Public option splits House Democrats

The House’s top two Democrats on Tuesday came out on opposite sides of creating a government-run insurance option, exposing a rift in the health care debate that President Obama must try to bridge when he addresses Congress on Wednesday night.

Among dozens of Democrats who have soured on Mr. Obama’s plans over the summer are Rep. Mike Ross, a moderate who helped broker a deal in July but now says he no longer supports that compromise because it includes the government-run “public option” plan.

“An overwhelming number of you oppose a government-run health insurance option, and it is your feedback that has led me to oppose the public option as well,” Mr. Ross said in a newsletter to his constituents in Arkansas. “There are so many other reforms we need to try first before we completely overhaul our entire system.”

The public option has become the biggest sticking point in the debate, with liberal Democrats insisting on it and moderates and Republicans balking.

That division extends to the top ranks of the House, where Majority Leader Steny H. Hoyer, Maryland Democrat, said he could support a bill that does not include a public option. But just hours later, Speaker Nancy Pelosi, California Democrat, said a government-run health plan was “essential to our passing a bill in the House.”

Mrs. Pelosi later insisted that the leadership was united in support of a public option, which she said was the best way to inject competition into the health insurance market, bring down prices and expand coverage to low-income Americans.

“There is no division. We all support a public option,” she said, adding that the consensus extends to the rest of the House, where she expects a majority of members to support a public option in whatever bill passes.

Speaking to reporters earlier, Mr. Hoyer said he prefers legislation with a public option but it’s not a deal-breaker for him.

The White House said Mr. Obama would use his speech Wednesday to try to better explain the government-sponsored health option and to lay out exactly what he wants in a reform bill. Mr. Obama previously left most of the negotiations to Democrats in Congress, who have struggled to cobble together a proposal that could attract a majority of votes.

White House press secretary Robert Gibbs said the speech would last 30 to 35 minutes and that Mr. Obama would make clear that the public option will not create a “grandiosely subsidized, unlevel playing field” that makes it impossible for private insurers to compete.

Republicans tapped Rep. Charles Boustany Jr. of Louisiana, a doctor, to deliver their response. Some Republicans questioned what Mr. Obama hoped to achieve in what they calculated was his 28th speech on health care.

Mrs. Pelosi accused House Republicans of offering only “distraction, misrepresentation and distortion” on the issue, and House Democrats are not counting on Republican votes to pass their bill.

In the Senate, a bipartisan proposal is starting to take shape. Senate Finance Committee Chairman Max Baucus, Montana Democrat, said he wants to get a deal out of his “gang of six” negotiators before Mr. Obama’s speech. His outline does not include a public option, but it does call for a series of insurance cooperatives that would allow businesses and individuals to pool together for coverage.

It also imposes a $6 billion tax on insurance companies to help pay for the overhaul - whose $1 trillion price tag has given pause to some voters and the lawmakers who represent them - and fines families $3,800 for not obtaining insurance coverage.

Mr. Ross said he reversed his position on the public option after attending 37 town-hall meetings and five telephone town-hall meeting during August. He said the message from voters was loud and clear, and he was listening.

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