The advocacy community is worried. It sees the public plan as an essential element of reform—a bridge, perhaps, to a single-payer system that would cover all Americans as a matter of right. The Institute for America’s Future, which is part of the liberal Campaign for America’s Future, gathered reporters on a conference call last week to push the virtues of a public insurance option, with Berkeley political science professor Jacob Hacker making the case.

The most telling news from the call came from Rep. Pete Stark, chair of the House Ways and Means health subcommittee. Stark, who was on the phone, told reporters that, without a public plan, reform might be ineffective. Then he delivered this message: Congress is likely to take a slower approach to health reform; voting on comprehensive reform wouldn’t happen until early 2010, because Congress has too many pressing priorities, such as the economy, and smaller-scale health care issues, like reauthorizing the State Children’s Health Insurance Program (SCHIP). He also said he had to give everybody a hearing, especially the American Medical Association, the American Hospital Association, and big PhRMA, all of which are likely to oppose a public plan for different reasons.

As for the insurance industry, Stark said, “They’re going to be easy to roll because nobody likes insurance companies.” It’s not likely AHIP, the insurers’ trade group, will let that happen, and it has begun to mobilize its own grassroots supporters, who can be counted on to tell Congress they like private insurance just fine.

And there you have it, the battle map for a public plan. It all should make for make for some interesting copy. ABC News began to get it with a reasonable story about the press conference. We will be watching to see if other media outlets do the same.


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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.