Obama says he is committed to preserving a health care system in which government, employers and individuals share responsibility. Many Americans may not realize the government already picks up nearly half the nation's $2.4 trillion health care bill, through programs including Medicare and Medicaid.

A public plan for the middle class could give a final nudge that puts the system firmly in government hands.

Obama's campaign proposal — a foundation for Democrats in Congress — called for setting up a national insurance marketplace through which individuals and small businesses could buy coverage. People could pick private insurance or opt for a government plan that would resemble coverage for federal employees.

A recent analysis by the Commonwealth Fund, a nonprofit group that sponsors health care research, is giving supporters of a public plan some ammunition.

The study estimated costs and coverage under a hypothetical health reform plan similar to what Obama proposed in the campaign. It found that a public plan like Medicare could reduce projected health care costs by about $2 trillion over an 11-year period. Premiums in the public plan would be at least 20 percent lower, partly because of reduced administrative costs. Within a decade or so, some 105 million people would be in the public plan, compared with about 107 million with private insurance.

Commonwealth Fund President Karen Davis said the administration has been very interested in the study. "Some of their top economists are on the phone, poring over it," she said in an interview.

Democrats say they will fight to ensure a public plan stays in the final bill.

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On the Net:

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Copyright 2009 The Associated Press.