Washington Matters


Obama Health Care Speech Resets Debate


President Obama took a huge risk with his attention-grabbing address to Congress last night, but he had little choice if he wanted to take back control of the health care debate and increase chances of passing a bill to his liking. His goal was to unite Democrats and reinvigorate them, to ease Americans' concern after a summer of raucous debate and to reach out again to moderate Republicans.

Appealing to Democrats, especially center-right Democrats was crucial because they are the ones who will determine whether meaningful legislation will pass. Rank and file Republicans would like nothing more than to see a large reform effort fall at the hands of divided Democrats. To a large degree, the speech did unify Democrats, in spirit at least, even as details remain to be fleshed out.

"There were good marching orders given here tonight," said Rep. James Clyburn, D-S.C. "I think that's really what we needed here most right now. Not every detail, but a sign of full engagement now by the president. That changes a lot. We won't want to let him down now. We're essentially on notice. The whole party."

Obama was careful to walk a middle road and urge both the left and right to move to the center. Among the standout parts of Obama's speech, for example, was a carefully worded line that, while not dismissing the controversial public option that liberals demand and conservatives oppose, put it on the table for negotiation.  "We should remain open to other ideas that accomplish our ultimate goal."

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The Senate Finance Committee will mark up its version of the legislation during the week of Sept. 21, and chairman Max Baucus, D-MT, has said and repeated last night after the address that a public option would not be included. "Do we include it to please a few and then drop it for necessity, or just not include it. I know it can't pass the Senate," Baucus said, although he left open the door somewhat to a type of trigger that might put a public option into use if insurers failed to provide policies to everyone at reasonable prices.  "People talk about a so-called trigger, but no one has fleshed it out," Baucus said. "I can see how that could be very complicated." Baucus will have a large say in the final legislation that will come out of conference work with the House, which is expected to act on legislation in two weeks. The plan that Obama described last night is much closer to the Baucus plan than to any of the more liberal bills produced by other House and Senate committees.

Obama also reached out to Republicans, most notably by promising the bill won't add to the deficit and by offering some type of medical malpractice reform long a Republican pursuit. That may help one or two Senate Republican moderates get on board, though it won't be enough to win scores of Republican votes.

Sen. Jon Kyl, R-AZ, for instance, called malpractice tort reform "health care overhaul all unto itself. You want to lower costs, that will do it. We should pass that separately, though, not as one part of a massive mess."  

Ultimately, much will depend on how well Obama was able to ease public concerns about a possible government takeover of the health care system and whether he was able to ease fears that people who have insurancce now will be hurt by reform. Undoubtedly, the polls over the next few days will show movement in the president's favor. The question is whether that will last for more than a few days.

 




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