Obama Plans Speech To Take Reins of health debate

 

Friday, Sep 04,2009, 9:03:06 AM   Click:

WASHINGTON_President Barack Obama will address important health care to Congress next week, opening an emergency push to regain control of the debate was to escape under withering Republican-led attacks.

Planning speech Wednesday night, just one day after the deputies return from their August break, underscores the determination of the White House to address the critical national priority Obama and morale of supporters who have been thrown on the defensive.

Unlike all the other rich nations, the United States lacks universal health care. Most health insurance is obtained through employers, and nearly 50 million of the 300 million Americans are without it.

Obama came to the presidency in January with almost unprecedented bipartisan popularity and strong backing for plan to make health care accessible to all Americans. But opposition has grown because of conservative attacks and liberal inability to counter them effectively.

Allies have been urging the president to be more specific about his plans and to take a greater role in the debate, and aides have signaled he will do that in the address to a joint session of Congress in the House chamber.

The speech's timing also suggests that top Democrats have all but given up hope for a bipartisan breakthrough by Senate Finance Committee negotiators. The White House had given those six lawmakers until Sept. 15 to draft a plan, but next week's speech comes well ahead of that deadline.

It follows an August recess in which critics of Obama's health proposals dominated many public forums. Approval ratings for Obama, and for his health care proposals, dropped during the month.

White House senior adviser David Axelrod told reporters Wednesday, "We believe this is the best way to kick off the final discussions, the final debate, and bring this thing to a close in a way that is meaningful."

Listeners to Obama's speech will have "a clear sense of what he proposes and what health care reform is not," Axelrod said. He declined to offer details of what the president might discuss.

Axelrod said earlier that all the key ideas for revising health care are "on the table," suggesting that Obama will not offer major new proposals.

But he may talk more specifically about his top priorities, and perhaps add details to pending plans, to save a high-profile initiative whose defeat would deliver a huge blow to his young presidency.

Obama has spoken forcefully for rules that would prevent health insurance companies from denying coverage based on an individual's health history and providing subsidies to low- and middle-income Americans to obtain health insurance.

Administration officials also have said a provision on end-of-life counseling sessions, part of a House Democratic bill, would likely be dropped from any final legislation. This summer, critics labeled the sessions "death panels," and while the notion was widely debunked, it still remained contentious and scared seniors.

Many advocates of sweeping health care changes _ which would include health coverage for virtually every American, greater competition among insurers and incentives to increase the quality of care instead of the number of medical procedures performed _ welcomed the president's more direct role. Obama and congressional Democrats clearly lost momentum during the August recess, they say, and the president's high profile and still-considerable personal popularity are needed to change the dynamic.

"He's got to get into the nitty-gritty and embrace very concrete proposals," said Ralph Neas, head of the National Coalition on Health Care.

Richard Kirsch, national campaign manager for the liberal advocacy group Health Care for America Now, said, "It's really clear they understand they have to provide more presidential leadership, more presidential direction."

Kirsch said Obama doesn't have to provide legislative language, but he must detail "the contours of the reform he needs."

It's far from clear that Obama's speech will satisfy grumbling liberals. For instance, he consistently has refused to insist on a government-run program to compete with private health insurers, a top goal of liberals, even though he says he prefers such an option.

Axelrod called the public option important, but stopped short of saying it was essential to a final bill.

Several lawmakers say Obama must convincingly show that he can reduce the cost of pending health care plans. Nonpartisan budget officials have said Obama's proposals could increase the federal deficit by about $1 trillion over the next decade.

Before Obama's speech to Congress was announced, two Republican senators who have been negotiating with Obama's Democrats on a way forward, Charles Grassley and Mike Enzi, indicated the talks would continue despite recent partisan rancor.