President Barack Obama tried to regain the offensive Wednesday night with an aggressive pushback against opponents of health care reform – yet he stopped short of a mandatory prescription for a government-run insurance option.
The tightrope walk on the signature issue of his presidency had two goals – soothing the divided Democrats gathered to hear him in the House chamber, while offering clarity to an American public that is skeptical and confused about what health care reform means for them. With Republicans unlikely to embrace any Democratic plan, Obama also offered his harshest criticism to date of the opposition, whom he described as consisting of “unyielding ideological camps that offer no hope of compromise.”
“I will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it,” Obama said. “I will not stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what’s in the plan, we will call you out. And I will not accept the status quo as a solution. Not this time.”
Of the charge that Obama’s plan would set up so-called “death panels” that would ration care to seniors, the president was blunt. “It is a lie,” he said, “plain and simple.” In the charged partisan atmosphere of the House floor, one Republican, Rep. Joe Wilson of South Carolina, yelled “it’s a lie” when Obama said illegal immigrants would not receive insurance benefits.
The great expectation Wednesday night was that Obama would be specific yet simple in his health care address. But while he offered ideas like creation of an insurance exchange for the uninsured and mandated coverage for pre-existing conditions - and even offered some outreach to Republicans by proposing some malpractice reforms - most of Obama’s proposals were not new and have already been chewed over in public for months.
The price tag for his proposal is $900 billion over ten years, which Obama says will be paid for with “savings within the existing health care system.”
Obama endorsed the idea of a public option that kicks in by 2013, but he also created wiggle room for Democratic leaders in Congress to negotiate – as he stopped short of threatening to veto any bill that does not have a public plan. He also said he was open to “triggers” for the public option and even non-profit insurance cooperatives for the uninsured.
And he called for both an individual mandate to carry health insurance as well as a requirement for businesses – with small businesses exempted – to offer health insurance.
While his policy ideas were not necessarily new, a more important message was delivered – Obama is now willing compromise his way toward getting just the right number of votes to pass health reform, even at the cost of losing votes from some of the more ideological Democrats in Congress.
In fact, Obama sounded more than open to compromising on the public option, and sought to downplay its importance, pointing to a Congressional Budget Office study that showed only 5 percent of Americans would enroll in government insurance.
“It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles,” Obama said. “To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end – and we should remain open to other ideas that accomplish our ultimate goal.”
Republicans remained unmoved and unimpressed by the prime time address, and called for a slower, incremental pace for health reform.
“We should listen to the American people and start over,” said Sen. Lamar Alexander (R-Tenn.) “Stop trying to pass thousand-page bills and start—step-by-step—to re-earn the trust of the American people. Focus on cost and the five or six steps we can take together to begin reforming health care”
And House Republican Whip Eric Cantor said the President “failed to say anything different or offer clear specifics, and with that in mind the reason for this overhyped speech is strangely unclear. The President has now delivered over 100 speeches where he’s discussed health care and said the same thing.”
So, Obama now faces three key tasks in wake of his speech: getting one or two Senate Republicans on board to top 60 in the Senate; convince increasingly agitated liberals that they’re not getting rolled and lure over just enough moderate Democrats needed to push health reform over the finish line.
Obama also has to hope that the American public turns the corner on his proposals – a poll released Wednesday showed a 52 percent disapproval rate of the president’s handling of health care.
To that end, he reached out to those who have insurance and fear change.
“First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have,” Obama said. “Let me repeat this: nothing in our plan requires you to change what you have.”
While Obama tried to use his national address to sooth a nation uncertain about the future of American health care, the outlook in the hallways and hearing rooms of Congress was anything but clear during the buildup to his speech.
The lead Senate negotiator, Max Baucus, is on the verge of ditching two Republican colleagues who have refused to sign on to any of his comprehensive proposals. Baucus has set a committee markup for next week, showing he’s ready to move ahead without Republican support.
Moderate House Blue Dogs showed no signs of coalescing behind the president to back a public option – with lawmakers like Mike Ross of Arkansas doing an about face and saying he outright opposes any public option. And liberals have refused to take the go along, get along route on health care and are increasingly vocal about voting against any bill that does not have a public option.
A senior administration official said Obama thinks the public option has taken on far too much weight in the scheme of things.
“This thing can take on outsized importance, and it has to folks there are those on the left and the right who have made this the whole of health insurance reform and the president simply rejects that idea,” the official said. “It would be a tragic thing if we let that kind of brittleness to stand in the way of doing something truly historic for the American people.”
One House Democrat, Anthony Weiner, believed liberals who were skeptical about Obama’s dedication to a public option, was won over.
“The President made a great argument for a public option. I'm glad he did,” Weiner said. “ Without a muscular public option the plan will not reduce costs.”