WASHINGTON – President Barack Obama and his congressional allies are entering the next phase of their push to overhaul health care with lower expectations of what can be accomplished – but with far greater certainty that significant legislation will be enacted by the end of the year.
After a long summer of raucous protests, discouraging poll numbers and unplanned tactical shifts, administration officials and Democratic leaders now are focusing on their two greatest challenges: scaling back the overall cost and developing alternatives to the government-run insurance option that liberals have championed.
Difficult as those tasks may be, the political stakes are so high that analysts and lawmakers on both sides say it is almost unthinkable that Congress would emerge from the battle empty-handed. And Obama’s decision to address Congress and the nation Wednesday night has only increased the pressure.
“August, no question, was a tough month for Democrats,” said Sen. Bob Menendez, D-N.J. “But the president is putting a lot of political capital here. We will expend whatever the necessary capital is to make (health care) happen. In my view, you don’t let the perfect be the end of the good.”
Obama has been making calls to Democratic lawmakers to lay the groundwork for his speech and prepare the party for what could be a rough road ahead. Some of his top aides Sunday continued to signal that Democratic liberals might have to accept a bill that does not include the robust public insurance option they sorely want.
David Axelrod, Obama’s chief strategist, said Sunday on NBC’s “Meet the Press” that Obama “believes the public option is a good tool” for ensuring the availability of affordable insurance. But Axelrod added, “It shouldn’t define the whole health care debate, however.”
Paradoxically, the tumult of the summer might make it easier for the president and Democratic leaders to proceed with a newly sharpened focus. After months of talking about seeking bipartisan support and wooing Republicans, Obama essentially has acknowledged that the GOP has united in opposition. Now he can concentrate on the daunting but more manageable task of crafting a legislative formula to unite his party’s moderate and liberal wings.
In his address to the joint session of Congress, Obama is expected to give a more detailed account of what he wants in the legislation – going beyond the principles of expanded access and improved choice that he has emphasized so far.
“Rest assured, there won’t be a lot of questions when it’s all said and done,” said Dan Pfeiffer, Obama’s deputy communications director. “We’re at the moment now for the president to take a more hands-on (approach), to step up his leadership role both publicly and with the Congress.”
That’s welcome news for Democrats, who need Obama to take the lead on any significant compromises.
“This is the moment where the president needs to be absolutely clear and needs to take the initiative,” said Rep. Chris Van Hollen, D-Md. “Part of his message has been and will continue to be that, while every member has things they think are most important, the object has to be getting a health care bill passed.”
With compromises all but certain, the final bill will not remake the U.S. health care system in one stroke. But major changes are likely, including a significant expansion of insurance coverage.
On Tuesday, Democratic leaders will be meeting with the rank-and-file behind closed doors to decide on strategy. A bipartisan group of six Senate Finance Committee members who have been seeking a compromise will hold another meeting in advance of their self-imposed Sept. 15 deadline.
Obama’s speech Wednesday – a politically risky use of his bully pulpit – probably will dictate the timetable and trajectory of legislative action on Capitol Hill, where House Democratic leaders are hoping to bring the legislation to the floor in a month and the Senate awaits action by the powerful Finance Committee.
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