It's hard to sell change voters don't think they need.
By KARL ROVE
August was the worst month of Barack Obama's presidency. And he seems to know it—he is now planning to deliver a speech to a joint session of Congress 232 days into his administration in a desperate attempt to save his biggest domestic priority, overhauling health care. He has already had the budget-busting $787 billion stimulus package, a budget that doubles the national debt in five years, an earmark-laden appropriations bill that boosted domestic spending nearly 8%, and a cap-and-trade energy tax that limped through the House with dozens of Democratic defections (and which has stalled in the Senate). These achievements are unpopular, so they are boomeranging on him.
Mr. Obama's problems are legion. To start with, the president is focusing on health care when the economy and jobs are nearly everyone's top issue. Voters increasingly believe Mr. Obama took his eye off the ball.
In addition, Mr. Obama is trying to overhaul health care without being able to tap into widespread public unhappiness. Nearly nine out of 10 Americans say they have coverage—and large majorities of them are happy with it. Of the 46 million uninsured, 9.7 million are not U.S. citizens; 17.6 million have annual incomes of more than $50,000; and 14 million already qualify for Medicaid or other programs. That leaves less than five million people truly uncovered out of a population of 307 million. Americans don't believe this problem—serious but correctable—justifies the radical shift Mr. Obama offers.
Moreover, he's tried to sell it with promises Americans aren't buying. He says ObamaCare will save money, but American believe it comes with a huge price tag because the Congressional Budget Office has said it will.
Workers are also rightly concerned they won't be able to keep their current coverage. Many businesses will drop their health plans and instead pay a fine equal to 8% of their payroll costs, which is less than what they pay for employee coverage.
Families believe they will be pushed into a government plan as the "public option" drives private insurers out of the market.
Health-care providers fear they'll be forced to follow one-size-fits-all guidelines drafted by bureaucrats, instead of making judgments for specific patients.
And seniors are afraid of Mr. Obama's plan to cut $500 billion from Medicare over the next decade, including $177 billion for Medicare Advantage. It's simply not possible to cut that much from Medicare without also cutting services seniors need.
Each of these concerns is energizing opposition among many previously uninvolved voters and political independents. Members of Congress, especially those in closely contested districts, saw this firsthand when they returned home in August.
The administration's problems have been compounded by tactical mistakes. Allowing House Speaker Nancy Pelosi to push for a Democrat-only bill shatters any claim Mr. Obama can make to bipartisanship, a core theme of his candidacy. Leaving the legislation's drafting to Congress has tied the president's fortunes to Mrs. Pelosi, who has a 25% approval rating nationwide, and Senate Majority Leader Harry Reid, whose approval rating is 37% in Nevada.
Sen. Jim DeMint (R., S.C.) was inartful but basically correct when he said if Mr. Obama loses on health care, "it will be his Waterloo." It would destroy confidence in the ability of Democrats to govern. Mr. Obama knows this, which is why he will stop at nothing to get a bill, any bill, on which the label "health-care reform" can be stuck.
Given the Democratic congressional margins, Mr. Obama has the votes to do it, but at huge costs to him and his party. Legislation that looks anything like the bill moving through the House will contain deeply unpopular provisions—including massive deficit spending, tax hikes and Medicare cuts—and create enormous ill will on Capitol Hill. This will be especially true if Democrats rely on parliamentary tricks to pass a bill in the Senate with 51 votes. The public's reaction in August showed that the president is creating the conditions for a revolt against his party in the 2010 elections.
On the other hand, if Mr. Obama jettisons the public option, he may spark a revolt within his party. The Democratic base is already grumbling and could block a bill if it doesn't include a public option.
Presidents always encounter rough patches. What is unusual is how soon Mr. Obama has hit his. He has used up almost all his goodwill in less than nine months, with the hardest work still ahead. At the year's start, Democrats were cocky. At summer's end, concern is giving way to despair. A perfect political storm is amassing, and heading straight for Democrats.
Mr. Rove is the former senior adviser and deputy chief of staff to President George W. Bush.
