The Note: Choice & Consequences — Liberals Threaten to Bolt on Health Care Reform

By RICK KLEIN This one he can’t solve over beers. Somebody’s going to be unhappy at the end. There will be winners and there will be losers. (Though that doesn’t make it a fair fight.) The middle — or what passes for it in Congress — is in control of the agenda, at least for now. One health care path is too far left to have a realistic shot at passing; the other, too far right. How this gets hashed out will be the defining battle of health care reform 2009. And the defining question for both sides: Is something better than nothing — even if it’s something they really, really don’t like? Among the very many obstacles to getting something substantive done: The two sides have different answers to that question. And at least on one of those sides — over on President Obama’s left — there’s disagreement on whether a half-measure beats no measure at all. That’s the president’s leadership challenge as he hits the road with two public events on health care Wednesday. (And when might he have something new to say?) As for his wishes — look out on the left. Time’s Karen Tumulty asks the president whether a co-op could be the “public option” he’s been looking for:  “Well, I think in theory you can imagine a co-operative meeting that definition,” Obama said. “Obviously sort of the legal structure of it is less important than practically how can it operate. There are concerns that in the past, attempts at setting up co-ops have not been successful because they just haven't been able to get off the ground; sort of the start-up energy involved may not exist if you're doing a state-by-state co-op effort as opposed to a broad national plan.” As for guidance to Congress: “The truth is we've actually, I think, provided more guidance than has been advertised,” the president said.  (Quick counter-point: “I did a lot of reading on the history of co-ops,” said Sen. Jay Rockefeller, D-W.Va., per ABC’s Z. Byron Wolf. “And it is not nice reading.”)  Choices, choices: “Congress, it's now clear, is crafting two quite different kinds of health-care reform. And the day that President Obama has to choose between them grows near,” Harold Meyerson writes in his Washington Post column. “Obama should thank the solonic six [in the Finance Committee] for their work, and, as much as is politically practicable, ignore it.”  “Bipartisan Senate negotiators are weakening some of his top priorities, leaving the president with a difficult choice: He can give ground, and implore disappointed liberals to go along with him. Or he can try to ram through a Democratic bill with his wishes intact, infuriating Republicans,” the AP’s Chuck Babington writes.  As for what the public wants: The president has a 53 percent approval rate in a new NPR poll, with 42 percent disapproving — “the narrowest gap of the Obama presidency to date,” NPR’s Ron Elving reports. “When asked about the plan now moving through Congress, a plurality of 47 percent was opposed and 42 percent said they were in favor, based on what they had heard about the plan so far.”  Nate Silver says the president needs a speech, as in “A Speech,” not a road show: “There is definite risk of overexposure. The President is not as popular now as he was a few months ago, and he's being associated with a still-unformed health care ‘bill’ that definitely isn't all that popular and in fact may be dragging his numbers down,” Silver writes at FiveThirtyEight.  Where’s the clamor, again? From Gallup: “Forty-four percent of Americans believe a new healthcare reform law would improve medical care in the U.S., contrasted with 26% who say it would improve their personal medical care. Forty-seven percent of Americans believe reform will expand access to healthcare in the U.S., while 21% say it will expand their own access to healthcare. . . . These results do not coalesce into a terribly optimistic picture of Americans' views of the perceived impact of healthcare reform.”  Getting crowded: “When wavering is what the U.S. economy seems to do best these days, the President confronts a new question: Does his own agenda threaten to choke off the economic recovery that he also promises — and that will define much of his legacy?” Nina Easton writes for Fortune. “Both of his legislative campaigns for the fall, health-care reform and the cap-and-trade plan to curb carbon emissions, could put new burdens on a weak economy.”  The administration’s favorite headline of the day: “Senators Close on Health Accord.”  “Assuming the fragile committee coalition holds, the legislation it produces would scramble the reform landscape by introducing policy ideas that have their origins in the political center,” Shailagh Murray and Paul Kane write in The Washington Post. “The bill is bound to disappoint liberals. But with prominent GOP backing, it also could prove more difficult for Republicans to reject out of hand — the approach they have taken to the House bill and a second Senate version, written by the health committee.”  Senate Majority Leader Harry Reid, D-Nev.: “There are times when I have to set aside my personal preferences for the good of the Senate and I think the country.” Anyone else have the good of the country in mind? “Because we want three Republicans to come along on this, we betray what the American people want?” Sen. Sherrod Brown, D-Ohio, tells the AP. “I don't think so.”  “Some Democrats are threatening to oppose any bill that excludes this [public] option, and sympathetic outside groups are pressuring wavering lawmakers,” Laura Meckler and Naftali Bendavid report in The Wall Street Journal. “Health Care for America Now, a liberal group, and the American Federation of State, County and Municipal Employees spent $800,000 on television ads targeting moderate Democrats, citing their opposition to a public option.”  They continue: “The liberal anxiety also is fueled by the White House, which has sent mixed messages. Asked Tuesday about the likelihood that the Senate Finance Committee bill will lack a vigorous public plan, White House press secretary Robert Gibbs declined to pass judgment.” Other types of movement: “Fearing a budding Finance Committee health care compromise will leave their priorities in the dust, many Senate Democrats are now looking to the next legislative steps to ensure their coveted policy reforms survive,” Roll Call’s David M. Drucker reports.  “There comes a point where some of us will say getting a bill out at any cost is not a panacea if it's a bad bill,” Rep. Eliot Engel, D-N.Y., tells McClatchy’s David Lightman and William Douglas.  Get ready for the liberal drumbeat: “There's no inherent value to passing a health care bill, per se. If it doesn't contain the elements that make it worthwhile, progressives shouldn't let it out of Congress, and Obama should make clear that a Blue Dog bill would be vetoed. A bad bill would be worse than no bill,” Scott Lemieux writes in The American Prospect.  A deadline that does matter: “Democratic leaders are clinging to hope of progress on health care reform before Congress breaks for its August recess, but marathon negotiating sessions in the House yielded no breakthroughs Tuesday, and the list of open issues grew longer rather than shorter,” Carrie Budoff Brown and Patrick O’Connor report for Politico. “For Pelosi, Ross and Waxman, the over-used ‘we're making progress’ claim now seems to suggest they are making anything but.”
