Obama signals healthcare reform flexibility

Barack Obama has signalled he would be prepared to scrap his long-standing opposition to the “individual mandate” that would legally require Americans to get health insurance.

The move is the latest sign of the White House’s increasing flexibility on the details of healthcare reform – a goal Mr Obama has made clear is his overriding domestic priority.

During the Democratic primary campaign Mr Obama criticized Hillary Clinton for proposing an “individual mandate” saying such a step would be too coercive. But in a letter to Edward Kennedy and Max Baucus, the two Democratic senators who are thrashing out the details of the healthcare bill on Capitol Hill, Mr Obama indicated he would be prepared to accept it with caveats.

“I share the goal of ending lapses and gaps in coverage that makes us less healthy and drive up everyone’s costs, and I am open to your ideas on shared responsibility [between individuals and employers],” he said in the letter, which was made public by the White House on Wednesday.

“But I believe if we are going to make people responsible for owning healthcare insurance, we must make healthcare affordable.”

Mr Obama said that there should be a “hardship waiver” for Americans who could not afford insurance even after the proposed public subsidies had been included. He also reiterated his support for a waiver for small businesses on the parallel mandate the bill would impose on employers to provide health insurance.

However, the president said he continued to stand by his plan to include a publicly-managed health insurance option in the bill. A number of centrist Democrats have joined the Republicans in opposing a public plan by arguing it would tilt the playing field away from the private insurance companies.

Mr Obama said: “I strongly believe that Americans should have the choice of a public health insurance option alongside private plans.”

The president’s letter is the latest sign the White House is prepared to make significant tactical concessions to ensure the overall bill gets enacted this year. Earlier in the week Mr Obama said he might be prepared to consider taxing employer-provided healthcare benefits to help pay for the estimated $120bn a year healthcare bill. During the general election Mr Obama lacerated John McCain, the Republican nominee, for proposing just such a measure.

However, if Mr Obama includes the healthcare reform in his 2010 budget, which he has said he may do, then he would be required by law to find ways of paying for it. Other proposed White House methods of paying for healthcare reform, such as imposing a ceiling on what upper income taxpayers can itemise on their tax returns, have already been shot down by Democrats and Republicans in Congress.