Table Manners: Coalitions fracture, as insurers turn against health reform

By Gorman Gorman

Oct 12, 2009 8:28am

ABC News’ Rick Klein reports: How many Nobel Prizes would you trade for Sen. Olympia Snowe's vote?

President Obama is now at the point in his presidency where symbolic wins — or concocted wins — just don't matter. They may actually hurt, as a narrative emerges of a president who's better at receiving accolades that racking up achievements.

As he confronts a base that's growing anxious — on gay rights, on health care, on Afghanistan — plus a right that's growing confident in its ability to hold up his initiatives — it's time for some real victories. Tuesday's vote in the Senate Finance Committee should be one of those.

Which is what makes the start of yet another health care week distressing for the Obama White House: All that time around the table didn't make for perfect manners — or agreements that are anywhere near perfect.

Is this what he gets for trying?

"After months of collaboration on President Obama's attempt to overhaul the nation's health-care system, the insurance industry plans to strike out against the effort on Monday with a report warning that the typical family premium in 2019 could cost $4,000 more than projected," Ceci Connolly reports in The Washington Post.

"The critique, coming one day before a critical Senate committee vote on the legislation, sparked a sharp response from the Obama administration. It also signaled an end to the fragile detente between two central players in this year's health-care reform drama," Connolly writes. "Though open to dispute, the analysis is certain to raise questions about whether Obama can deliver on his twin promises of extending coverage to millions of uninsured Americans while also curbing skyrocketing health-care costs."

The White House strategy was to keep stakeholders working from the inside for as long as possible. But the flipside is that inviting folks in means they're free to criticize your furnishing choices.

 "Several major provisions in the current legislative proposal will cause health care costs to increase far faster and higher than they would under the current system," Karen Ignagni, the top industry lobbyist in Washington, wrote in a memo to insurance company CEOs, per the AP's Ricardo Alonso-Zaldivar.

Swinging back — the White House response, per ABC's Jake Tapper: "This is a self-serving report paid for by opponents of health reform, and was prepared by a firm that specializing in tax shelters."

This could get ugly: "There is a feeling among White House officials that they were misled" by Ignani, one such official tells Politico's Carrie Budoff Brown.

Undermining the case: "The proposals before Congress would probably not cut overall US health care spending significantly anytime soon, health policy specialists say," The Boston Globe's Lisa Wangsness reports. "The bills under construction, which will be the focus of congressional attention this week, include many incremental or slowly phased-in programs designed to eliminate waste and reward quality and efficiency. But they stop short of such bold cost-cutting moves as aggressively overhauling the way care is organized and doctors and hospitals are paid, or investing intensively in finding the best treatments for diseases and tying the results to reimbursements."

Surely not helping the case, either: "The Democratic National Committee has agreed to pull a TV ad featuring former Senate Majority Leader Bob Dole, R-Kan., following objections Dole conveyed to the White House that the ad twists his support for a bipartisan compromise for health care reform legislation into something else entirely," Jake Tapper reports. "The ad, which was set to launch Monday, features Dole and other Republican former officials advocating in general terms for health care reform."

"The ad doesn't reflect what I was trying to do," Dole told Tapper.

But there's a new voice for reform: Dr. Louis Sullivan, HHS secretary under President George H.W. Bush, tells Tapper he supports the Finance Committee bill.

"The election is over. It's now time to come together and govern. It's time for action," Sullivan said on "Good Morning America" Monday. "There are a number of things that I would not be enthusiastic about. But I am not enthusiastic about the failure to enact health care reform."

How do you like these odds? "The future of U.S. health-care legislation now depends on warring Democrats, number-crunching analysts and, possibly, one senator from Maine," Bloomberg's Kristin Jensen and Laura Litvan report. As for the stakeholders: "Insurers are upset that the finance panel scaled back penalties for not buying insurance. The hospitals, which agreed to contribute $155 billion in savings toward the effort, said not enough new people will be covered by the finance committee's version."

