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President To Flesh Out His Vision In Speech
Address to Congress Is Effort To Seize Control of the Debate

By Anne E. Kornblut, Ceci Connolly and Shailagh Murray
Washington Post Staff Writers
Thursday, September 3, 2009

After spending weeks on the defensive in the fight over his top legislative priority, President Obama will attempt to regain the initiative in the health-care debate with an address to a joint session of Congress next Wednesday night.

Aides said Obama will use the speech to add more specifics to his vision for overhauling the nation's health system. He will be attempting a difficult balancing act, seeking to win moderate Senate Democrats to his cause without embracing compromises that would alienate liberal House Democrats. He is not expected to associate himself with any one bill, but a senior administration official said the president's goal is to be "much more prescriptive" than he has been, mapping out ways to merge proposals and "move Congress toward one single solution."

The White House is scrambling to take control of the health-care debate after watching from the sidelines as various Democratic proposals were assailed in town hall meetings during Congress's summer recess. "Clearly, over the August break we lost some momentum," said Sen. Charles E. Schumer (D-N.Y.). "It shows the president is in this fight for keeps; he's not backing off. He's doing just the right thing to take the momentum back."

White House advisers acknowledged that the president has begun to shift away from endorsing broad goals while allowing the legislative process to run its course. Early on, senior adviser David Axelrod said, Obama "was very clear about his principles."

"But now we're in a different phase," he added.

For better or worse, the high-profile speech is likely to tie Obama closer to the issue in the minds of Americans. Almost exactly 16 years ago, then-President Bill Clinton also attempted to break a logjam on health care in Congress with a prime-time address to lawmakers, and his administration's efforts ended in spectacular failure.

Senior Obama administration officials met with the president Tuesday to debate whether a televised news conference, an address to the nation from the Oval Office or a speech to Congress would be the most effective forum for him to deliver his message. They concluded that a congressional address was the best way to "move the debate to the next level," one official said.

The joint session will come as Senate leaders are rethinking their strategies on the issue. One option, leading Democrats said Wednesday, is to tailor a bill to the demands of Sen. Olympia J. Snowe (R-Maine), a key moderate who has displayed the most willingness to continue negotiating with Democrats.

Another option, lawmakers said, is to attempt to make any package that comes to the Senate floor more attractive to Republicans by including tighter cost controls and slowing the pace of providing coverage to the 47 million Americans who have no insurance.

Obama called Democratic leaders Wednesday morning to discuss the address. He then left for Camp David, where he is expected to keep a relatively low profile until returning to a full public schedule after Labor Day.

After spending weeks in often contentious discussions with their constituents on health care, lawmakers expressed uncertainty -- and concern -- about what the president will say next week. Rep. Chris Van Hollen (D-Md.) said he expects Obama to explain that he is open to compromise with Republicans, but only up to a point. "He will make it clear that he can't allow that goal to torpedo that entire effort," Van Hollen said. "We've had a national conversation. What we've not had is a chance to focus again on why it's important to do health-care reform."

Eight months after taking office, Obama is confronting powerful crosscurrents within his own party on an issue that has bedeviled administrations for decades. More liberal lawmakers, already disappointed that Obama has ruled out a single-payer approach, say whatever legislation he signs must include a government-run insurance option for people who cannot find an affordable private plan.

During the presidential campaign, Obama embraced the concept of the public option but declined to spell out precisely how he would structure a public insurance program. Many centrist Democrats in Congress oppose a public alternative, fearing that it would undermine the existing insurance market. In the face of strenuous opposition, Obama and several top advisers have said the administration may be willing to drop the idea.

Several moderate Democrats urged Obama to seek a compromise and said they hope he will push a pragmatic version that does not include the public option currently contained in the draft of the House legislation.

"To the extent that he provides specifics, he should lay out the common denominators," said Rep. Stephanie Herseth Sandlin (S.D.), a leader of the Blue Dog Coalition, a group of 52 centrist House Democrats from largely rural districts. Obama, she said, should tell the nation: "We cannot achieve what many people had hoped at the outset, and we should be ready to strike a deal."

But Obama must be wary of a potential uprising from the liberal wing of his party. On Monday, he will travel to Cincinnati for an annual Labor Day picnic sponsored by the AFL-CIO, putting him in front of thousands of union members whose leaders are urging a public option and mandated employer coverage.

Republicans swiftly dismissed the congressional speech as too little, too late. "I don't think the problem is the messaging, I think the problem is the substance," said Senate Minority Leader Mitch McConnell (Ky.). "The problem is what he's trying to sell. I think there's been serious blowback and negative reaction across the country to what they are proposing."

But Democrats think salesmanship is part of the problem, and they are pressing the president to take a more forceful role in selling reform by expressing in very clear terms what the bill would and would not do. They are especially urging that he confront misinformation about rationing of care and "death panels" that would supposedly decide which patients were worthy of treatment.

"All those beliefs out there, those came about because of poor messaging," said Sen. Ben Nelson (D-Neb.), a crucial moderate swing vote. "I don't know how you fix it, but you have to."

Staff writers Michael D. Shear, Paul Kane and Alec MacGillis contributed to this report.

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