Barring a major public groundswell or miraculous reversal in Congress, Barack Obama's healthcare reform package will not include the provision that matters most to the Democratic base, the so-called public option. Why has a president who entered the White House with the second-biggest winning margin of any Democratic president since the New Deal, and who is blessed with solid Capitol Hill majorities in both chambers of Congress, struggled to save this key agenda item?
Was the White House's public relations rollout insufficient to counter the stronger-than-anticipated resistance from healthcare opponents? Was the public option always just a bargaining chip to give away in exchange for what the president really wants? What happened to the vaunted Obama campaign apparatus, which was supposed to morph into a machine delivering support for Obama's agenda? Did Obama simply lack the political will or political capital? Or should he have been less of a consensus seeker and more of a Rove-ian steamroller?
Maybe there's some truth to all those scenarios. Call it the public option's "imperfect storm." Yet the policy stumble by a president who demonstrated so much political skill over the past two years merits further inquiry into what went wrong, and why. Here are four possible explanations:
1. Despite solid Democratic majorities on Capitol Hill, Obama was never going to get his public option provision through Congress – and certainly not through the Senate – because the votes just aren't there.
Earlier this week, during an interview with CNN's Wolf Blitzer, Sen. Kent Conrad said flatly that there "was never enough support" in his chamber for the public option. As Salon's Mike Madden reports, Conrad and two fellow Democratic senators at the center of the negotiations who might have made a difference, Montana's Max Baucus and New Mexico's Jeff Bingaman, never committed their full resources to the battle. "Bingaman may be the prime example of the way some Senate Democrats seem to have approached the healthcare debate this summer: count votes first, figure out what should be in the bill later," writes Madden. "And while you're counting, take the most pessimistic view possible."
And thus, all the Democratic Snoopy dancing following Pennsylvania Sen. Arlen Specter's party switch and the long-overdue seating of Minnesota's Al Franken was premature. Sixty senators are better than 59, and certainly the mere 45 that Democrats claimed just four years ago. But a majority that is filibuster-proofed against the minority's obfuscation still remains susceptible to majority-party defections – or, to be precise, just one such defection. Given the business-friendly profile of Baucus and others, and the pending 2010 reelection challenges facing the likes of Nebraska's Ben Nelson, it's no wonder Harry Reid couldn't keep those 60 Dems toeing the line. To put it as politely as possible, Reid is no Lyndon Johnson.
Apparently, Obama is no LBJ (presidential version), either. Given the reflexive Republican biting of Obama's extended hand, perhaps the president should have dispensed from the start with any serious effort to find accommodation with the GOP. The White House could have spoken otherwise for public consumption, but it should have assumed all along that this would be a Democratic-led proposal. Instead of wasting energy on trying to persuade Republicans, it could have worked over dissenting Democrats in the Senate, and had a better shot at jamming the public option through.
Now the Obama administration seems to get it. At long last, on Tuesday, the New York Times reported that the White House and its Democratic allies on Capitol Hill are now prepared to push through healthcare alone, without help or bipartisan cooperation from congressional Republicans. "The Republican leadership has made a strategic decision that defeating President Obama's healthcare proposal is more important for their political goals than solving the health insurance problems that Americans face every day," grumbled White House chief of staff Rahm Emanuel. But if anybody should have anticipated that scenario, it was the guy Obama hired as his right-hand man. Emanuel still bears both the scars and lessons from a similar confrontation over healthcare 15 years ago. Why did it take him till August to experience this epiphany?
2. Obama misplayed his hand by failing to properly explain what the public option is, how it works, who will have to pay for it – and, most of all, to show that he's prepared to fight for it.
A president has to be educator in chief as well as commander in chief. But the White House lost control of the public option narrative very early on because, as Salon's own Joan Walsh wrote on July 21, Obama hesitated from the start to lay down clear markers and defend them publicly. "I'm clear about why this is a tough fight for Obama. But I think he may be making it harder than it needs to be. I realize it's difficult to define when still playing politics – necessarily – but I really want to know his bottom line," Walsh pleaded, noting that on a range of disputed elements, including the public option, Obama was curiously vague and uncommitted about his intentions. That he has been only slightly more clear and committed in the ensuing month hasn't helped.
It wasn’t until after weeks of being eclipsed by noisy, half-crazy protesters that the White House finally went on the offensive. Obama flew into New Hampshire to conduct his own, nationally televised town hall. It was not an unalloyed triumph. Asked by one questioner to defend the public option, the president offered what had the potential to be a powerful analogy, if executed correctly, when he compared the competition the public option would introduce to the insurance system to that which the U.S. Postal Service creates in the market for package delivery. So far, so good – until the president denigrated the USPS. "I mean, if you think about it, UPS and FedEx are doing just fine, right? No, they are. It's the post office that's always having problems."
For starters, Americans actually have a pretty high regard for the Postal Service. And of course, the price one pays at the counter for postage to mail stuff is subsidized by taxpayer dollars, because the USPS is part of the federal budget. The Postal Service delivers letters and packages pretty darn effectively and often at far lower cost than private carriers – and thus, helps keep market prices in check. But it was easy for opponents to pounce on the long-standing, if wrong, public perception that the Postal Service is somehow just another slow, costly and bumbling bureaucracy.
Barney Frank -- at the town hall meeting where he famously asked one heckler "On what planet do you spend most of your time?" -- also asked the rhetorical question the president should be asking of those claiming that the market is more efficient and the public option too expensive: If the government is such an inefficient, expensive provider of insurance compared to the private sector, why are critics so worried that rational consumers will choose the public option?
