conservative Blue Dog coalition in the House of Representatives. At 538.com, Nate Silver pointed out several months ago that the number of uninsured in Ross's district far exceeds the mean for uninsured in all congressional districts.

More than one-fifth of Ross' constituents lack health care coverage altogether -- and that doesn't even account for the underinsured.

Then there's the Senate, where Finance Committee Chairman Sen. Max Baucus, D-Mont., a recipient of oddles of campaign dollars from the health care industry, has held up the works by insisting on crafting a "bipartisan" health care reform bill (that may get one Republican vote, if he's lucky) that will contain no public option.