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http://www.washingtonpost.com/wp-dyn/content/article/2009/08/28/AR2009082802603.html?wpisrc=newsletter
Starting Over On Health Care
Obama Has to Write His Own Bill
By Bob Dole
Monday, August 31, 2009
Health-care reform is the No. 1 domestic priority. With all the charges and countercharges, those who will be affected, the American people, are understandably confused. Many are angry. Reform of our health-care system is a gigantic undertaking, but too many measures have been drafted in congressional committees by liberal Democrats. It's become too much for many to grasp.
After 35 years in Congress, I know there are times when a fresh start is advisable.
If I were a White House adviser, I would suggest that the day Congress reconvenes, President Obama's version of reform should be introduced by Democratic leaders in the House and Senate. Health-care reform is the vital issue of our time, and Obama should be out front with his specific plan on this make-or-break issue.
Many of us were taught that the president proposes and Congress disposes. Today, Congress is doing both -- with the president relegated to the role of cheerleader in chief as he campaigns for various House committees' efforts. Certainly, Obama supports much in these proposals -- but Barack Obama is our president, not a commentator.
Obama's approval numbers would jump 10 points if Americans knew he was fully in charge. A tactical move of introducing his own plan would also stir more Republicans to become active for reform in critical areas. Right now the president's biggest problem is with congressional Democrats, who are split and searching for a way out of the medical wilderness.
In short, the president, Congress and the public are choking on all this, and choking is not covered by the legislation.
When I served as Senate Republican leader, I recall President Ronald Reagan telling me after he'd sent a bill that I would introduce that he wanted it all -- but that if I could get 70 to 80 percent, to run with it, and he would try to get the rest later. Neither Reagan nor Obama has been considered a master of Congress, but both are known for their great popularity and for understanding the art of reaching for more than they could reasonably expect. Now, consider this: Members of Congress want to keep their jobs. They support their president, but they also want to be employed, with a good health plan (like the one they enjoy now), after this president or even the next has come and gone. So votes on this issue are not simply partisan. They are also about survival. Most lawmakers, Republican or Democratic, will think long and hard before casting this vote -- to avoid backing into a buzz saw.
Once the president has staked out his position, which will provide room for amendments, the debate will narrow, and bipartisan bargaining and other political maneuvering can begin.
The goal is getting legislation without driving certain private sectors, such as the health-insurance industry, out of business. Issues such as administrative costs and coverage for those with preexisting conditions can be resolved without any "public option" or the "co-op" provision under discussion. All of these can be postponed for five years or more. If the industry has not shown marked improvement by then, reforms could be imposed because most of the proposed legislation, if passed, would not be implemented for three to four years in any case. I believe the industry is responsible and would clean up its act, as needed, as soon as possible.
Along with former senators Howard Baker and Tom Daschle, I serve on the advisory board of the Bipartisan Policy Center, a group searching for common ground on health care, energy, agriculture, transportation and national security. After more than a year of work on health care, we made our recommendations public in June. We were assisted by many experts, including Chris Jennings, President Bill Clinton's top health adviser, and Mark McClellan, who headed the Centers for Medicare and Medicaid Services and the Food and Drug Administration under President George W. Bush.
Out of Congress now, we have no votes and no power -- but we have our credibility. It is pleasing that many lawmakers, particularly the Senate Finance Committee leaders, Democrat Max Baucus and the GOP's Chuck Grassley, have looked favorably upon some of our recommendations.
Having watched Congress tackle health reform before, I think it best to avoid the "reconciliation" process, by which part of a plan could be written into legislation that requires 51 votes, and not 60, on its way to passage. This president may be up to his ears in Democratic votes, but I suspect that many will not vote for a bill put forth through reconciliation.
Republicans have different ideas but for the most part are positive about reform if the government has a minimal role. Democrats would eventually regret it if Republicans are forced to take a nearly party-line vote. Obama should get the credit if legislation passes but, more important, get the blame if final legislation draws only a few GOP votes and brings more taxes, more government and more spending .
A bipartisan ending will have more credibility with the American people. Indeed, most important legislation in U.S. history has had broad bipartisan support. As a supporter of bipartisan health reform, I hope the president has gotten some rest in the past week. I also hope he puts the final touches on his own health bill. I'd bet a bottle of aspirin that it would cure many of his headaches.
The writer is a retired Republican senator from Kansas and former majority leader.
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