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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Obama’s Health Reform Strategy: How Effective?

Robert Pear and Sheryl Gay Stolberg provide a fairly balanced assessment of White House leadership on health reform in their Sunday New York Times overview, “Obama Strategy on Health Care Legislation Appears to Be Paying Off.”
As the authors report, the bills have advanced “further than many lawmakers expected” and “five separate measures have been pared down to two” — the farthest advance of major health reform legislation to date. They quote senior White House advisers saying the bills’ advancement “vindicated Mr. Obama’s strategy of leaving the details up to lawmakers.”
Stolberg and Pear describe the White House strategy as calibrated to encourage momentum above spending a lot of time trying to win on specific policy disagreements:

White House officials approached their work like a political campaign, and they said they had learned as much from the 2008 presidential race as from the health care fiasco of 1993-94. They said they learned the importance of pressing on and keeping up momentum, even when cable television commentators — and some fellow Democrats — declared their initiatives dead.
Congressional Democrats said it often seemed as if the top priority for the White House was simply to advance health care bills to the next step in the legislative process…Indeed, that is exactly what White House officials were trying to do. They described their legislative strategy as a very step-by-step process, in which they kept intensely focused on the next specific goal: passing a bill out of this or that committee, resolving the doubts of particular lawmakers, like the liberals who met with Mr. Obama on Thursday.

The article quotes White House Chief of Staff Rahm Emanuel describing the President’s strategy as giving “leeway to legislators to legislate,” but “not leeway to take a policy off track.” But he cautions against overconfidence, adding “you don’t see any shimmying in the end zone…No spiking the ball on the 20-yard line here.”
Pear and Stolberg touch on the critique of the President’s strategy:

The legislative progress has come at a price. In the absence of specific guidance from the White House, it has moved ahead in fits and starts. From here on, the challenges will only grow more difficult…In the Senate, where Democrats will need support from every member of their caucus to reach a critical 60-vote threshold to avoid a potential filibuster, Mr. Obama’s hands-off strategy carries particular risks. ..Without clear direction from the president on the public option, the Democratic leader, Senator Harry Reid of Nevada, moved ahead last week on his own, unveiling a bill that includes a government-run plan, but allows states to opt out.
Even close allies of the White House sometimes questioned its approach…“It felt like it was getting out of control at the end of July and in the beginning of August,” said John D. Podesta, a former chief of staff to President Bill Clinton who informally advises the Obama White House. “People were getting nervous that it was going every which way.” Mr. Podesta said the president risked “giving too much rope to a Congress that is liked a lot less than he is.”

The White House has received a lot of criticism for giving verbal support for the public option, but not fighting for it, Indeed the Administration made a point of saying the public option was not essential. It appears that Team Obama decided that joining in the public option debate more energetically might have endangered the reform package by prolonging debate and attracting more attacks from the right. Instead they will support the Democratic consensus that will be worked out between the House and Senate distillations. Keep it moving forward.
They may be right. If Democrats can keep losses in next year’s mid-term elections to a reasonable minimum, it is possible that economic recovery will kick in more vigorously, placing Obama and the Democrats in good position for ’12. With even modest gains in ’12, they can pass an amendment providing a stronger public option. OK, that’s three big “ifs,” but not an implausible scenario.
Polls indicate a solid majority of the American people want a public option of some kind. For example, an NBC News/Wall Street Journal Poll conducted by the polling organizations of Peter Hart (D) and Bill McInturff (R). Oct. 22-25, 2009, indicated that 72 percent agreed that it was “quite important” (27 percent) or “extremely important” (45 percent) to “give people a choice of both a public plan administered by the federal government and a private plan for their health insurance.”
But Obama and Reid can add, and they don’t yet have 60 votes to support a strong public option, although Open Left‘s Chris Bowers believes a ‘robust’ public option, including “the original vision of a public option, tied to Medicare rates, that is available to everyone in America” is still a possibility.
It appears some of the DINOs and moderate Republicans are bucking the will of their constituencies. That’s where the progressive fight should be going forward: to hold those Senators accountable in their states for dissing their constituents to curry favor with the health insurance industry. Sens. Joe Lieberman (CT), Ben Nelson (NE), Blanche Lincoln (AR), Olympia Snowe (ME) and Susan Collins (ME) should be hammered with reminders that a lot of voters in their respective states want a public option.
A Daily Kos poll, conducted 9/8-10, found that 55 percent of Arkansas respondents supported a public option. Another Daily Kos poll, conducted back on August 17-19, asked Nebraskans “If Ben Nelson joined Republican Senators in filibustering and killing a final health care bill because it had a public health insurance option would that make you more or less likely to vote for him or would it have no real effect on your vote?,” 21 percent said “more likely” with 15 percent chosing “less likely” and 64 percent selecting “no effect.” Not much of an advantage either way there.
Sen. Joe Lieberman’s Connecticut constituency supports the public option by 64-31, according to a Quinnipiac University poll, conducted 9/10-14. Regarding the two Maine Republicans, a poll by Democracy Corps, conducted 9/23-27, found,

…Mainers overwhelmingly support a government sponsored non-profit health insurance option, 63 to 27 percent. And they support this option from the start significantly more strongly than they support a “trigger” (52 to 34 percent) that would create the government sponsored non-profit health insurance option only if private health insurance companies do not make affordable coverage available within several years.

Alternatively, if Reid is unable to cobble together 60 votes for allowing a majority vote on a bill with a public option, Dems could go the ‘budget reconciliation’ route, with 51 votes needed to get one. In that event, there will be even more weeping an gnashing of teeth among conservatives about the lack of bipartisanship, a theme they will try to make into a prevailing meme. Dems can challenge it by emphasizing majority rule — not super majority rule — is the moral standard of democracy and the public option is consistently supported by a majority of Americans.
Despite the assertion of Stolberg and Pear, Obama and Reid can both credibly argue that they have made a sincere effort to recruit Republicans to support the public option voters want, and media coverage has been adequate to back them up. But the GOP has become an ossified, hard-line political party that places a higher value on obstructing change than bringing it about. That’s not a tough sell.
Democratic leaders should fight like hell to get 60 votes to allow a vote on the public option. There’s no getting around the fact that support of 60 percent of the Senate would add credibility to health reform. But if we don’t get it, then anything over 51 votes through budget reconciliation is an acceptable — and defensible — alternative.

One comment on “Obama’s Health Reform Strategy: How Effective?

  1. gdb on

    “There’s no getting around the fact that support of 60 percent of the Senate would add credibility to health reform.” Really, credibility for whom?? JP Green and David Broder?? Who now knows or cares what the Senate margin was that passed Medicare or Social Security?? What most in the general public will reward or punish at the polls in 2010 and 2012 is “what does it obviously do for me at this time (forget 2013 or 2014!!). Do the Republicans a BIG favor: pass any ol’ bill to make Obama happy that has mandates with no serious cost control.


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