Think this could be fun? Rep. Alan Grayson, D-Fla., is holding a town-hall forum on health care Monday; all 200 seats were snapped up barely 24 hours after the event was announced, the Orlando Sentinel reports.

On Afghanistan — when you're not crazy about the advice from generals on the ground …

"Several Administration officials tell me that President Obama's national security team will generate new military and strategic options for Afghanistan beyond the recommendations already presented by General Stanley McChrystal," ABC's George Stephanopoulos reports.

Among the dangers of having the plans out there publicly: Sen. Dianne Feinstein, D-Calif., told Stephanopoulos on "This Week" that the president must approve McChrystal's recommendations for an additional 40,000 troops.

"I don't know how you put somebody in, who is as 'cracker jack' as General McChrystal who gives the president very solid recommendations and not take those recommendations if you are not going to pull out," said Feinstein, chair of the intelligence committee. "If you do not want to take the recommendations then you put your people in such jeopardy."

Does Sen. John McCain, R-Ariz., think the war can be won without those troops? "I do not," he said on CNN's "State of the Union."

Any wonder where Vice President Joe Biden comes down? "Al Qaeda is almost all in Pakistan, and Pakistan has nuclear weapons. And yet for every dollar we're spending in Pakistan, we're spending $30 in Afghanistan. Does that make strategic sense?" Biden said recently in the White House Situation Room, per Newsweek's Holly Bailey and Evan Thomas.

A warning to Hamid Karzai: "We often overlook the progress made in Afghanistan because of the serious challenges that still exist," Secretary of State Hillary Clinton tells the BBC. "But we are very clear that, if this election results in him being re-elected, there must be a new relationship between him and the people of Afghanistan, between his government and governments which are supporting the efforts in Afghanistan to stabilise and secure the country."

Is this a portrait that offers prospects? "Even as President Obama leads an intense debate over whether to send more troops to Afghanistan, administration officials say the United States is falling far short of his goals to fight the country's endemic corruption, create a functioning government and legal system and train a police force currently riddled with incompetence," The New York Times' Elisabeth Bummiler and Mark Landler report. "Nearly seven months after Mr. Obama announced a stepped-up civilian effort to bolster his deployment of 17,000 additional American troops, many civil institutions are deteriorating as much as the country's security."

On gay rights — another speech with not much new in it from the president over the weekend.

In its aftermath: "Tens of thousands of gay-rights activists marched Sunday in Washington to show President Obama and Congress that they are impatient with what they consider piecemeal progress and are ready to fight at the federal level for across-the-board equality, including for the right to marry and the right to serve in the military," The Washington Post's Nelson Hernandez and Yamiche Alcindor write. "Attendees expressed complicated feelings about Obama. Nearly every person interviewed said he or she had voted for him, but many people said they were disappointed by what they see as a lack of action on key gay-rights issues, such as letting gays serve openly in the military."

This won't relieve much pressure: "Congress could be receptive to President Barack Obama's pledge to end a 16-year-old policy banning gay people from serving openly in the military, a top Democratic lawmaker said. The Pentagon also signaled openness to a change," The Wall Street Journal's Elizabeth Williamson and Neil King Jr. write.

Pressure growing on House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid?

The Washington Post's Jonathan Capehart: "They've done a good job of letting Obama take all the heat from the gay community for inaction in Washington. But if the shameful ban on gays serving openly in the military is to end, if gay and lesbian couples are to share in the rights and responsibilities of marriage that would come with the demise of the Defense of Marriage Act, Congress must overturn them, sending bills to Obama."

"We are tired of the compromises and delays," Cleve Jones, organizer of Sunday's march, told ABC's Devin Dwyer. "The trouble with a long list of demands like we have is the tendency that [Congress] will ask for priorities. But there are no fractions of equality. We are equal in every respect and true equality can only come from the federal government."
Bristling over the pace — and at the leadership of the Human Rights Campaign:

"Essentially, [Joe] Solmonese is asking for patience and silence until the last day of Barack Obama's second term for any sort of movement on gay equality," Andrew Sullivan blogs at The Daily Dish. "If you do not really believe in your own equality, why should anyone else? I know it's difficult and I know the president has a lot on his plate. But you know who really have a lot on their plate? The servicemembers out there risking their lives for our security, enduring sacrifices Joe Solmonese cannot even imagine, serving their country day in day out – only to be treated as pariahs, and fired for the sole crime of being gay."

