President Barack Obama on Thursday outlined four provisions he indicated must be part of health care reform, pointedly declining to include a public insurance option as a necessary part of the mix.

The president answered questions from listeners of conservative Michael Smerconish’s radio show — broadcast today from the White House — and he asserted that he continues to want to try to forge a bipartisan health care bill.

But he accused the Republican leadership of pursuing a strategy from early in the debate of seeking to deny him a victory and damage him politically in the way that the failure of health reform in 1994 damaged former President Bill Clinton.

Republican leaders charge that Obama allowed the debate early on to move to the left and was never serious about negotiating with them.

The White House this week has tried to quiet an uproar by liberals over comments last weekend by Health and Human Services Secretary Kathleen Sebelius, who said the public option was not an “essential element— of health overhaul. White House officials said a government insurer remains a preferred strategy but not a necessary one, a stance affirmed by Obama on the radio show.

But Obama’s insistence that the legislation include a list of options could preclude Democrats from passing a more narrowly tailored bill under reconciliation, which would require only 50 Senate votes instead of the 60 needed under threat of GOP filibuster.

Asked what the bill must include, Obama said it must be deficit-neutral, reduce health costs, provide a “health exchange— that people can use to choose insurers and include health insurance changes — like guarantees that insurers cannot refuse to cover people because of pre-existing conditions or drop patients who get sick.