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Obama Pushes Insurance Reforms
As He Hits the Road, President Finds Few Openings to Confront Critics of Plan

By Michael D. Shear
Washington Post Staff Writer
Saturday, August 15, 2009

BELGRADE, Mont., Aug. 14 -- President Obama on Friday promised a new era of protections against insurance companies that drop customers when medical crises hit and said people who already have coverage would be among the biggest beneficiaries of his plans to revamp the health-care system.

Eager to address criticism of Democratic plans for health-care reform, Obama traveled here and spoke at a campaign-style town hall meeting, the kind of forum where his allies in Congress have faced boos and jeers from skeptical constituents in recent days.

But the president, whose popularity and powers of persuasion may well make him the reform effort's most effective spokesman, encountered the same difficulty he faced at a town hall meeting this week in New Hampshire: For the most part, the critics were nowhere to be seen.

The crowd of about 1,300 that gathered in an airplane hangar here Friday was overwhelmingly friendly and supportive, applauding repeatedly. Only two men put the president on the spot -- something White House officials had indicated they were hoping would happen more often.

A welder wearing a National Rifle Association jacket accused Obama of secretly planning to pay for the reforms by raising taxes, and an insurance salesman wanted the president to explain why he was "vilifying" insurance companies.

Obama gave both men detailed answers, explaining how he would pay for the changes -- not by taxing the middle class -- and saying that, although some insurance companies have been "constructive," others have fought against "any kind of reform proposals."

Earlier in the week, senior Obama adviser David Axelrod said White House officials were hoping to have Obama answering questions -- even tough questions -- because they have confidence in his ability to offer satisfying explanations the American public will believe.

"It's very important," Axelrod said. "There is a whole lot of misinformation out there. The best way to deal with it is directly."

'He Needs a Confrontation'

The composition of the crowds at the town hall events is a delicate matter for the White House. Having enthusiastic, friendly crowds that demonstrate support for the president's agenda is a positive thing. And Obama's allies are eager to show the contrast between his supporters and the angriest opponents of his plans.

But the president clearly needs to have a foil against which to offer his corrections to what he considers mischaracterizations of the health-reform plans. John Weaver, the political strategist who helped John McCain organize hundreds of often-confrontational town hall meetings, said Obama needs to put himself in tougher venues where he can confront his critics.

"He needs a confrontation to end some of this information," Weaver said. "We don't know if that's his strength. But that's his opportunity right now. If he really wants to turn the tide of the debate, he has to engage."

Brian Burgess, a spokesman for Conservatives for Patients' Rights, which opposes the president's health-care plans, said that Obama should be eager for a more confrontational crowd but that the White House should also be anxious about what that might bring.

"The president is very, very good at handling hostile crowds," Burgess said. "He keeps his cool very well. But the danger for him is that he might get some tough, tough questions and he might misstep."

Burgess noted that Obama said in response to one question Friday that people will "more than likely" be able to keep their health insurance under his plan, a slip that critics seized on immediately.

White House officials say they made no attempt to load the audience with voters who have a particular view of health-care reform. They said tickets to the town hall events have been given out much more broadly than in previous administrations. President George W. Bush often distributed tickets through the state Republican Party.

But the pomp and circumstance surrounding the president -- and the presidency -- often mutes the kind of unruly crowds that might otherwise exist. On Friday, Air Force One sat just feet from the hangar where Obama spoke.

There had been speculation that Friday's town hall might become more unruly, like some of the events that lawmakers have hosted across the country. Obama acknowledged that the health-care debate is emotional, but he also suggested that the images of tempers flaring at town halls meetings in recent days are not representative.

"TV loves a ruckus," he said.

Yet Obama was clearly hoping for the type of confrontational questioning that would allow him to dispel false claims. At one point, he practically begged for tougher questions. "And I want somebody who's got a concern or is skeptical about health-care reform" he said. "Here we go, there we go. I knew we could find a couple here."

At the beginning of the event, he even turned a positive question around so he could answer the critics.

When a man called Medicare one of "the best social programs this nation has ever put together," Obama responded by dredging up one of the frequent criticisms of the health-care program for seniors -- that it is a government-run system.

"So when you hear people saying, 'I hate government programs, but keep your hands off my Medicare,' then there's a little bit of a contradiction there," he said. "And I have been hearing that quite a bit, all right, so I just want to, I want to be clear about that."

Making His Case for Reform

Obama is embarking on a final public relations push on health-care reform before heading off on vacation. From Montana, Obama heads to Colorado on Saturday for another town hall.

As he has in the past few weeks, Obama on Friday framed his case for reform around controversial practices of insurance companies, with a particular focus Friday on people who have trouble getting health insurance with preexisting medical conditions and those who are denied payment for treatments even if they have coverage. The goal is to try to make reform seem more appealing to those who already have coverage; polls suggest the insured are lukewarm in their support.

All the scary stories heard about others having trouble getting coverage or payment for treatments should make people think, "There, but for the grace of God, go I," Obama said. He made sure to mention, as he has done at every stop, that his mother wrestled with her insurance company in the final months of her battle with cancer.

He tried to rebut the notion that health-care reform represents a "government takeover," noting that most people's coverage would remain what it is today.

"I don't want government bureaucrats meddling in your health care, but I also don't want insurance bureaucrats meddling in your health care," he said.

Randy Rathie, the welder, told Obama that explanations of how reform would be funded have been lacking. "You can't tell us how you are going to pay for that," Rathie said. "The only way you are going to get that money is to raise our taxes."

Obama told Rathie that the money for the changes would come from efficiencies and other savings and from people who make more than $250,000 a year.

A few moments later, insurance salesman Marc Montgomery asked Obama in a respectful but firm voice about his portrayal of the insurance industry.

"My intent is not to vilify insurance companies," Obama said. "If I was vilifying them, I would be saying private insurance has no place in the insurance market. What I've been saying is, 'Let's work with the system we've got.' "

Both men said after the event that they were not satisfied with the president's responses.

"I feel he's not being totally genuine because his plan is to have a public plan," said Montgomery, who waited overnight in line at the Belgrade City Hall for tickets to the event. "That's what he wants is a public plan, and a public plan will eventually drive other insurance companies out of business."

As to the cost of the changes, Rathie said after Obama left, "I'm afraid where it's coming from is out of the taxpayer's pockets again."

Staff writer Alec MacGillis contributed to this report.

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