Thoughts from Kansas

Washington Post, 12/22/2009 – Obama rejects criticism on health-care reform legislation:

"Nowhere has there been a bigger gap between the perceptions of compromise and the realities of compromise than in the health-care bill," Obama said in an Oval Office interview with The Washington Post about his legislative record this year. "Every single criteria for reform I put forward is in this bill." …

He said the Senate legislation accomplishes "95 percent" of what he called for during his 2008 presidential campaign and in his September speech to a joint session of Congress on the need for health-care reform. …

Obama said the public option "has become a source of ideological contention between the left and right." But, he added, "I didn't campaign on the public option."

The first few quoted paragraphs are correct. He laid out a number of important principles over the summer and in his September speech to Congress, and the bill which passed the Senate and that which passed the House both adhere to those principles in large part.

But the notion that he didn't campaign on the public option is horse-hockey. Look over the Healthcare section of the campaign's Issues page, and you see that his plan was built around three main planks: security and stability of existing coverage ("If you like the insurance you've got, no one will take it away from you," was the line I recall from his speeches at the time), expanded options for those uninsured or unhappy with their insurance, and reduction of insurance cost and the rate of medical expenses.

Here are the bullet points for that second item:

Quality, Affordable Choices If You Don’t Have Insurance, the Obama Plan:

* Creates a new insurance marketplace — the Exchange — that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices.
* Provides new tax credits to help people buy insurance.
* Provides small businesses tax credits and affordable options for covering employees.
* Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice.
* Immediately offers new, low-cost coverage through a national “high risk” pool to protect people with preexisting conditions from financial ruin until the new Exchange is created.

The first three items are in the House and Senate bills (I think), the last was never much a part of the debate, but that fourth item sounds familiar. I remember talking about it when I knocked on doors in Nevada, and I seem to recall it being in his speeches and debates. ThinkProgress has catalogued his defense of this "public health insurance option" fairly consistently as President, too.

So I can't fathom why he'd claim he "didn't campaign" on it. It's not even true that he didn't campaign for it, and that's important.

We need a public option, and since the Senate seems hell-bent on blocking one, we'll need to come back for it. And I'd hope that President Obama himself would start the drumbeat for a return to this issue right now. His preferences are well-known, his mandate to enact health care reform is hard to question, and there's no harm in leaving himself wiggle room to begin the campaign for a few small tweaks he hopes to see down the road.

As a general matter, I'm comfortable saying that President Obama can play the n-dimensional chess that is politics better than anyone I know, and I don't try to second-guess him. But there's nothing gained by misrepresenting his public record. And it strikes me as bad strategy, as weakening his position against any backlash to come.

As Atrios keeps saying, voters have to like this thing. So even if the President hated the bill's final form, I'd expect him to talk it up and give cover to people who voted for it. But he doesn't need to give cover to Ben Nelson or Joe Lieberman or other opponents of the public option. They are either not members of his party nor his political allies (Lieberman) or they benefit politically by being able to point out a way in which they are more conservative than most Democrats. So embracing that part of the bill does no one any good.

Over the last two years, the country had a conversation about having the government participate directly in providing insurance to every American who wanted it. And it's fairly popular, a steady 60% of the public favor a public option. That's change you can believe in, and more importantly, change you can campaign on. For decades, Democrats have campaigned on exactly the sort of health care reform due to pass the Senate the morning of Dec. 24. Passing this bill will turn the table, forcing Democrats to defend their actions rather than propose bold plans. There's no reason that part of the defense can't note that key parts of the plan – popular, useful, and necessary components – were left on the cutting room floor, and that voters need to send a Congress to DC that will finish what they started.