President Obama just wants to make everyone happy. At least that was the impression he put forth on the campaign trail: unity among all in the desire for change. Ten months into his first year, he’s had to make much in the way of compromise. On his top domestic policy issue – from contentious townhalls to circumspect senior citizens — Obama has had to rely heavily on his immense powers of articulation more than any other president in recent memory to straddle to the tightrope of public opinion to get his heatlhcare reform ideals passed. His efforts to marry apparent discordant entities (i.e., the role of insurance companies in a public option provision) within the reform debate have been stressed lately on the heels of his recent address to Congress on healthcare reform. As the president knows, it will take more than just a kumbaya approach to reform if one is serious about calling health reform what it is and what it isn’t — insurance reform.

In the process, he has alienated practically all Republicans (except the one with the halo — Olympia Snowe); driven more conservative Democrats to act like Republicans; and given insurance companies a renewed fervor to fight any legislation that contains the word “public”.  It comes as no surprise to Big Insurance, or health policy watchers .. for that matter,  that the Dems’ latest moves to check the former’s ability to make profits involve imposing further regulatory mechanisms that specifically target Insurance’s exemption from federal antitrust laws. These laws (essentially on the books for over 60 years) allow them to expand their reach and influence nationwide, stunting competition and discouraging new startups. Insurance lobbies have argued for the exemption previously on the grounds of lowering, say, premiums due to the “necessary” controlled expansion of risk pools — at the same time giving an olive branch to the federal government to place an end to practices of “unethical standards” in its industry, a fairly loose characterization and one meant to provide very little government oversight while giving the appearance of insurance companies’ heightened attempt at morality posturing.

Championing this push by the Judiciary Cmte. for increased federal regulation is Sen. Majority Leader Reid (D-NV). Although he has really yet to say so, this could be a move to insert some potency into a public option provision into the Senate reform measure. By now, it’s public knowledge that the House versions are the more liberal, invoking the inclusion of a public option all along the way since the outset of committee introductions. The Senate Finance Ctme. measure, on the other hand, is more politically charged and remains the wildcard in any ultimate reform language at passage.

Obama is being somewhat reticent on this issue, urging “partisan machinations” to be placed at the wayside. At least that’s what he publicly states. As this issue gains traction and possibly becomes a dealmaker at debate time, the political implications could mean more for on-the-fence Senate Democratic moderates in their constituents’ eyes than it does for the obvious short term “losses” for Big Insurance. That’s potentially good news for Obama, Reid (in terms of his problematic reelction bid), the PR-influenced White House, progressives, and the American public — who still favor a public option in a big way.

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