While President Barack Obama is calling a government-run insurance program to compete with private insurers “important” in health care reform, House Speaker Nancy Pelosi is saying it’s a necessity for her chamber of Congress.

Nancy Pelosi

At a press conference in San Francisco Aug. 21, Pelosi, a California Democrat, said “there’s no way I can pass a bill in the House of Representatives without a public option,” according to published reports.

Pelosi noted that the idea of health co-ops, which could be featured in the Senate Finance Committee’s final reform legislation, cannot take the place of the public option.

The common structure of a health care cooperative is a non-profit, non-government run operation with oversight by consumers. Co-ops do everything from providing care and, in some cases, own their own hospitals. The goal, seen as a benefit to many, is that co-ops minimize the need for profit.

“If they want to have [co-ops] for their state, perhaps that could be included in the legislation,” Pelosi said. “But it is not a substitute for a public option.”

Earlier this month, the House Energy and Commerce Committee passed its version of the America’s Affordable Health Choices Act, joining the Ways and Means, and Health and Labor committees in passing legislation on comprehensive health reform. In September, the full House is set to debate a compilation of those bills.

As Pelosi was making the public option an absolute at a podium in California, President Obama was clarifying his stance on the government-run program in Washington, D.C., at the “Organizing for America” national health care forum.

Obama said the goal is for a marketplace where Americans can choose from both private and public insurance plans.

“If we have a public option in there, that can help keep insurers honest; it can provide a benchmark for what an affordable basic plan should look like,” the president said. “And so even though we’ve got a whole bunch of insurance regulations that ensure that any private insurer that’s participating in the exchange is giving you a fair deal, this is sort of like the belt-and-suspenders concept – it means that not only do they have to abide by these regulations, but they also have to compete with somebody whose interest is not just profit but instead is interested in making sure that the American people get decent care.”

Obama followed by saying that “the public option is just one option.”

“It will be voluntary,” he said. “Nobody is talking about you having to be in the public option.  The only thing that we’re talking about is this being available to you as a choice, expanding consumer choice.  And we think that’s a good idea.”