  We’re suckers for new analogies: “You can think of Congress’s efforts to pay for health reform as being a little bit like a battle to slay a many-headed Hydra,” David Leonhardt writes in The New York Times. “Members of Congress have come up with one idea after another to pay for covering the uninsured. But they still haven’t put together legislation that could pass. And that’s in large part because most of those ideas have a basic flaw. They do not raise revenue as quickly as health costs rise.”  Another shot at bipartisanship? The Washington Post’s Ruth Marcus reminds us that there’s always Wyden-Bennett and Daschle-Dole-Baker: “Tom Daschle showed that the front door is open. Bob Dole and Howard Baker showed that they could walk through it. Won't President Obama take another look — and join them?”  
(Sen. Ron Wyden, D-Ore., will be on ABCNews.com’s “Top Line” Wednesday — live streaming at noon ET at ABCNews.com.) The president hits two town halls in two different media markets Wednesday — yet, it appears, without much new to say. First up is a high school in Raleigh, N.C., at 11:55 am ET; then comes a late afternoon event at a Kroger supermarket in Bristol, Va.
Air cover from the DNC: The “Broke It” campaign launches Thursday, taking on key GOP leaders over the economy. “They supported the Bush policies that sank our economy into recession,” the script of the TV ad reads. “They broke it — now they refuse to fix it.” The campaign also includes a radio component, plus local press calls targeting GOP leadership: Rep. Mike Pence, House Minority Leader John Boehner, House Minority Whip Eric Cantor, Senate Minority Leader Mitch McConnell, and Senate Minority Whip Jon Kyl. “The goal is to not only detail the benefits the stimulus opponents are seeing in their individual states, but to also lay the blame of the still-sputtering economy on the policies of the Bush administration,” Politico’s Jonathan Martin reports.  (And just a reminder that the AARP isn’t the only group that knows how to hold a tele-town hall. Senate Republicans have been hosting them on the health care issue since June 6 — with more on tap before the August recess. Organized by Sen. Lamar Alexander, R-Tenn., GOP aides say they have drawn more than a million callers so far.) Feeling confident (remember how Harry Reid felt when Social Security was going nowhere fast, in 2005?): “House Republicans, and a handful of Democrats, are on the verge of a historic victory for American taxpayers and for the American health care economy,” Pence, the chairman of the House Republican Conference, told reporters Tuesday, per ABC’s Dean Norland.  Look for the Republican Study Committee (though not the House leadership bill) proposal Thursday: “What it’ll do is make it so that it’s financially feasible [to obtain health coverage], attractive — and foolish for anybody not to be insured through the tax code,” RSC Chairman Tom Price, R-Ga., said on ABCNews.com’s “Top Line.”  Tightening belts (and buying belts at Marshall’s?): “With the budget deficit soaring toward $2 trillion, the Department of Justice has figured out how to play its part: double-sided photocopying,” Jonathan Weisman reports in The Wall Street Journal. “To cut costs, the Forest Service will stop painting vehicles green. There are other acts of national sacrifice. The Forest Service will no longer repaint its new, white vehicles green immediately upon purchase. The Army will start packing more soldiers onto R&R flights. The Navy will delete unused email accounts.”  “Some of these cuts are so small they would be a rounding error of a rounding error in the federal budget,” said Brian Riedl, a federal budget expert at the Heritage Foundation. Challenges ahead: Attorney General Eric Holder sits down exclusively with ABC News’ Senior Justice Correspondent Pierre Thomas Wednesday in Washington for a discussion on closing the detention camp at Guantánamo Bay, and whether the Justice Department will move forward with a criminal investigation into the Bush administration’s interrogation practices. Look for the interview on “Nightline” Wednesday night, with excerpts earlier on “World News with Charles Gibson,” and more on Thursday’s “Good Morning America.” Gitmo: “The fate of one of the youngest detainees at the Guantánamo Bay prison is emerging as a major test of whether the courts or the president has the final authority over when prisoners there are released,” William Glaberson writes in The New York Times. “After a federal judge said earlier this month that the government’s case for holding the detainee, Mohammed Jawad, was ‘riddled with holes,’ the Obama administration conceded defeat and agreed that Mr. Jawad would no longer be considered a military detainee. But the administration said it would still hold him at the prison in Cuba for possible prosecution in the United States.”  