Health bill's grim political prognosis
With confused messages and strategy, the Obama administration has worked itself into a fine fix on its top issue.
By Matt Mackowiak
Given that the Obama administration's communications team has been widely praised as skillful and effective, it's surprising that Congress' August recess has confirmed what many suspected: The White House is devoid of a coherent message on its signature issue, health-care reform.
Let's review where things stand. The legislation in Congress has failed to meet President Obama's stated criteria - namely, that it be deficit-neutral, bend the cost curve down over time, and insure everyone.
The nonpartisan Congressional Budget Office has said that the House bill would add more than $230 billion to the federal deficit over 10 years. At a Senate Budget Committee hearing before the recess, CBO director Doug Elmendorf testified that the bill would not only fail to bend the cost curve down, but would "expand the federal responsibility for health-care costs," bending the cost curve up. It's also clear that the most far-reaching of the Democratic proposals would not achieve universal coverage.
In addition, public dissatisfaction with the Democratic plan is substantial. An NBC News-Wall Street Journal poll released last week found that 47 percent of Americans disapprove of Obama's performance on health care, while only 41 percent approve. Forty percent worry about the bill not doing enough, while 54 percent worry about it going too far. Town-hall-style meetings across the country have underscored the dissatisfaction for members of Congress with direct, impassioned appeals.
The administration recently compounded these problems by suggesting it could accept a reform bill without a public option. Liberal opposition to this suggestion was fierce and unrelenting.
A letter signed by 60 liberal members of Congress said they would not support a bill without a public option. Meanwhile, Sen. Kent Conrad (D., N.D.), who has advocated private health cooperatives as an alternative, admitted there are not enough votes to pass a public option in the Senate, and that to continue to push for one would be "wasted effort."
The White House made two strategic errors with the public-option trial balloon. First, you never negotiate with yourself this early in the process. This bargaining chip would have had greater value if it were offered with Congress meeting in conference to reconcile different versions of the bill.
Floating the idea did have the potential advantage of making Democrats seem conciliatory and reasonable. It could have put pressure on Republicans to justify their opposition to private cooperatives, lest they appear opposed to everything. But by changing course twice in two days last week and embracing the public option again, the White House lost this opportunity, too.
The New York Times reported on Wednesday that the administration was prepared to end bipartisan negotiations on health care and "go it alone," quoting White House chief of staff Rahm Emanuel as saying, "The Republican leadership has made a strategic decision that defeating President Obama's health care proposal is more important for their political goals than solving the health insurance problems that Americans face every day." However, the same day, White House press secretary Robert Gibbs contradicted Emanuel by saying, "We are focused on a process that continues in the Senate with both parties" and denying that any plan to "go it alone" existed.
The White House is everywhere and nowhere simultaneously. The administration's heavy reliance on the president to deliver its message has left it with no B team to push the agenda effectively. Outside voices will fill the void, as we've seen with former Democratic Party Chairman Howard Dean stating that a bill with no public option would be worse than no bill at all.
Obama is in an unenviable position. His White House is under assault from all sides and constantly playing defense, with very few opportunities to shift the debate. The health-care legislation is unpopular and politically perilous, and it does not even meet the president's criteria. The remaining choices are unattractive and fraught with risk.