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In St. Louis area, Obama pounds drum for health-care initiative

By Scott Wilson
Thursday, March 11, 2010; A03

ST. CHARLES, MO. -- President Obama made an impassioned case Wednesday for his health-care proposal, delivering a folksy, partisan argument for reform as industry groups prepare a multimillion-dollar advertising campaign to defeat it.

Stripping off his suit jacket and pushing up his sleeves within minutes of entering a stuffy high school gym in this St. Louis suburb, Obama criticized his Republican opposition, Washington's wasteful spending and rising insurance premiums. He spoke with evident anger about "political gamesmanship" in Washington leading to "terrible consequences," as he evoked the outsider's message that he delivered successfully in his 2008 campaign.

"Congress owes America an up-or-down vote," he said over raucous applause, which greeted his remarks at several points. "The time for talk is over. It's time to vote."

Obama's appearance at St. Charles High School was the most visible element of his endgame strategy to push through health-care legislation. Unfolding inside and outside the Capital Beltway, the effort is designed to revive the sense that passage is inevitable, a feeling that evaporated when Democrats lost their filibuster-proof Senate majority in January. One senior administration official described the final phase as "working both sides of the street."

A populist message

Obama is visiting media markets that touch multiple congressional districts, particularly in swing states such as Missouri and Pennsylvania, which he visited earlier this week. He might head to Cleveland early next week for a town hall-style appearance to discuss health care, White House aides said Wednesday.

The president is delivering to his audiences a sharply populist warning that doing nothing about the health-care system would reward the insurance industry and Wall Street investors, easy targets in communities anxious about the economy. He is also calling on the public to make its opinion known to members of Congress as he works to secure enough House votes to pass the measure before he leaves the country late next week.

Wavering Democrats

At the same time, Obama intends to lobby wavering House Democrats to vote for a Senate version of the legislation and to support the subsequent reconciliation process, which Republicans have characterized as an unjustified use of majority power. Among the rewards Obama is ready to offer, White House officials said, are election-year visits to competitive congressional districts, where a presidential appearance can bring in hundreds of thousands of dollars in campaign funds.

"The president has breathed some new life into this effort," said Dan Pfeiffer, the White House communications director. "The opportunity to get this done exists, but it won't last forever."

For much of the past year, the White House health-care strategy revolved around maintaining momentum behind the politically vulnerable initiative. The effort faltered, though, as Republican critics convinced more and more Americans that it was an unwieldy and expensive government intrusion. When Democrats lost a special election in Massachusetts, and with it the Senate supermajority, the health-care bill appeared moribund.

But late last month Obama introduced his own 11-page health-care proposal. He then followed it up with a seven-hour televised work session with Democratic and Republican congressional leaders, indicating at its conclusion that he would do whatever it takes to pass a bill.

"We will continue this momentum, as you've seen in the last few weeks," said Rahm Emanuel, the White House chief of staff. "And we must keep people focused on the price of failure."

In recent days, Obama has reduced his argument to a simple campaign-style choice with a clear set of campaign-style opponents, namely insurance companies, a recalcitrant Republican opposition and a Washington political culture he campaigned against in 2008.

As he did in suburban Philadelphia earlier this week, Obama framed the debate in his 35-minute speech in St. Charles as a choice between doing something about the health-care system or leaving it unchanged, even as insurance companies announce double-digit rate increases.

"I don't believe we should give either the government or the insurance companies more control over health care in America," Obama said. "I want to give you more control over health care in America."

His visit to Missouri, a state he lost in 2008 by less than one percentage point, came against a backdrop of mounting industry opposition to his proposal.

The U.S. Chamber of Commerce has announced a $10 million advertising campaign opposing Obama's proposal. Demonstrators in St. Charles displayed signs reading "Health Care Strictly a Power Grab."

A senior administration official said the advertising effort "validates our argument that the bill is good for American families and not necessarily good for the insurance industry."

'This gets harder'

But the official, who spoke about internal White House strategy on the condition of anonymity, said the gathering opposition from the chamber and other groups "should be a warning sign to members of Congress."

"This gets harder and not easier as time goes by," the official said.

White House press secretary Robert Gibbs told reporters Tuesday that Obama had not made any phone calls to undecided lawmakers so far this week. Obama planned to meet at the White House on Thursday with the Congressional Black Caucus and the Congressional Hispanic Caucus in separate sessions on health-care legislation.

"We are not backing down, we are not quitting St. Charles, and we are going to get this done," Obama concluded. Then he waded into the cheering crowd to shake scores of hands.

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