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Obama Backs Public Option, Exchanges, Cap on Out-of-pocket Costs

Janice Simmons, for HealthLeaders Media, September 8, 2009

For the past month, Washington pundits have speculated about the specifics of healthcare reform legislation—and who will support it. With Congress coming back from its summer recess today, the answers are expected to emerge quickly on the presidential and congressional fronts.

President Obama will give a nationally televised speech on healthcare reform on Wednesday night. But on Monday afternoon, speaking to about 5,000 union members and their families at a Labor Day picnic in Cincinnati, Obama pulled the curtains back slightly on what he might be saying on Wednesday about healthcare reform.

"The debate has been good, and that’s important because we’ve got to get this right. But every debate at some point comes to an end. At some point, it’s time to decide. At some point, it’s time to act," Obama told the audience.

In particular, he saw reforms "where Americans and small businesses that are shut out of health insurance today will be able to purchase coverage at a price they can afford." This would mean the inclusion of a new health insurance exchange, which would use "competition and choice" of insurance plans "to hold down costs and help deliver them a better deal."

And it would include a public insurance option—an issue that has had a rousing effect at many congressional town hall meetings during August. "I continue to believe that a public option within that basket of insurance choices will help improve quality and bring down costs," Obama said.

But Obama reminded the crowd that lawmakers should not overlook other healthcare reform measures. This includes placing a cap on out of pocket expenses, he said, "so you don’t have to worry that a serious illness will break you and your family even if you have health insurance" and outlawing denial of coverage for those with preexisting conditions.

The Senate Finance Committee is not expected to include a public option or any government plan in its healthcare reform bill that is anticipated this week. The "gang" of six senators—three Democrats and three Republicans and led by Chairman Max Baucus (D-MT)—had been ironing out details via teleconferencing on Friday.

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