So far, many on the left appear to be going along with Obama's strategy, holding their fire despite their frequently stated view that health care overhaul isn't worthwhile or even possible unless it forces private insurers to compete with the government to cover those who currently don't have insurance.
Big insurers who have been in close talks with Obama's White House and congressional Democrats to reach a deal that could bring them tens of millions of new customers hate the idea of having to compete with a government plan, which they say would devastate their businesses.
Obama used his address to Congress Wednesday night to make the case for the so-called "public option," but he also said it was "only one part of my plan," and stressed that he was open to other ideas about how to rein in insurance abuses and make coverage affordable for those who currently don't have it.
"He didn't define the plan like I would have defined it," said Rep. Raul Grijalva, D-Ariz., a leader of the liberal Progressive Caucus, which is insisting that any health care legislation contain such an element. "But he didn't slam the door. ... We weren't thrown under the bus."
Grijalva and Rep. Lynn Woolsey, D-Calif., another leader of the group, wrote to Obama Thursday thanking him for "reiterating your support" for a public option and requesting a meeting with him as soon as possible to talk about defining what it would look like.
Behind the scenes, Vice President Joe Biden huddled in the basement of the Capitol reassuring members of the Congressional Black Caucus during a wide-ranging meeting that the administration strongly supports including a government-run insurance plan in the overhaul.
The idea is expected to be included in a measure under development in the House, where liberals are dominant and three committees have approved legislation that includes some form of government-run insurance plan. But the idea is anathema to Republicans and many centrist Democrats who have outsized influence in the Senate, where the Finance Committee is drafting a health care overhaul that omits it.
Leaders in both chambers acknowledged Thursday that while they support a government-run plan to compete with private insurance, it's not a must-have item. Sen. Harry Reid, D-Nev., the majority leader, said he could be satisfied with establishment of nonprofit cooperatives, along the lines expected to be included in the Finance measure.
And House Speaker Pelosi, D-Calif., who has said no measure could pass the House without a public option, declined to call it a nonnegotiable demand. As long as legislation makes quality health care more accessible and affordable, she said, "we will go forward with that bill."
Lobbyists for labor and liberal groups monitoring the issue acknowledge privately that the public option is probably a nonstarter in the Senate, and their best hope for reviving the idea is to pass legislation without it and then fight hard for it in House-Senate negotiations to produce a final product before Congress sends Obama a health bill.
"What we heard is that he's going to fight for it, and we can hardly ask for better than that," said Bill Samuel, the legislative director for the AFL-CIO. "Sure, we're concerned about the Finance Committee - we want to see the draft strengthened and we want to see (a public option) in the bill when it comes out of conference. We're going to work very hard to make sure that happens."
Obama's approach is a calculated gamble whose outcome will go a long way toward determining whether his push for a health care overhaul will succeed. It's designed to show he's open to compromising with Republicans, even if it means sacrificing one of his party's key objectives, in the interest of getting something big accomplished.
But it also risks alienating the very activists on the left who helped propel Obama to the White House. Liberals have been hammering at Obama and congressional Democrats to insist upon a government-run insurance plan, saying a failure to do so would constitute a betrayal of the principles the president ran on.
"To avoid losing the grassroots army that got him elected, President Obama needs to do more than express a preference for the public option - he needs to draw a line in the sand and fight hard for it," said Adam Green, a spokesman for the liberal Progressive Change Campaign Committee, in the hours before Obama's speech. The group circulated a petition asking Obama to "demand" the public option in his speech and invoked the president's campaign slogan in their plea: "Letting the insurance companies win would not be change we can believe in."
But Families USA, an influential liberal advocacy group that's been closely involved in the debate, has been meeting with progressive lawmakers to persuade them that a public plan is not a holy grail.
"There are many non-controversial, very helpful provisions in health care reform that supporters of health care reform should treasure, and no single measure that doesn't fully meet expectations should derail moving forward," said Ron Pollack, the group's executive director.
Associated Press Writers Stephen Ohlemacher and Erica Werner contributed to this report.