Washington Even with victory in hand, President Barack Obama can’t put health care to rest.
He still has to sell skeptical Americans on the benefits he claims for the massive overhaul Congress finally approved — and try to save the political skins of fellow Democrats who put their jobs in jeopardy by voting with him.
The White House’s chief goal after the health care debate was to be a change in focus to jobs measures and populist issues — intended to be music to the ears of Americans suffering from high unemployment and a limping economic recovery. That’s still the case, but the health overhaul is bound to be a major issue through the November elections and beyond.
Despite the year of caustic debate, Obama emerges with a stronger hand.
He’s moved on from Phase One of his presidency — stalled. Now he’s on to Phase Two — buoyed.
The cliffhanger House vote that approved the overhaul is one of those presidential achievements with multiple side benefits: fresh clout in a capital that worships winners, bragging rights on a key promise kept, and a history-making, country-changing one at that, praise for presidential perseverance against daunting odds, a respite from talk of a mired presidency.
It was news so good that Obama invited dozens of aides to the Truman Balcony for an after-midnight champagne celebration. Senior adviser David Axelrod said Obama was the happiest he’d seen his boss since Election Night when he won the White House — perhaps even happier. “Elections just give you the chance to do things,” Axelrod recalled a jubilant Obama saying. “This is the real thing.”
How much it will help during the rest of his term, though, is a bit murky. One clue will be found as the president’s campaign-related travel schedule unfolds over the months until this fall’s congressional elections.
Standing by his promise to provide political cover for those who helped him on health care is about more than keeping his word. If Obama were to see the Democratic congressional majority ended or severely diminished in November, it could make it much harder to push legislation through Congress.
Most of those who could suffer from their “yes” votes are moderate Democrats in conservative-leaning districts and states. Siding with Obama were 17 Democrats who are seeking re-election in districts that Republican John McCain won in 2008, including top GOP targets such as Tom Perriello in Virginia, Betsey Markey in Colorado, Harry Mitchell in Arizona and Suzanne Kosmas in Florida. One other moderate Democrat running a difficult race for the Senate in a right-tilting state — Brad Ellsworth in Indiana — voted for the measure, too.
One question is how much these in-danger Democrats could benefit from Obama’s help.
His fundraising prowess will be welcomed by nearly all, and it can take place in the background, far from the candidates’ districts if need be. His history of inspiring grass-roots supporters and bringing new voters to the polls will be helpful, too, in some places, though harder to apply in congressional races than in his own White House bid.
There still will be some Democrats who will not want a direct, in-person appeal to voters from a president with job approval ratings hovering around 50 percent.
Another health care task that won’t disappear any time soon for Obama is pushing back against Republicans. GOP leaders have made clear they will use any tactic available — at the polls, in Congress and in the courts — to try to punish Democrats for the legislation and to undo it. Aides say Obama plans to aggressively engage the GOP’s universal opposition to the bill and efforts to repeal it.
Where the president probably can make the most headway on both offense and defense is with the public.
Polls show people are split over whether they like the bill. So, Obama will seek to improve those numbers, starting with an appearance Thursday in Iowa City, Iowa, and a series of outside-the-Beltway health care-focused events that White House communications director Dan Pfeiffer said would come “periodically” — not daily or even weekly, but regularly though the end of the year.
White House advisers believe there’s plenty of time before November to make the bill’s benefits real for voters, especially the few parts that take effect soon, among them rebate checks for seniors affected by the Medicare drug coverage gap, permission for 26-year-olds to stay on their parents’ health plans and bans on insurers turning away children with medical problems or setting lifetime coverage limits.
They also believe that GOP gripes about legislative procedures used by Democrats will fade to a distant memory.
And, Pfeiffer said, “It is helpful for health care reform to go from the theoretical to something real.”
The sales job is hardly a slam dunk.
The gigantic bill remakes the nation’s health care system — one-sixth of the economy — in a way feared by some as an overly huge and expensive government intrusion.
The changes will come gradually, with some not fully phased in for a decade. Some of the biggest shifts, for instance, such as mandates for most Americans to carry insurance, new places to buy it and new employer obligations, and a ban on denying coverage to the sick, are four years off.
Explaining what happens when, which hardly fits on a legal pad much less a bumper sticker, will not come easily when the target audience is an angry public with a short attention span.
“He knows that the legislative process has been confusing, that it’s taken a long time,” White House health reform director Nancy-Ann DeParle said.
Legislatively, Obama’s approach for the rest of the year was largely set no matter health care’s outcome, starting with a steady diet of jobs- and small business-related votes.
He’ll also press for action on populist-leaning measures with broad appeal, such as tougher financial industry regulations and rolling back a recent Supreme Court ruling that allows unions and corporations to funnel unlimited dollars to political campaigns.
Even those measures are tough lifts, though, with potentially large partisan opposition. And with the November elections looming, the window for congressional action on anything, much less something else big and controversial, is fast closing.
Across the street from the Capitol, there’s the strong expectation of another Supreme Court vacancy. That would steal the remaining oxygen from any legislative issue.