The Note: Obama Sells Health Plan to Public, Congress

By Caitlin Taylor

Jun 22, 2009 8:07am

By RICK KLEIN The table is set. Everyone’s been in their seats for a while. The restaurant is getting crowded. More than a few customers are already disputing the bill. Is it almost time for President Obama to start ordering off the menu? It’s a moment, of course, that the president has been putting off — his inclination being to let Congress handle the messy work, and show up in time to embrace something that’s been tidied up. But the first full week of health care debate on Capitol Hill makes clear that the default position — the easiest outcome to achieve — is going to be getting nothing done. All of which might make it helpful for Democrats (and maybe a few Republicans) to know what something should look like. Enter Obama (again), selling people what they think they need, still aren’t sure they want, are pretty sure they don’t understand, and are growing convinced that they can’t afford. “Americans overwhelmingly support substantial changes to the health care system and are strongly behind one of the most contentious proposals Congress is considering, a government-run insurance plan to compete with private insurers, according to the latest New York Times/CBS News poll,” Kevin Sack and Marjorie Connelly write in the Sunday New York Times.  Yet: “It is not clear how fully the public understands the complexities of the government plan proposal, and the poll results indicate that those who said they were following the debate were somewhat less supportive,” Sack and Connelly write. “It is not clear how fully the public understands the complexities of the government plan proposal, and the poll results indicate that those who said they were following the debate were somewhat less supportive.” “A New York Times poll released [Sunday] said that a striking 72 percent of Americans support a public health-care plan, and 57 percent are willing to pay higher taxes to cover all Americans,” ABC’s John Hendren reports. “Nevertheless, the president's chances for an optional health care plan that would be run by the government may be fading. Republicans and some Democrats have expressed skepticism.”  With the president’s sales pitch continuing this week, his first obstacle: perceptions. “No one can figure out a politically acceptable way to pay for an overhaul of America's health care system, and until someone does, the effort is stalled,” McClatchy’s David Lightman and William Douglas report. “Maybe indefinitely.”  “President Barack Obama is seeing the downside of his light touch on revamping the nation's health care system,” per the AP’s Chuck Babington. “While too early to rule out eventual success, it seems Obama will have to be more forceful and hands-on.”  Against that backdrop, illusions (or more than that) of momentum: “AARP, the nation's largest seniors lobby, will give its blessing today to an offer by drug manufacturers to contribute $80 billion over the next decade to reduce the cost of comprehensive health reform, in part by discounting the price of Medicare prescriptions,” Ceci Connolly reports in The Washington Post.  “This is an early win for reform and a major step forward,” the AARP’s Barry Rand plans to say, alongside President Obama at the White House Monday. “The agreement is the latest in a series of cost-cutting deals the government has made with insurance companies, doctors, hospitals and medical-device manufacturers as it seeks to find ways to pay for proposed changes to the health-care system, including expanding insurance coverage to 46 million uninsured Americans,”Janet Adamy and Jonathan D. Rockoff report in The Wall Street Journal. “The agreements would take effect only if Congress passes legislation to fix the health system.”  Plus, a bill signing: The Family Smoking Prevention and Tobacco Control Act becomes law at 2 pm ET in the Rose Garden — a great chance to urge Congress along for a fresh week. The next choice up may a familiar one (blame preexisting conditions): Is bipartisanship even a goal anymore? “Behind-the-scenes attempts to get a deal with Republicans on nonprofit co-ops as an alternative to a public plan have led only to frustration, complains a key Democrat. He and his colleagues may have to go it alone, said Sen. Chuck Schumer,” the AP’s Ricardo Alonso-Zaldivar reports.  “I don't think I could say with a straight face that this [co-op proposal] is at all close to a nationwide public option,” Schumer, D-N.Y., told the AP. “Right now, this co-op idea doesn't come close to satisfying anyone who wants a public plan.” Over to Sen. Max Baucus, D-Mont.: “I think it’s very important to get a good, bipartisan bill.”  “I think there's a lot of concern in the Democratic caucus,” said Sen. Dianne Feinstein, D-Calif. 
“Senate Democrats say President Obama doesn't have the votes yet to pass health-care reform,” Ken Bazinet writes for the New York Daily News. “Disagreements over how big a role the government should play, staggering cost estimates and concerns that states could get shortchanged on existing programs have some senators urging a go-slower approach.” 
