At Last, Firing Back on Health Reform

Thursday, September 10, 2009

After a listless summer during which his opponents dominated the health-care debate, President Obama used a dramatic appearance before Congress on Wednesday to seize control of the autumn, the season of decision for the initiative he has turned into the central test of his presidency.

Having avoided specifics in order to give the House and Senate room to legislate, he piled on the details, openly battling the "blizzard of charges and counter-charges," out of which, he said, "confusion has reigned."

It was a speech designed to clear the air by sweeping aside misconceptions about what he was for, reassuring senior citizens about the future of Medicare and insisting that the alternative to reform was a steady deterioration in the coverage Americans enjoy.

He also hit back hard against distortions and outright lies. "Instead of honest debate, we have seen scare tactics," Obama declared. "Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge."

By joining specifics, a powerful moral argument and an unapologetic defense of government's role in promoting social justice, the president sought to rescue the health-care debate from the mire of a congressional system that has encouraged delay and obstruction. By putting himself on the line, he sought to restore his reputation for political mastery and to rekindle some of the magic he had conjured during a presidential campaign built on the expansive themes of change and hope.

He offered a robust defense of a "public option," which would give the uninsured a government-backed alternative to private coverage. But he insisted that the public option had come to play too large a role in the health-care debate, suggesting he would accept alternatives such as a "trigger," which would bring the option into being only if private insurance companies failed to provide sufficiently affordable policies.

Obama's target audiences were diverse: liberal activists and members of Congress, moderate rank-and-file voters, and a few Republican senators -- above all Sen. Olympia Snowe of Maine, his most likely ally in a party that has broadly rejected his overtures.

In the past month or so, Obama has seen the first signs of rebellion on a left that believes its support has been taken for granted. The administration's failure to share the left's view of the public option as the centerpiece of reform turned a dry policy idea into a potent symbol and a rallying point for progressive disgruntlement.

So the president sought to revive the enthusiasm of his base by insisting that his principles, including his belief in the public plan, remained intact and that any compromises would be undertaken with an eye toward advancing his, and his base's, larger purposes.

Invoking the memory of Edward M. Kennedy's lifelong commitment to the quest for universal coverage, he sought to persuade progressives that it would be a catastrophic mistake to lose a chance to achieve a central liberal purpose first voiced by Theodore Roosevelt.

To moderate voters, he argued that the whole point of change was to respond to their criticisms of America's way of delivering health care. The summer assaults had led many Americans to worry about what they could lose from health-care reform and how much it might cost. Obama reminded them of what they had to gain.

Reform would end the "arbitrary cap" on lifetime coverage and limit out-of-pocket expenses. "It will be against the law for insurance companies to deny you coverage because of a pre-existing condition," he said. "As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most."

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