On climate change — can a new name un-stick a Senate bill?

"We are also convinced that we have found both a framework for climate legislation to pass Congress and the blueprint for a clean-energy future that will revitalize our economy, protect current jobs and create new ones, safeguard our national security and reduce pollution," Sen. John Kerry, D-Mass., and Sen. Lindsey Graham, R-S.C., wrote in a Sunday New York Times op-ed.

Monday is Columbus Day — no White House or Hill events of note — but diplomacy gets no such breaks.

The latest from Secretary Clinton's trip: "U.S. Secretary of State Hillary Clinton urged Northern Ireland on Monday to push forward with the final steps in its peace process, lending diplomatic muscle to a cause long supported by Washington and her own family," Reuters' Jeff Mason and Anne Cadwallader report.

The get-tough election? "Republicans are stepping up attacks on House Speaker Nancy Pelosi, deciding that a major part of their 2010 electoral strategy will be linking Democratic candidates to her," Naftali Bendavid reports in The Wall Street Journal. "Now, with Democrats holding huge congressional majorities and with Barack Obama in the White House, Democrats are more easily tied to just about anything coming out of Washington. Thus Republicans are betting that voters now associate the House speaker with policies that make them uncomfortable, like generous government spending and a cap-and-trade system for fighting global warming."

Pressure on Pelosi, over House Ways and Means Chairman Charlie Rangel, D-N.Y.: "He should step down from his chairmanship of the Ways and Means Committee if they want to improve their chances for 2010. Otherwise, they might see their approval rating come down to single digits," Arianna Huffington said on the "This Week" roundtable.

Both sides can play nasty: "New Jersey Republicans complain that Gov. Jon Corzine, a Democrat, has turned nasty to gain ground in his re-election bid this year. Republicans elsewhere should brace themselves," John Harwood writes in The New York Times. "That is because Mr. Corzine's strategy for a comeback victory has turned into a template for Democratic candidates to survive in the 201 0 midterm elections. Its shorthand description: winning ugly."

A break for Corzine? "The Star-Ledger today endorses independent candidate Chris Daggett and recommends his election as the next governor of New Jersey," reads the Sunday editorial. "The newspaper's decision is less a rejection of Gov. Jon Corzine and Republican Chris Christie than a repudiation of the parties they represent, both of which have forfeited any claim to the trust and confidence of the people of New Jersey. They share responsibility for the state's current plight."

A break against Reid? "Nevadans say they're ready to replace longtime Democratic incumbent Sen. Harry Reid with an untested Republican. Which Republican? Undecided," Benjamin Spillman reports in the Las Vegas Review-Journal. "In the latest poll, 38 percent of voters viewed Reid favorably compared to 50 percent with an unfavorable view."

Don't miss Al Hunt's "behind-the-scenes power players": Sen. Jack Reed, D-R.I., Rep. Kevin McCarthy, R-Calif., and White House economic adviser Michael Froman. "If Larry Summers moves on from his post as director of the National Economic Council, Froman, who reconnected with his old law school classmate when Obama ran for the Senate in 2004, would be a leading candidate to replace him," Hunt writes in his Bloomberg News column.

The Kicker:

"Good answer!" — Biden communications director Jay Carney, when his boss declined to describe a moment where he had influenced the president's thinking, per Newsweek.

"She was very kind and I didn't have any deep or interesting conversations with her." — John Keatley, the photographer hired to take the cover photo for Sarah Palin's book, to Politico.

For up-to-the-minute political updates check out The Note's blog . . . all day every day:

http://blogs.abcnews.com/thenote/

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