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Health-Care Overhaul 2010

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In Illinois, a Similar Health-Care Fight Tested Obama as State Senator

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By Michael D. Shear and Ceci Connolly
Washington Post Staff Writers
Wednesday, September 9, 2009

From a back-row seat in the Illinois Senate chamber, Barack Obama listened silently as political adversaries mocked his health-care reform bill: Socialized medicine. Hillarycare redux. Too expensive. Back-door route to a single-payer system.

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Then, as now, the fate of Obama's health-care-for-all vision rested largely on whether he could deflect the attacks and hold together a fragile, unlikely coalition in support of change. The 2004 fight for the Health Care Justice Act in Illinois tested not only his skills as a legislator and community organizer, but his powers of persuasion as well.

It was, in a sense, a practice run for this year's health-care campaign.

On Wednesday night, Obama will rise once again to defend a major policy initiative in jeopardy. What began as a popular idea from an even more popular president has bogged down in bitter talk of "death panels," anxiety about the nation's soaring deficit and splits within the Democratic Party over the role of government.

The president brings to the current battle skills honed five years ago -- the last time he heavily invested political capital in the treacherous issue. Just as he did in Springfield, Ill., Obama has approached this year's debate with an appetite for broad consensus, even if compromises along the way have disappointed some of his most loyal backers.

Obama has reached out to doctors, Republican lawmakers and even the industry players he often denounces. He has moved methodically -- some say ploddingly -- and has framed even modest achievements as major advances. And he has so far declined to clearly spell out his specific desires.

All were also hallmarks of his first major health-care fight, according to interviews with more than three dozen friends, adversaries and former colleagues. But with time running out to get something done this year, the president finds himself under enormous pressure to engage.

When he spoke on the floor of the Illinois Senate five years ago, Obama's 18 months of work had reached a critical juncture. In much the same way, his address to a joint session of Congress on Wednesday is a signal moment in a cliffhanger drama that could go either way.

A New Focus

The telephone on Jim Duffett's desk rang. It was a week after the 2002 elections, and Democrats in Illinois had taken control of the legislature. He picked up the phone and heard Barack Obama's voice.

Obama wanted to discuss health care with Duffett, the head of a liberal coalition advocating a single-payer health-care system in Illinois. Obama was about to become the chairman of the state Senate's health committee.

"He said: 'I want to do public hearings. I'm now the chair. I want to do public hearings on affordable, accessible, guaranteed access," Duffett recalled in an interview recently.

At that moment, they were a pair made for each other. But little in Obama's past had signaled that he would try to make health care his legacy.


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