An email released by the State Department on Thursday hints that Hillary Clinton had a secret, behind the scenes role in crafting Obamacare, with the help of former White House Chief of Staff Rahm Emanuel.

In the May 2010 email, Neera Tanden, who served as a policy adviser to Clinton's 2008 campaign and heads the influencial liberal group Center for American Progress, wrote of what she termed "super secret" negotiations over the healthcare law.

Tanden informed Clinton that she was pitching New York Times healthcare reporter Robert Pear on the idea that many elements of Obamacare could be traced back to proposals originating with Clinton.

Tanden wrote, "The one question I wanted to ask you is about your idea on using FEHBP as a kind of a public option. I know you gave that to Rahm last August, and then mysteriously, it was in the Senate Finance package like a month later."

The "public option" was an idea being pushed by liberal activists that would create a government-run insurance plan (sort of like Medicare) to be offered to consumers on health exchanges alongside competing private plans. Liberals saw it as an essential way to drive down costs and keep insurers in check, while it was attacked as a Trojan Horse for a full government takeover of the healthcare system. Ultimately, the idea was scrapped to help ensure the law's passage through the Senate, an outcome that many liberals blame on Emanuel, arguing he didn't fight for the idea.

In this email Tanden is suggesting that an alternative to the public option originated with Clinton, and went through Emanuel, and into the final bill in order to secure passage. Emanuel, during the 1990s, served as a senior adviser to President Clinton.

The provision that Tanden appears to be referring to is one that's now called the multi-state plan program. Under the program, the Office of Personnel Management, which runs the Federal Employees Health Benefits Program (FEHBP), contracts with private health insurers in each state to sponsor plans.

"None of us had ever discussed it in the policy process of the WH and I didn't hear of it in the Hill, so my assumption is that Rahm gave them your idea as a substitute for the public plan, which didn't have the votes," Tanden wrote to Clinton in the email sent roughly two months after Obamacare's final passage. "I know that was all top secret, but I'm wondering if I should give Robert some hint of this only because it was a linchpin to moving the bill. I would get him sniffing around on it, so he'd write it more as his own reporting discovery (hopefully). i know institutionally it was hard for Rahm to be pitching public plan substitutes."

She continued, "On the other hand, everything is leaking out now, including our super secret bill writing process in August. I can see the arguments on both sides of this, so wanted to check in on it."

Clinton responded to the email without confirming or denying Tanden's account, but writing, "I tried calling you but got vm. Let me know when I can reach you."

Another, email, however, implies that Clinton felt out of the loop in the White House thinking on healthcare.

The previous September, after a summer in which opponents of the healthcare legislative push protested in townhall meetings, Clinton emailed Tanden, "Neera--Hope you've had a good, albeit, busy summer and are a little rested up in prep for the full court health care push. What is happening on that front? Is there a new strategy? I know POTUS will speak on 9/9. Will we hear the specifics of what the Admin wants Congress to do? Let me know if I can help? H"

After Tanden sent her an email filling her in on the state of play for healthcare coming out of summer recess, Clinton still wanted more information. "Can I call you? I have a few health care questions? What # should I use?" Clinton wrote.