They're back: the public plan, the reincarnation of Harry and Louise, and the limits of Obamacare.

Many advocates of universal health care put competition and consumer choice at the center of the latest major push for health reform. Dozens of major organizations close to the Democratic Party, including the AFLCIO, Moveon.org, and the Children’s Defense Fund, fought on behalf of a remarkably modest solution: creation of a public health plan — essentially a nonprofit insurance company — to compete with the commercial health insurers. They largely abandoned the movement for a singlepayer health system, which had been gaining ground since the demise of the Health Security Act during Bill Clinton’s administration, fifteen years ago. This faith in marketled solutions for health care remained largely unshaken, despite the recent financial collapse. The final version of the Patient Protection and Affordable Care Act (ACA) did not include a provision for a robust public plan — or even a weak one. But the controversy over this issue has left a lasting mark on the course of health care reform.