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As Deadline Nears, Obama Steps Up Health Care Push

July 22, 2009 at 6:00 PM EST
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With the days ticking down until President Obama's target date for a deal on health care reform, the White House is pushing to convince the public and Congress that swift action is necessary.
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JIM LEHRER: President Obama goes national tonight in search of action on health care reform. He plans a White House news conference, as House and Senate leaders continue laboring to craft bills and to win votes.

NewsHour health correspondent Betty Ann Bowser has our lead story report.

BETTY ANN BOWSER: House Speaker Nancy Pelosi emphasized the positive today, despite obstacles that have slowed health care reform’s momentum.

REP. NANCY PELOSI, D-Calif., Speaker of the House: We’ve made great progress.

BETTY ANN BOWSER: She appeared at a news conference today, flanked by Americans who recounted their health care woes.

MOLLY SECOURS: I bought the insurance with a major carrier, and still it wasn’t enough to prevent me from nearly losing my home.

BETTY ANN BOWSER: Pelosi said she expects the House to pass a Democratic reform bill before the August recess.

REP. NANCY PELOSI: I have no question that we have the votes on the floor of the House to pass this legislation. It is the legislative process; I keep saying that over and over again. I’m feeling pretty positive about it.

BETTY ANN BOWSER: Other House leaders have questioned whether a vote that soon is feasible. And there’s little chance of Senate action by then.

The president is set to make his case tonight in a primetime news conference. Not only is he trying to blunt Republican attacks against the Democratic plan, he’s also trying to quiet dissent within his own party over the cost.

Fiscally conservative House Democrats — the so-called Blue Dogs — have threatened to withhold support in the Energy and Commerce Committee. They’re demanding major changes to rein in health care costs and scale back the bill’s price tag.

Today, Blue Dog leader Mike Ross of Arkansas issued a statement, saying, “We are making progress; however, we have a long way to go.”

And House Minority Leader John Boehner warned Americans against believing what President Obama says tonight.

REP. JOHN BOEHNER, R-Ohio, House minority leader: Tonight, we’ll hear the president likely say some — repeat some of the myths that he’s been repeating over the last several months. He’ll say that the Democrat plan will reduce health care costs in America, but it’s pretty clear that the director of the Congressional Budget Office says the health care curve not only will not decrease, that the health care curve will increase.

Some legislators want to start over

Amy Walter
The Hotline
What congressional Democrats are trying to do right now is try to take a lot of this stuff off the table right now and move it into the Senate, get those negotiations started. The problem right now is that you don't have all the Democrats on board.

BETTY ANN BOWSER: Boehner urged Mr. Obama to scrap the current plan and start over.

On the Senate side, Finance Committee Chairman Max Baucus continued talks in his office aimed at a bipartisan bill. He told reporters there was progress and that he had informed the president.

SEN. MAX BAUCUS, D-Mont.: He deeply appreciated the approach we're taking. I'm very encouraged. We have no choice but to keep going down this road where we just keep allowing senators to keep asking questions, because everybody there really wants a bill. Everybody there is committed.

BETTY ANN BOWSER: Baucus spoke after Republican Orrin Hatch of Utah announced he's dropping out of Finance Committee negotiations because he couldn't go along with some of the proposals on the table.

JIM LEHRER: Judy Woodruff takes it from there.

JUDY WOODRUFF: For more on the political state of play for health care reform and some perspective on President Obama's public relations push, we're joined by Amy Walter, editor-in-chief of the Hotline, National Journal's political daily.

And James Morone, professor of political science at Brown University and co-author of the book, "Heart of Power: Health and Politics in the Oval Office."

Thank you both for being with us.

Amy Walter, to you first. First, from a congressional standpoint, where does health care reform stand right now?

AMY WALTER, Editor-in-chief, The Hotline: Well, it seems like we're still standing in the same place that we were not that long ago, which is we have Democrats still fighting amongst themselves about what kind of plan they're going to put forward.

Certainly in the piece, as you saw, you have Nancy Pelosi, the speaker of the House, saying she has the votes. Conservatives say, "Not so fast." But we don't know that the vote's actually going to be decided or actually voted upon in the full House before they go away to recess.

What Republicans -- I'm sorry, what congressional Democrats are trying to do right now is try to take a lot of this stuff off the table right now and move it into the Senate, get those negotiations started. The problem right now is that you don't have all the Democrats on board.

What Speaker Pelosi knows, though, is she has a 40-seat cushion right now, so she can lose some of those Blue Dogs. She just can't lose 40 conservative Democrats.

Many presidents have tried reform

James Morone
Brown University
We've been doing this since 1935. Harry Truman ran on this in 1948, that great come-from-behind victory, and he encountered the exact same thing. We always have these enormous problems. And what's so striking is how similar the kinds of debates are.

JUDY WOODRUFF: Amy, was it always going to be this hard? Or has something happened that has made it even harder?

AMY WALTER: I think we always knew this was going to be hard. This is -- and Speaker Pelosi said, this is a legislative process. Of course it's going to look like this.

The problem is that it's now -- you have a president right now who wants to be able to sell a health care plan, but there's nothing definitive right now. It's very nebulous.

And so once -- as it sits out there and sits out there and sits out there without a real definition, it makes it easier then for Republicans to define it and define it simply, as you saw in the piece, as something that's unworkable, that's costing too much money, and that's not going to solve the health care crisis.

JUDY WOODRUFF: James Morone, for some perspective, this is not the first time a president has had a hard time getting health care done.

JAMES MORONE, Brown University: That's right, Judy. We've been doing this since 1935. Harry Truman ran on this in 1948, that great come-from-behind victory, and he encountered the exact same thing.

