Obama Calls Reform Moral Obligation, Health Care Showdown

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End In Sight, Dems Lobby Health Bill Waverers


President Barack Obama and Democratic leaders lobbied intensively for historic health care legislation Friday, striving to resolve a last-minute dispute over Medicare while gaining another precious "yes" 48 hours ahead of a climactic vote.

With a showdown set for Sunday on the House floor, Democratic leaders still didn't command the 216 votes they needed, so every undecided lawmaker was the focus of personal attention from House Speaker Nancy Pelosi and the White House, and every "no"-to-"yes" conversion was trumpeted by party leaders.

Obama, who delayed an overseas trip to help ensure passage of the legislation, planned to meet with Democratic lawmakers at the White House Saturday afternoon. Senate Majority Leader Harry Reid is also expected to attend the meeting.

In an 11th-hour pitch, the president spoke to an enthusiastic crowd at George Mason University in Virginia, lobbing attacks at the insurance industry with his coat jacket off and sleeves rolled up.

"The only question left is this: Are we going to let the special interests win once again, or are we going to make this vote a victory for the American people?" he said.

Obama described the stakes in stark terms, using words uttered so rarely out of the White House that they seem all but banned: "If this vote fails." What then? "The insurance industry will continue to run amok," the president said, pointing to rising rates, denials of coverage and limits on care.

Meanwhile on Capitol Hill, the vote-counting spotlight swung to Rep. John Boccieri, D-Ohio, who announced that he would support the bill despite voting against an earlier version. "I'm not worried about the election," he said. "I'm worried about doing what's right."

Boccieri became the fourth House Democrat to switch from "no" to "yes." Shortly after he announced his decision, Pelosi predicted: "When we bring the bill to the floor, we will have a significant victory for the American people."

The good news aside, the White House and Democratic leaders faced a last-minute snag as some lawmakers complained about a provision in the bill on how health providers are paid under Medicare. Pelosi and senior White House officials raced to find a solution.

"I'm a 'no' unless they fix it," said Rep. Peter DeFazio, D-Ore. "We spent months working this out. If we don't get it in this bill, we will never get it."

The conversation was all about how Democrats would vote because Republicans have formed a virtually impenetrable phalanx of opposition for the past several months.

Retiring Rep. Bart Gordon, D-Tenn., and first-term Rep. Betsy Markey, D-Colo., announced their support Thursday; liberal Rep. Dennis Kucinich, D-Ohio, did so earlier this week.

The momentum wasn't all in the right direction for Democratic leaders. Some rank-and-file Democrats who backed sweeping health care legislation when it passed the House in November showed signs of defecting. Weaker restrictions on federal funding of abortion was a concern, but not the only one.

Rep. Stephen Lynch, D-Mass., a former union activist, said even a one-on-one meeting with Obama on Thursday hadn't convinced him that the legislation did enough to reform the health system and rein in insurers and drug companies.

"I'm still currently opposed," Lynch said in an interview Friday. "But the president asked me to think about it, and if there were some type of measure that might move me to a better place on the bill, then he wanted to hear about it."

As rumors flew around the House chamber of more possible opponents-turned-supporters — and also of previous "yes" voters who might withdraw their support — Pelosi worked her members, seeking out lawmakers individually or in small groups on the House floor to try to win them over.

Obama postponed until June a planned Asia trip that was set to begin Sunday, allowing him to stay in town for the House vote and action next week in the Senate. He's playing host to individual lawmakers seeking favors or reassurance. House Democrats were also hoping to get a letter of support signed by enough Senate Democrats to guarantee passage of the package of changes in that chamber, something leaders hope will reassure rank-and-file House members that they won't be left hanging out to dry.


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Pres. Obama Won't Allow Special Interest Groups To Stop HC Reform Agenda...New Strategy Planned

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(The White House's Strategy appears to have shifted on Health Care Reform. Watch)

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(President Obama tells a caller to the "Michael Smerconish" radio show that he would "love" GOP assistance in getting a health care reform bill passed, that he's open to compromise, but won't give in on the core principles.)

