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Axelrod: Health Care Reform Now a Reality

In a newsmaker interview, Judy Woodruff talks to senior White House adviser David Axelrod about the long political push to pass health care reform, the role of House Speaker Nancy Pelosi and what public opinion polls say about the overhaul.

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    Next — next, to our interview with the president's senior adviser, David Axelrod, on the vote, the battle to get it passed, and what's ahead.

    I spoke with him just a short time ago.

    David Axelrod, thank you for joining us.

    Reaction at the White House today, more jubilation or more relief?

  • DAVID AXELROD, Senior White House Adviser:

    Well, look, there's a great deal of joy here, because, after 13 long months, we have brought a greater measure of security to the American people, a brighter future to the country. We have dealt with a problem that's been bedeviling America for 100 years. And there's a great feeling of accomplishment.

    But we also understand the responsibility that comes with that to implement this program in an effective, efficient way, to be accountable for it. You know, we're already shifting our attention to how we make this work best for the American people.


    Well, a lot of people, until very recently, thought that this might not happen. How close did the president come to thinking that it might not happen?


    I have to tell you, it's been an extraordinary experience to watch him through these 13 months, because there were a thousand different moments when this could have skidded off the track. And there were many people who advised him to scale down his aspirations for this program, to — to do this in a piecemeal fashion, or to just turn away from the issue altogether.

    I remember, Judy, walking in to his office in the summer and saying, you know, this has great political cost. And he told me — he had just come back from Wisconsin, where he saw a woman who had ovarian cancer, two small children, and insurance, and was still going bankrupt, and was worried she was going to leave her family in — in a financial ruin.

    And he just patted me on the shoulder and he said: "So, you know, it's worth the fight. Let's keep going."

    And that's the kind of encouragement that he's given us throughout this process. And that's one of the great joys of working for Barack Obama.


    Well, speaking of that, in that period in late January, after Scott Brown won, the Republican — as a Republican in Massachusetts, the Senate race, the president had…




    There was some delay until we knew what the White House was going to do. There are a number of reports that House Speaker Nancy Pelosi was the one who said to the president, don't scale this back.

    Is that correct?


    Well, first of all, let me say I have just enormous, high — enormously high regard for Speaker Pelosi. I think she is a hero for the leadership she's provided here and on so many other issues.

    I must say, in the 13 months we have been working on this issue, I have never seen the president flag or consider any — anything but a comprehensive approach, because he knew, if we didn't do it comprehensively, then we couldn't ban discrimination against people with preexisting conditions. And there were several other things that we wouldn't have been able to achieve unless we dealt with it comprehensively.

    So, I have seen those reports, too. But, believe me, the president didn't need any encouragement to move forward. And — and it's his will and his determination that helped see us through some very difficult times.


    David Axelrod, a number of House members whom the president lobbied — and I'm thinking of Dennis Kucinich, among others — said that one of the arguments the president made to him was that what it would mean to his presidency if he lost this vote.

    How much was that a part of the argument the president was making, that this would undermine the presidency?


    Judy, I don't think it was so much about undermining the presidency. I think the president viewed this as a test of whether we, as a country, had the ability to deal with big challenges.

    And he felt that, if we weren't able to succeed yesterday, that it would send a terrible signal about our ability to handle other challenges that we face. And he's made that point again and again to people.

    There's no doubt that it also would have emboldened those who have taken the position that defeating the president at every turn is somehow a triumph for their party, the Republican Party. I think that's the wrong attitude.

    And, hopefully, we can move on now, and work together to solve other problems. But, in any case, we're going to move this country forward.


    Well, even — and, as you say, there is that discussion, because, even with the win, there's conversation that — that there's still been a cost to this presidency. You have got the Republicans bitterly separated from the White House over this issue.

    We have — we have seen the American people — opposition to the bill rise to a point where it's over 50 percent in a number of polls. So, how do you calculate the cost?


    Well, first of all, Judy, I wouldn't — the preponderance of polls show the country is about evenly split on this.

    And that makes sense, given the volume of propaganda and lobbying and interest group efforts that have been associated with it. But now it's a reality. And we're going to go ahead and implement it. And people will understand. Small businesses across this country when the president signs the bill will be eligible for tax credits of 35 percent for each employee for whom they provide health care.

    Kids with preexisting conditions this year will now be able to get coverage. Lifetime caps and annual caps on what insurance companies will pay out will go away. These are important provisions and advances and benefits that people will see.

    In terms of the tone in this town, we're just going to keep on working with whomever wants to work with us. I was disappointed this morning to see Senator McCain say the Republicans won't work with the president on anything for the rest of the year as punishment because they're unhappy about the passage of the health insurance bill.

    You know, that's more appropriate to a sandlot than to governance of this country. He's a great — he's a good man, Senator McCain. And he's shown independence in the past. So, I hate to hear that. And I hope that we can overcome that spirit and work together to solve other problems.


    As you know, a lot of criticism is flying around out there about this bill. On the one hand, you have the right arguing it's going to — it's a federal government takeover of health care; it's going to raise people's premiums.

    On the other hand on the — from the other side of the spectrum, people are arguing, it doesn't do enough; it doesn't take effect soon enough.

    Which of those criticisms concern you the most and you think it's most important to straighten out in people's minds?


    I must tell you, I'm not concerned about criticisms of either stripe, because the truth now will be known. What's going to happen is that significant improvements are going to be made almost immediately.

    The thing is, the program is going to be phased in over four years, but there are going to be immediate benefits to many Americans, to small businesses, to people with preexisting conditions and others that they can feel right away.

    So, they will know how far this bill goes. And the other thing is that — are the things that aren't going to happen. The Chicken Littles who predicted that life as we know it would end when this program passes, and that somehow this will have a catastrophic — catastrophic impact on people's health, none of that is going to happen.

    People who have health care they like are going to keep it. Hopefully, they will have a little more leverage vis-a-vis their insurance companies. So, I think these doomsday predictions are going to be proven false very quickly.

    And I think that's why there was such desperation and almost a frantic sense on the part of Republicans yesterday in the House, who used language that was completely out of sync with what the reality of this program is in order to attack it.


    Well, finally, most immediately, you have got to get it through the Senate this week. And then you have got talk by Republicans they're going to try to repeal it. And then you have got in the state these legal challenges, attorneys general saying they're going to try to make sure it doesn't take effect in their states.

    How concerned are you that it is going to stand up to all these challenges?


    Oh, I'm very — I'm very — I'm very confident.

    As to the — the repeal efforts, I invite any — anyone who wants to run for public office to go to small businesses and say, you know, that 35 percent tax cut for health care you just got, we want to take that away from you, who want to — who wants to look in the eyes of a child with a preexisting condition who now will get coverage and say, you know what, we don't think that was the right thing to do, or tell people whose lifetime caps are now coming off their insurance, so if they get sick, they won't go bankrupt, to say, you know, we're going to put the insurance companies back in the driver's seat.

    If people want to campaign on that, they're welcome to do it, and we will join that debate. As for the legal challenges, there isn't a major piece of legislation that's been passed in this country that hasn't endured legal challenges. We're very confident about the constitutionality of what we're doing here.

    And, in fact, the piece that's being challenged, the mandate, is an idea that many of the Republicans in Congress when they were talking to us about this bill thought was an absolutely essential ingredient for the plan.

    So, you know, there's the politics at play here. But, at the end of the day, we're going to move forward. This is going to give greater security to the American people and a better future for our country. And we're enthused about it.


    David Axelrod, senior adviser to President Obama, thank you very much.


    Thanks, Judy. Good to be with you.


    And you.