3. Obama knew from the outset that the public option was going down in flames, but shrewdly included it anyway as a feint to his base and a bargaining chip to cede to the opposition.
Anyone who read "The Audacity of Hope" knows how the president thinks about public controversies. He sets out the strong case made by both sides, indicates that he's inclined as a Democrat and a progressive toward one side, but admits that he might not know everything and that the best idea may thus lie somewhere between. If you take that political philosophy and apply it to negotiation, the shrewd approach is to stake out a position far from the opposition so that moving toward them during negotiation still yields a pretty satisfying outcome. And if you presume that was the White House's plan for the public option, then it was never more than a bargaining chip inserted to distract opponents so they would be relieved to have it discarded and might therefore go along with other parts they'd normally oppose. By this logic, Obama inserted the public option as a shrewd ploy to score points from his supporters by advocating it, but also from his detractors by sacrificing it.
For liberals – who view the public option as more "essential" than the president seems to – political gamesmanship of this sort is greeted with unvarnished cynicism. "If a public plan gets into a final healthcare bill, it's going to be because of public pressure, because people who put Obama in office demand one," writes Firedoglake blogger Jane Hamsher, after chronicling all the moves and countermoves starting in late spring between the White House, PhRMA, Blue Dog Democrats and key senators like Baucus to set the table for the co-op alternative to the original public option. "Because in the grand scheme of White House priorities," Hamsher concludes, "it was something that could acceptably be dealt away in pursuit of a higher political objective by the guy who was calling the plays: Rahm Emanuel."
Jonathan Cohn, a leading expert on healthcare and the author of "Sick," takes a more sanguine view of how the White House approached the public option negotiations. "My best guess – and, again, it's just a guess – is that Obama believes what he's said all along. He favors the public plan, deems it important, but doesn't consider it absolutely essential," Cohn told me by email. "I'm sure he knew it could be a bargaining chip. And I would guess he figured he might end up giving it away. But I'm not prepared to conclude he was committed to giving it away from the get-go. If progressives could build support for it, certainly, I think he was happy to have it in there – and even spend a little political capital on it." (A request for comment from White House healthcare spokesperson Linda Douglass received no response.)
4. President Obama is not nearly as good at mobilizing supporters from the White House as was candidate Obama during last year's campaign to reach the White House.
If you don't know what Organizing for America is, or you do but feel as though you haven't heard much from this organization, then the point is already made. Following the election, pundits and presidential scholars wondered aloud whether and to what degree the swift, state-of-the-art, high-tech Obama campaign outreach operation could be converted to a policy mobilization machine. As the Democratic National Committee's outreach operation, OFA is that machine, and the debate over healthcare reform offered the perfect opportunity to take it out for a spin.
But so far, at least, OFA has fallen short of expectations. The organization seemed to get a late start and to begin from a defensive posture.
An email to supporters from OFA director Mitch Stewart went out the second weekend of August, decrying the misinformation emanating from protesters and enjoining the Obama faithful to counteract the falsehoods by talking to their neighbors. On Thursday, Obama sat down with OFA representatives and DNC chairman Tim Kaine for a 90-minute webcast rally session with OFA volunteers to "discuss the importance of grassroots organizing in winning the battle over health insurance reform – the same type of organizing that was so critical to his campaign for President last year." This use of the combined powers of the White House, national party and OFA is exactly the right idea – if about three weeks too late. The town-hell protesters had already shaped media coverage by then.
"OFA has tens of thousands of active members who could be mobilized," the National Journal's Kevin Friedl reported about a month ago. "The question remains, though, whether the group can channel any of that into effective lobbying." Friedl quotes activist Greg Dworkin, a veteran Daily Kos blogger, who warned that while "everybody knows how to go out and vote … not everyone knows how to contact their local representative in a way that the representative will hear them." (Requests for comment about OFA's performance from the DNC's Brad Woodhouse were not answered.)
To be fair to the administration, we have been here before on healthcare. It's a messy and controversial policy area, as the president himself admitted during an interview this week with Philadelphia radio talk show host Michael Smerconish. Because of its complexity, and the anxieties many Americans feel about their health insurance, it's difficult to build consensus for any change. As I have argued elsewhere, Obama either invested or wasted a lot of political capital just to move the debate this far and may get little to nothing in return.
But the White House should have been better prepared for the assault to come. South Carolina Sen. Jim DeMint signaled very early on that many conservatives and Republicans hoped the administration's healthcare proposal would become Obama's "Waterloo," so why wasn't the White House out there on offense more strenuously? Given the ideological divide in America, has the president allowed his desire to be a uniter precluded the style of unapologetic partisanship that would leverage the Democrats' congressional gains from the last two election cycles? And what flags is the president willing to plant and how steadfastly will he defend them? Rather than start with a finish date and broad objectives, he should have started with a clear plan and an unambiguous defense of the public option, and retained control over that plan instead of leaving it to the sort of congressional tinkering that has led to the "co-op" substitute now gaining favor with Senate Democrats.
Politics isn't beanbag, as the saying goes, and presidential politics most certainly isn't easy. The battle over the public option raises the question of whether, when it comes to his more noble and most coveted priorities, Obama is prepared to practice the same type of politics that his predecessor, with thinner congressional majorities, deployed in pursuit of an ignoble and less popular agenda.