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(Pres. Obama tells American citizens that quality Health Care is a Moral Obligation.)

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As public pitchman, President Barack Obama accuses special interests of fighting to block his health care overhaul. "They run their ads. And let's face it, they scare people," he told one weekend audience.

Yet Obama has spent months assembling a formidable lineup of special interests of his own, an essential element of a plan to remake the health care system and succeed where President Bill Clinton memorably failed.

"We have the American Nurses Association, we have the American Medical Association on board," Obama told the weekend crowd in Grand Junction, Colo. "We have an agreement from drug companies to make prescription drugs more affordable for seniors. ... The AARP supports this policy."

In the parlance of Washington, the organizations on both sides are special interests — the insurance industry and business groups strongly opposed to the direction health care legislation is taking in Congress, as well as the groups of doctors, nurses, drug makers and labor unions working to pass an overhaul despite any misgivings they may have.

Part of the permanent landscape in the capital, they all lobby Congress and federal agencies on the issues they care most about. Many purchase political ads in campaign season or try to turn out their own memberships to vote for preferred candidates. They have enormous sums at stakes in the outcome of the struggle over Obama's proposed remaking of the health care system.

Take just two:

* America's Health Insurance Plans has emerged as a leading opponent of the portion of Obama's plan that calls for the government to sell insurance in competition with private companies.

* The Pharmaceutical Research and Manufacturers Association is unhappy about the same provision but has pledged to spend a staggering $150 million on television commercials in support of the administration's quest for legislation.

What's the difference?

"They're stakeholders when they're with you, and they're interest groups when they're against you," Mary Matalin, a Republican, said recently, a tongue-in-cheek explanation that hints at the unappealing aroma associated with the label "special interests."

White House spokesman Robert Gibbs seemed to understand as much when he said the administration is benefiting from the help of "interest groups," avoiding the more unsavory term "special interests."

"It'd be sort of odd to go to a town hall meeting and rail against interest groups that are supporting reform ... who have acknowledged that it's time for health care reform," he said. The president's criticism is aimed at "interest groups that are aligned to keep the status quo either because it benefits them or they have a vested interest."

Far more than semantics is involved.

Eager to succeed where Clinton failed, Obama nailed down agreements with deep-pocketed drug makers and others. The effect was not only to secure allies who could pay for grass-roots and advertising campaigns but also to drive a wedge between Republicans and organizations that have supported them in the past.

Despite the obvious turbulence surrounding Obama's proposals, there is evidence the strategy is working. GOP discomfort was obvious when Rep. John Boehner, the House Republican leader, accused the drug industry of trying to protect its own profits by "cutting a deal with the bully" on health care.

It marked a turnabout from the days when congressional Republicans received two-thirds of the political contributions handed out by the pharmaceutical industry.

Ken Johnson, a senior vice president at PhRMA, sought the high ground in response. "We have been working diligently for more than a year to advance bipartisan health care reform. We're proud of those efforts, and they are completely consistent with our core principles."

The drug makers went first in making a deal with the White House, agreeing to pick up $80 billion in additional costs over the next decade to help defray the expenses of the legislation.

The American Hospital Association agreed to shoulder an additional $155 billion.

In exchange, both won assurances the White House would protect them against attempts in Congress to seek additional cuts in their projected Medicare and Medicaid payments.

The American Medical Association's key issue was different. Doctors hope the legislation will allow them to avoid a looming 21 percent cut in payments under Medicare. The cost to the government for that would be about $230 billion over a decade.

Obama also agreed to require individuals to purchase insurance, reversing a position he held during his campaign. "My thinking on the issue of mandates has evolved. And I think that that is typical of most people who study this problem deeper," he said.

It was a bow to the special interests — some now with Obama, others not — that suddenly opened up the possibility of millions of new customers with insurance to help pay for their health care.



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