The Note, 6/19/2009: Price Tags: Health care costs rise — for the president, too

ABC News’ RICK KLEIN reports: It's been an expensive week — and we're not just talking health care.This has been the start of something huge — though it also may have been the beginning of the end of something that might have been even bigger.The hard part has certainly begun. Surprise: Health care is expensive. The ways to pay for it are unpopular. The nation is essentially broke. People tend to like their health insurance. Congressional action is achingly slow.(And might President Obama have done too good a job convincing people that fiscal responsibility matters? Did he want the public to actually take his message to heart at the moment that he's seeking to spend $1 trillion-plus on health care?)A new House draft of health care reform out Friday will be another target for critics. As for the Senate — tune in again next month.At the current rate, the latest salvo from the president may not require a response: "For those who simply criticize without offering new ideas of their own, I have to ask — what's your answer?" Obama said last night at a party fundraising dinner, per ABC's Sunlen Miller. "Don't tell me that we're going to tinker around the edges and that nothing's going to change." (What if both of those things happen? Who takes the biggest political hit if health care reform doesn't do it all?)"It's so predictable," the president said of the criticism. It's time for some of that patented Obama cool. This president and this White House are often at their best when the swirl of conventional wisdom tells them that they're stumbling.Yet this is more than straw men and caricatures: "President Obama's hopes for quick action on comprehensive health-care reform ran headlong this week into the realities of Congress, as lawmakers searching for the money to pay for a broad expansion of coverage discovered that it wasn't easy to find and descended into partisan — and intraparty — bickering," Ceci Connolly writes in The Washington Post. "In a high-level meeting at the White House yesterday, Obama conveyed his concern over early pronouncements by the Congressional Budget Office that a bill drafted by the Senate health committee would cover just 16 million additional people at a cost of $1 trillion, said one official with knowledge of the session who was not permitted to talk to reporters and so spoke on the condition of anonymity," Connolly writes."That is not his idea of good, affordable, universal coverage," said this adviser. (Well, what is it, then?)(Delay: "House Democratic leaders, meanwhile, said they will wait until next month to unveil plans for financing their bill," Connolly writes. DeLay? "My goal is not bipartisanship," said Sen. Chris Dodd, D-Conn.)Among the president's many obstacles: The path toward fiscal restraint is also the path toward incrementalism.As long as this is about spending, can it be about anything else?"The solid armor of President Barack Obama's popularity may have a crack — a nearly $2 trillion-sized one," the AP's Jennifer Loven and Liz Sidoti report. "There's continued and considerable public restiveness over eye-popping federal budget deficits, a potential danger for both Obama's ambitious agenda and his political fortunes. . . . Obama has greatly expanded the government's reach — and, polls say, stoked people's concerns." Cue the cost-cutting: "The high cost of securing health insurance for all Americans, the top domestic priority of President Obama, has Congressional Democrats scrambling to scale back their proposals or find ways to trim tens of billions of dollars a year from existing health programs," Robert Pear writes in The New York Times. Do they want to wake up seniors in this fight?"A key Senate committee, pressed to find ways to pay for a health-care expansion, is considering cuts in Medicare that would kick in automatically if other efforts to trim spending in the program fail," Laura Meckler and Greg Hitt write for The Wall Street Journal. "In the past, Congress has been reluctant to make politically difficult cuts to Medicare spending due to protests from industry and patients." Wasn't the idea to cover more people? "U.S. senators seeking to lower the price tag of a health-care overhaul below a $1.6 trillion estimate are cutting back proposed subsidies to help low-income Americans buy insurance," Bloomberg's Laura Litvan and Ryan Donmoyer report."Sources say that it's a major scale-back of the outline they had before," The Washington Post's Ezra Klein reports on the Senate Finance Committee draft. "Specifically, subsidies have dropped from 400 percent of the poverty line to 300 percent. Medicaid eligibility has been tightened to 133 percent of poverty for children and pregnant women and 100 percent of poverty for parents and childless adults." Is the public option done already? "A draft proposal in the Senate to overhaul the nation's health-care system would require most people to buy health insurance, authorize an expansion of Medicaid coverage and create consumer-owned cooperative plans instead of the government coverage that President Obama is seeking," Lori Montgomery and Shailagh Murray write in The Washington Post. Nobody told House Speaker Nancy Pelosi: "We will have a public option in the House that will be real. If it's not real, it's no use doing. And if we don't do a public option, I'm not sure we have as effective a public health care reform as we wish," said Pelosi, D-Calif., per ABC's Dean Norland. House Ways and Means Democrats are looking to release their draft Friday — but will any of this help the politics along? "House Democrats have lots of potential targets for higher taxes as they aim to expand health care coverage, from wealthy Americans and the nation's employers to anyone who pops the top on a soft drink," the AP's Erica Werner reports. "Also under consideration are higher alcohol taxes, increases to the Medicare payroll tax and a value-added tax, a sort of national sales tax, of up to 1.5 percent or more.A victory lap (almost) from The Wall Street Journal editorial page: "This was supposed to be a red-letter week for national health care, as Democrats started the process of hustling a quarter-baked bill through Congress to reorganize one-sixth of the economy on a partisan vote. Instead it was a fiasco." Chins up in the White House (but seriously?): "In their heart of hearts, few in the Obama administration would have predicted late last year that they would be this well positioned by June to achieve a major victory on health