Then there’s Republicans — if anything, more united than they were a week ago: “The CBO estimates were a death blow to a government run health care plan,” Sen. Lindsey Graham, R-S.C., told ABC’s George Stephanopoulos on “This Week” Sunday.  “A government plan, no matter what you call it, will increase costs, it will reduce choices, and essentially, it will not allow you to keep what you have,” said House Minority Whip Eric Cantor, R-Va., on “Good Morning America” Monday. Where’s the pressure headed next? “The question now is whether we will nonetheless fail to get that change, because a handful of Democratic senators are still determined to party like it’s 1993,” Paul Krugman writes in his New York Times column. “The real risk is that health care reform will be undermined by ‘centrist’ Democratic senators who either prevent the passage of a bill or insist on watering down key elements of reform. . . . This time, the alleged center must not hold.”  Time to sell? “Obama’s supporters are clamoring for him to campaign for health care like his own election was on the line,” Politico’s Carrie Budoff Brown reports. “In a way, they say, it is — because the fate of health care may well determine the course of his presidency, given how far out on the limb he is in calling for a bill this year.”  “President Barack Obama will take his case to the American people this week on a plan to overhaul the U.S. health-care system as Congress struggles to find a bipartisan way to approve his top domestic priority,” Bloomberg’s Kristin Jensen and Nicole Gaouette report. “Obama invited the ABC television network to broadcast from the White House on June 24 and will take health-care questions from the public in the East Room. Three House panels will hold hearings during the week, and Senate Finance Committee Chairman Max Baucus is rushing to finish draft legislation before Congress starts a weeklong recess on June 29.”  Time to own? “Now it’s their turn to actually run the country,” New York Times columnist Ross Douthat writes. “And just as Bush-era conservatives couldn’t really make tax cuts pay for themselves, Obama-era Democrats aren’t really going to be able to finance universal health care without substantial middle-class tax increases, or substantial spending cuts. They’re looking for both, and maybe they can pull it off.”  “The president needs to get more involved, both to save his Democrats from self-induced chaos and to rescue his signature initiative from becoming an unappealing combination of higher taxes and meager help for the uninsured — the Amazing Shrinking Healthcare Plan,” Doyle McManus writes in his Los Angeles Times column.  Getting out there: “He’s not bound by convention. It has been an article of faith that the president may be overexposed, that the bully pulpit needs to be selective, carefully utilized; too much use of the currency would debase it,” Bloomberg’s Al Hunt writes. “To this White House, there seems no such thing as too much coverage. In five months, the president has given 173 speeches, held almost two-dozen press conferences, including three formal prime-time sessions, and given more than 50 media interviews, according to calculations by CBS News correspondent Mark Knoller.”  A good sign for those who miss Ted Kennedy’s voice: The senator is on-camera in a new TV ad for his friend, Sen. Chris Dodd, D-Conn. “Quality health care as a fundamental right for all Americans has been the cause of my life, and Chris Dodd has been my closest ally in this fight,” Kennedy, D-Mass., says in the ad, per Politico’s Glenn Thrush.  Perhaps a bigger concern — the context: “Despite signs that the recession gripping the nation's economy may be easing, the unemployment rate is projected to continue rising for another year before topping out in double digits, a prospect that threatens to slow growth, increase poverty and further complicate the Obama administration's message of optimism about the economic outlook,” The Washington Post’s Michael A. Fletcher reports.  As for the big foreign challenge of the day, a shift: “The violent day in Iran, and the White House’s condemnation of the government's reaction, seemed to move America ever further from the hard-headed negotiations with a distasteful regime that Obama had promised on his campaign, and toward a focus on freedom and democracy more associated with Obama’s predecessor,” Politico’s Ben Smith writes. “Also on display: The tension between Obama's pragmatism and his sense for a historic moment.”  ABC’s Jake Tapper: “But President Obama continued to keep arm's length from the protestors themselves, concerned that too tight an embrace of their cause would hurt their credibility and potentially lead to even more bloodshed. The president made clear that his concern focused on the violence, not the legitimacy of the elections.”  Columnist E.J. Dionne Jr.: “Obama's initial caution served the interests of freedom by making clear that the revolt against Iran's flawed election is homegrown. As the struggle continues, we cannot pretend that we are indifferent to its outcome. It's not easy to walk the progressive path. But Obama has always said that he knows how to deal with complexity. This is his chance to prove it.”  