AP bulletin out of Dublin: “Irish justice minister: Ireland is accepting 2 released prisoners from Guantanamo Bay.” Also Wednesday: “Homeland Security Secretary Janet Napolitano is expected to outline Wednesday the Obama administration's domestic approach to preventing terrorist attacks — a strategy that will rely in large measure on refining and expanding initiatives launched under President George W. Bush,” The Wall Street Journal’s Cam Simpson reports.  The RNC’s biennial meeting starts Wednesday in San Diego, and it’s calendar time: “Members of a select RNC panel aimed at reforming the primary process will hold their first meeting during the four-day-long meeting in San Diego. And members of the full committee will be allowed to testify on behalf of their preferred remedies,” Reid Wilson writes for The Hill.  And: “Minnesota Gov. Tim Pawlenty (R), a potential 2012 contender whose profile has grown in recent weeks, will address the body in a keynote speech on Thursday.” On your schedule Wednesday: ex-presidential contenders on energy. Sen. Lamar Alexander, R-Tenn., touts nuclear energy at a noon ET speech at the American Enterprise Institute.
 
Sen. John F. Kerry, D-Mass., is at the National Press Club at 1 pm ET touting a proposed US/Chinese partnership on climate change prior to December’s Copenhagen talks. What we didn’t get this week: “Relations between the United States and China are getting cozier as their battle against the global recession has drawn them closer together. But things aren't quite so warm when it comes to some hot-button topics, particularly climate change,” the Los Angeles Times’ Jim Puzzanghera and David Pierson write. “U.S. and Chinese officials ended two days of high-level talks in Washington on Tuesday still at loggerheads on the issue, a top priority for President Obama.”  
 
What the Chinese did get, at least: “China’s most tangible take away from the meetings may be the signed basketball they received from President Obama, which one Chinese official raised above his head during the policy-makers’ closing remarks,” ABC’s Kirit Radia and Matthew Jaffe report.  A presidency with too many, well, goals? “From soccer to the Olympics to even the college football championship system, Obama certainly has been outspoken on sports issues. But is the president risking overexposure by weighing in on so much outside the political arena?” ABC’s Karen Travers writes.  Gates-gate fallout: “The right-wing attempt to exploit the president's comment in order to rally a race-based opposition is not only ugly, but dangerous. If it were ever to succeed, the country would pay a terrible price in the form of renewed antagonisms and suspicions for a generation or more,” Bob Shrum writes for The Week.  Sarah Palin: the new Hillary Clinton? “The Alaskan who shot to stardom a year ago as the tough embodiment of Diana the Huntress has now stepped down as governor and morphed into what the Republicans always caricatured Hillary as — preachy, screechy and angry,” Maureen Dowd writes in her New York Times column.  Said GOP strategist Mike Murphy: “If Sarah Palin looked like Golda Meir, would we even be talking about her today?” Health scare in the Capitol: Per ABC’s Z. Byron Wolf, “5 high school students who work in the Senate as pages have flu-like symptoms that the attending physician believes are ‘most likely’ influenza and ‘quite possibly’ the swine flu.”  Card-check wars: Running Wednesday in Virginia newspapers, a message for Senators Jim Webb, D-Va., and Mark Warner, D-Va.: “Bin-ding Ar-bi-tra-tion. ‘bīn-dĭng ‘är-bə-’trā-shən -n: A mandate from the federal government to business owners whereby a bureaucrat decides the terms of a non-negotiable two-year ‘employment’ contract. That contract is then forced by law onto private businesses and their employees if the owner and labor union cannot agree on terms of a contract.”  Another endorsement for Mayor Michael Bloomberg, I-N.Y.: “I think he is a great candidate. I think what he has done for education, what he has done to manage the economic problems New York is having, what he has done for safety, what he has done for tourism, he is an independent guy who is always trying to solve problems,” Colin Powell told CNN’s Larry King. “And he is working for the whole city. So I think Mike Bloomberg should be given a third term. And yes, I would say, reelect Mike Bloomberg.”
The Kicker: “This is about having a beer.” — White House Press Secretary Robert Gibbs, trying not to impart too much meaning onto Thursday’s scheduled summit between the professor and the police officer.  “No by proxy.” — Sen. Jeff Sessions, R-Ala., casting votes for three Republican colleagues on the Senate Judiciary Committee on Judge Sonia Sotomayor’s Supreme Court nomination. 
Today on the “Top Line” political Webcast, live at noon ET: Sen. Ron Wyden, D-Ore.; Ana Marie Cox of Air America. 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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