care," Kevin Sack writes in The New York Times. New from the ad wars: Health Care for America is launching a $1.1 million television advertising campaign aimed at senators in 10 states: Arkansas, Delaware, Florida, Iowa, Louisiana, Maine, New Mexico, North Carolina, Oregon, and Washington. Says the ad: "You'd have health care between you and your doctor — that's the president's plan. Keep the coverage you have now. Or choose from a range of plans — including a public health insurance option to lower costs and keep insurance companies honest." New pressure coming Friday on Iran: Rep. Mike Pence, R-Ind., is teaming up with House Foreign Affairs Chairman Howard Berman, D-Calif., to force a vote on a resolution in support of the Iranian dissidents."Both Pence and Berman had expressed concern and admiration for the supporters of Mir Hussein Moussavi, who was defeated by Iranian President Mahmoud Ahmadinejad in an election on June 12 that many international observers worry was illegitimate," Roll Call's Jackie Kucinich writes. "The non-binding bill, the subject of day-long talks, is meant to nudge the Obama administration towards a tougher position without being so harsh it drives a new wedge between Washington and Teheran," Politico's Glenn Thrush reports. Some rhetorical back-up, from Charles Krauthammer: "Where is our president? Afraid of ‘meddling.' Afraid to take sides between the head-breaking, women-shackling exporters of terror — and the people in the street yearning to breathe free. This from a president who fancies himself the restorer of America's moral standing in the world." Is that tougher position the right one? Peggy Noonan thinks not: "John McCain and others went quite crazy insisting President Obama declare whose side America was on, as if the world doesn't know whose side America is on," Noonan writes in her Wall Street Journal column. "This was Aggressive Political Solipsism at work: Always exploit events to show you love freedom more than the other guy, always make someone else's delicate drama your excuse for a thumping curtain speech." Sen. John Kerry, D-Mass., has Obama's back: More involvement in Iran's election means "more of an excuse to make America the target and America the excuse for their actions," Kerry said, per The Boston Globe's Joe Williams. On financial reform — is the president doing enough?"Mr. Obama has a clear vision of what went wrong, but aside from regulating shadow banking — no small thing, to be sure — his plan basically punts on the question of how to keep it from happening all over again, pushing the hard decisions off to future regulators," Paul Krugman writes in his New York Times column. "To live up to its own analysis, the Obama administration needs to come down harder on the rating agencies and, even more important, get much more specific about reforming the way bankers are paid." Arianna Huffington: "In just a few months, we've gone from saving the banks in order to save the economy to just saving the banks. It's the opposite of mission creep," she writes. "The larger problem continues to be the administration's habit of conflating the health of the Wall Street economy with the health of the real economy — when, in fact, the two economies have become decoupled." Steven Pearlstein: "By deciding to contort and trim their proposal to accommodate the objections from powerful interest groups and key members of Congress, members of the Obama team have now made it politically acceptable for everyone to treat this as just another special-interest free-for-all of the sort that helped cause the crisis in the first place," he writes in his Washington Post column. Uniting critics on left and right: "President Obama's plan to increase the authority of the Federal Reserve is emerging as a major stumbling block to congressional approval of his overhaul of financial industry regulations," Jim Puzzanghera reports in the Los Angeles Times. From the annals of oversight — new pressure over TARP watchdogs: "The lone sitting Republican member of Congress on the Congressional Oversight Panel [Thursday night] dubbed the Treasury Department's challenge of the independence of bailout watchdog Neil Barofsky ‘outrageous,' ‘unprecedented,' and ‘disturbing,' and he called on the Panel to launch an immediate investigation," ABC's Matthew Jaffe reports. "It's highly outrageous and highly irregular and we are going to get to the bottom of it," Rep. Jeb Hensarling, R-Texas, told Jaffe.The gripe: "Officials of the Treasury Department admitted late Thursday that they have asked the Justice Department to weigh in on how much power they have over the Special Inspector General for the $700 billion Troubled Asset Relief Program," ABC's Jake Tapper and Matthew Jaffe report. Remember when the big fight was going to be over cap-and-trade? Time for a new label, already: "Democrats like to talk about green jobs and cap-and-trade. A new strategy memo says they need to ditch those phrases, play down global warming and fight back on what their plans will cost Americans if they want to prevail in the high-stakes energy debate about to erupt on Capitol Hill," Jill Lawrence reports for Politics Daily. The latest "This Week" spotlight profile: Education Secretary Arne Duncan. "The tremendous challenge and opportunity is to use these resources to drive change and drive reform in ways that will live for decades long beyond when the last dollar's been spent," Duncan tells ABC's Jennifer Parker. Coming Sunday on "This Week": Sen. Chris Dodd, D-Conn., and Sen. Lindsey Graham, R-S. C., debating foreign relations, banking, and health care. The roundtable: George Will, Cokie Roberts, Sam Donaldson, Robert Reich, and Bill Keller of The New York Times. ABC is soliciting questions for next week's health care forum — partnering with Digg.com. Tweet your way through the Radio and Television Correspondents Dinner Friday night. Your hashtag, per Ana Marie Cox: #nerdprom2The Kicker:"Thank you for calling me ‘senator' and not ‘sir.' " — Sen. John McCain, R-Ariz., in a dig at Sen. Barbara Boxer, D-Calif., on "Hannity." "Here I am shooting hoops again. And it's because of him. If I ever have an opportunity to play with him, I want to be able to halfway get around that court well enough." — Rep. Baron Hill, D-Ind., admitting that he's brushing up his hoops game in the hopes of a hardwood meeting with the president.

Today on "Top Line," ABCNews.com's daily political Webcast: Rep. Rush Holt, D-N.J., and Jeff Zeleny of The New York Times. Noon ET. Follow The Note on Twitter: http://twitter.com/thenote