The Obama administration remains confident it can pass a negotiated health care compromise with bipartisan support this year and is open to alternatives to a government-run health insurance plan, White House chief of staff Rahm Emanuel said Thursday.

The two most important factors in the upcoming debate are how Congress decides to keep health costs down and the way lawmakers design a new “health care exchange” able to compete with private insurers, Emanuel said.

Emanuel would not rule out enacting an overhaul under a congressional procedure known as budget reconciliation instructions that would make it immune to filibuster in the Senate. But he added that Republicans who resist the administration’s effort risk being associated with the status quo.

“Our goal is to get it through the normal process — that’s why we’re working very extensively, very aggressively toward that,” Emanuel told a group of reporters. “Reconciliation exists as a tool, but that’s not the goal.”

Asked about alternatives to a government-run plan, such as a proposal by Sen. Kent Conrad , D-N.D., to create member-run health insurance cooperatives, Emanuel said the goal is to expand consumer choice by creating an entity similar to a traditional Blue-Cross-Blue Shield plan.

“The structure of the market-exchange is as important to the functioning of what you’re trying to achieve as cost control and choice and comparative shopping,” Emanuel said.

Emanuel said the administration is in a much stronger position to enact meaningful health care reform than the Clinton administration was when it attempted an overhaul in 1993 and 1994. He noted Secretary of State Hillary Rodham Clinton , who unsuccessfully sold much of that plan, had made that observation in private conversations.

Emanuel, who served as a high-level aide in the Clinton White House, pointed to the decision of the influential seniors group AARP to endorse an agreement to reduce drug prices this week, calling it a “significant piece of political business.”

He said the support a wide variety of health providers are offering for some type of overhaul is essentially boxing in opponents, because it portrays them as advocates of a broken system.

“They know failure is not an option,” Emanuel said of the providers supporting the administration’s efforts. “that was not the psychology going into 1993 and 1994.”

Emanuel said the administration will continue to stress two statistics as it prods lawmakers in the House and Senate to complete their work: 14,000 individuals lose health coverage every day, and health costs rise on average 10 percent annually.

“This is a debate about cost and coverage,” Emanuel said. “Those are the two numbers that are relevant in health care.”

Emanuel said Congress has the bandwidth to simultaneously deal with health care, comprehensive energy legislation and a proposed overhaul of financial regulations.