We always have these enormous problems. And what's so striking is how similar the kinds of debates are.

Just one quick example: In every scene in this movie, we've had the same idea of people coming in and saying, "Look, we just cannot afford this." So that's a very old story.

Lyndon Johnson, when he passed Medicare, we just found some newly released tapes of him complaining to newly elected Ted Kennedy of Massachusetts that those fools in the budget office went and projected the costs of Medicare six years down the line. "I'm losing votes." Bottom line: If we had had good cost projections for Medicare, we believe it would never have won.

JUDY WOODRUFF: You mean accurate cost projections?

JAMES MORONE: Accurate projections. Actually, accurate projections for the costs down the line. LBJ might have known, but he managed to hide them.

JUDY WOODRUFF: James Morone, why has it been so hard? Is it always the cost that just makes this as difficult as it is?

Avoiding past mistakes

Amy Walter
The Hotline
This doesn't take place in a vacuum, and this is not the same environment in which Clinton was trying to put his health care plan through. [One] issue here is that Barack Obama's already used a lot of his political capital on passing the stimulus.

JAMES MORONE: It's hard for a number of different reasons. For the profession itself, what we're doing is taking -- every year, we're spending a little bit more of our economy to health care. Anything that threatens to stop that is going to gore an awful lot of sacred cows.

Secondly, this is a major battle for control of the high ground in American politics, and everybody in Washington knows that. If Obama gets this through, Roosevelt fails, Truman failed, Carter, Clinton, they all failed. If Obama wins, he's on an extraordinary roll.

If he's defeated, this is a major defeat for him and a victory for the Republicans. Combine the sheer difficulty and the politics, and you've got a recipe for trouble.

JUDY WOODRUFF: Amy, the Obama people have said over and over again they have studied what the Clintons went through in the early '90s, that they were determined not to make the same mistakes again. What's happened with that?

AMY WALTER: Well, this doesn't take place in a vacuum, and this is not the same environment in which Clinton was trying to put his health care plan through.

You know, the first issue here is that Barack Obama's already used a lot of his political capital on passing the stimulus, on auto bailouts, on doing more for the banks, et cetera. So he's already spent a lot of that. And his line of credit with voters is running out a little bit. He still has very strong approval ratings; they're just not as strong as they once were.

He doesn't need to convince voters and Americans that health reform is important. He needs to convince them that, one, it's going to give them more positive results than negative results, which right now in the polling we've seen only 25 percent of the folks that we surveyed thought that it would have positive impact on their life -- health care reform would -- and that they need to know that -- it is, on top of all the other money that we've spent, it's going to have a benefit.

And I think there's been so much going out the door right now, the government spending so much money on so many things, that asking voters to accept more money going out for something that they don't quite understand yet is asking a lot.

JUDY WOODRUFF: James Morone, is there a lesson that President Obama could learn from these other presidents who also struggled with health care?

Speed is a key factor

James Morone
Brown University
Obama has learned an important lesson from history when he says, "Do it by August." As Amy just implied, every day, he loses a little bit of the luster.

JAMES MORONE: Yes, there are many lessons, and one goes directly to what Amy just said, and that's the lesson of speed. Lyndon Johnson gathered all of his advisers in a room after his huge 1964 landslide victory -- second largest in Democratic Party history -- and he said, "Look, every day I lose power. Every day I lose votes. You've got to get Medicare fast."

In that sense, Obama has learned an important lesson from history when he says, "Do it by August." As Amy just implied, every day, he loses a little bit of the luster. And six months from now, you know what "Nightline's" going to be covering: the midterm elections. That's going to make it almost impossible. One lesson: speed.

JUDY WOODRUFF: And, Amy, at the same time, the president, the speaker today, when she said -- she said, I think we do have the votes to get this done, but there was immediate pushback from the conservative Blue Dog Democrats, who said, Wait a minute. Where does she get that idea from?

AMY WALTER: Right, because she knows -- and it goes to the point about the midterm elections -- there are 49 Democrats right now that sit in districts that John McCain won. That's a very important number to remember. These folks know that they're on the line in 2010.

And if they take a very difficult vote right now and the Senate takes out all of those controversial provisions -- because right now the Senate is saying, what's going on in the House right now is not going to make it into a Senate bill, then they've put themselves out on the line, walked the plank, and they're not going to get any back-up from the Senate. The ultimate bill won't look like that. So why take a risk for something when we know the ultimate bill is going to look very different?

JUDY WOODRUFF: James Morone, from your perspective, is there something the president could say tonight? Is there a way that he could frame this that could be helpful to him? Or what should he avoid, I guess, is the other side of the coin?

JAMES MORONE: What he needs, what he has to find a way to get is a movement going. Look, this is very scary for Congress, as Amy just suggested, for a lot of congresspeople, particularly in swing districts.

If they don't get a whole lot of Tweets, a whole lot of e-mails, a whole lot of phone calls, this isn't going to go anywhere. So what Obama needs to do more than getting into the weeds or answering critics is generating excitement that translates into stuff in congressional in-boxes. Without that, it's never going to win.

JUDY WOODRUFF: And, quickly, Amy, for opponents, what do they need to do to keep this from going forward?

AMY WALTER: Well, I think they've been doing an effective job, which is saying, why are we spending more? What are we going to get for it? How is it going to benefit you, average American?

Tell me, if you cannot put a price tag on it, if you can't put a number on it, if you can't tell me in five seconds or less why this is good for the average American, then that is going to be very difficult to be able to sell.

JUDY WOODRUFF: Amy Walter, James Morone, thank you both.

JAMES MORONE: Thank you.

JIM LEHRER: The president's news conference is available tonight on our Web site at newshour.pbs.org.