In an article published in the AMA Journal, President Obama called for establishing a public option for Obamacare websites. 

The reason for the public option is simple: the spectacular failure of Obamacare state co-ops that were supposed to be a lower-priced alternative to private insurance.  To date, 13 of the 23 state co-ops established when Obamacare was rolled out have since failed, with more collapses expected by year's end.

Two more state co-ops bit the dust in the last few days.  InHealth Mutual, Ohio’s co-op, is closing shop after losing $129 million of taxpayer funds.  And Oregon's beleaguered co-op is also going under.  That  collapse follows the spectacular failure of the Oregon Obamacare health insurance portal that cost taxpayers more than $300 million and whose website was so dysfunctional that it never signed up a single customer.

Reuters:

"Now, based on experience with the ACA, I think Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited,” the president wrote.

Public programs like Medicare often deliver care more cost effectively by curtailing administrative overhead and securing better prices from providers, Obama said.

Republicans and some Democrats opposed the inclusion of a government-run plan similar to Medicare in the original Obamacare law, and the so-called "public option" did not make it into the final legislation.

Since the ACA became law, the uninsured rate has declined to 9.1 percent in 2015 from 16 percent in 2010. Most enrollees live in counties with at least three policy issuers, which helps keep down costs, Obama said.

However, 12 percent of those enrolled in plans through the exchanges live in areas with only one or two issuers. Adding a public plan in such areas would give consumers more affordable options, he said.

Obama also called on Congress to increase financial assistance to purchase coverage, which he said would help middle class families who are stilling struggling with premiums.

Obama said spending on prescription drugs, which rose 12 percent in 2014, remains a problem, and he urged Congress to act on his proposal to increase transparency around manufacturers' production and development costs. He said the federal government should be given the authority to negotiate prices for certain high-priced drugs.

Spending more taxpayer money to get a public option up and running, increasing subsidies due to soaring costs for insurance companies, browbeating drug companies to reveal why it takes a billion dollars to get a drug to market – does this sound like a program that's thriving and successful?

The public option is a Hail Mary pass for Obamacare – a last-ditch effort to salvage the program and cement the president's legacy.  There's always a single-payer option, but that would eliminate the need for state exchanges and make several other Obamacare programs superfluous.  The public option is the last chance to keep Obamacare relatively intact.

The president doesn't expect Congress to pass a public option while he is in office.  But Hillary Clinton has endorsed the idea, so if the Democrats ever seize control of Congress, we can expect the public option to become law.