The bigger picture, per the Washington Times’ Jon Ward: “The tumultuous aftermath of Iran's presidential election more than a week ago has complicated the president's plans to engage Tehran in a quest for a ‘grand bargain’ to stop the Islamic Republic's pursuit of a nuclear weapon.”  For his critics, getting there: “I appreciate what the president said yesterday. But he's been timid and passive more than I would like and I hope he will continue to speak truth to power,” Sen. Graham said on ABC’s “This Week.”  On the stimulus, mayoral angst: “President Obama is facing complaints from big-city mayors and county politicians that parts of the economic stimulus package are shortchanging their constituents,” the Los Angeles Times’ Peter Nicholas writes. “Vice President Joe Biden has been holding private conference calls on the stimulus with elected officials from around the country, some of whom have been telling him that metropolitan regions are losing out to rural areas in the competition for stimulus money.”  Watchdog angst: “Most of the $2.2 billion in economic stimulus money for Army Corps of Engineers construction projects will be spent in the home districts of members of Congress who oversee the corps' funding, a USA TODAY analysis found,” Matt Kelley writes. “Two-thirds of the money will be spent in states or districts represented by members of the House and Senate appropriations subcommittees that direct how the Corps of Engineers spends its money, the analysis found.”  From your annals of transparency: “Five months into his administration, Mr. Obama has signed two dozen bills, but he has almost never waited five days. On the recent credit card legislation, which included a controversial measure to allow guns in national parks, he waited just two,” Katharine Q. Seelye reports in The New York Times. “Now, in a tacit acknowledgment that the campaign pledge was easier to make than to fulfill, the White House is changing its terms. Instead of starting the five-day clock when Congress passes a bill, administration officials say they intend to start it earlier and post the bills sooner.”  And — why we won’t hear about participants in White House meetings about “clean coal”: “After Obama's much-publicized Jan. 21 "transparency" memo, administration lawyers crafted a key directive implementing the new policy that contained a major loophole,” Newsweek’s Michael Isikoff writes. “In a little-noticed passage, the Holder memo also said the new standard applies ‘if practicable’ for cases involving ‘pending litigation.’ “  Sen. John Ensign, R-Nev., returns to work in Washington Monday, with not-so-flattering headlines back home: “In a new Las Vegas Review-Journal poll of Nevada voters, 39 percent had a favorable view of Ensign, a drop of 14 percentage points from a month ago. The percentage who regarded Ensign unfavorably, 37 percent, was up 19 points from a month ago, when just 18 percent viewed him negatively.”  Senate Minority Leader Mitch McConnell, R-Ky., gets a Washington Post profile: “The senator from Kentucky is shifting his role from behind-the-scenes fixer to party leader,” Perry Bacon writes. “He has cast himself as a man willing to work with President Obama when they agree on issues, although Democrats say they don't much see evidence of his bipartisanship. And while other Republicans attack Obama on nearly every issue, McConnell has persuaded his Senate colleagues to pick targeted, potentially winnable fights against the Democrats, such as the party's current push to make sure health-care reform does not include a government-run insurance option.”  Rep. Barney Frank — investment maestro? “While other lawmakers have suffered declines in their personal investments because of the plummet in stock prices, the liberal Massachusetts Democrat has fared better by being conservative in his own finances, putting his $896,000 investment portfolio largely in state and local municipal bonds,” The Boston Globe’s Susan Milligan reports.  “It’s not just coincidence — it’s putting my money where my mouth is,” said Frank. “I made money while other people lost money.” JibJab’s latest effort featuring the president — per the Chicago Sun-Times’ Lynn Sweet. 
The Kicker: “The president told me he was going to bronze my propeller.” — Peter Orszag, President Obama’s budget director, on his prize if he staves off a collapse in investor confidence because of the nation’s debts.  “I may be Darth Vader to some groups, but to a lot of others I'm Luke Skywalker.” — Senate Minority Leader Mitch McConnell, R-Ky. 
Today on “Top Line,” ABCNews.com’s daily political Webcast: Ralph G. Neas of the National Coalition on Health Care, and Karen Tumulty of Time magazine. Noon ET. Follow The Note on Twitter: http://twitter.com/thenote For up-to-the-minute political updates check out The Note’s blog . . . all day every day:

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