Obama prepares to try to reclaim lost ground in health debate — again

When President Barack Obama tries to salvage his healthcare agenda on Wednesday, it won’t be the first time.

Obama’s heavily anticipated address to a joint session of Congress comes just six weeks after the White House tried to reclaim the healthcare debate in a nationally televised primetime press conference.

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Obama also held three town halls in August that were supposed to give him momentum after conservative opponents took control of the healthcare debate by criticizing Democratic proposals and lawmakers at local town halls.

Now some of Obama’s allies in Congress say he needs to spell out his demands in this week’s joint address if he is to regain momentum he failed to gain from those earlier appearances.

“It can't just be the absence of the current system, which has been his main argument to date,” said Paul Light, a New York University professor and expert on the presidency. “He needs to provide a compelling portrait of just what kind of world he wants to create with his healthcare package.”

Obama made a conscious decision to stay on the sidelines of the debate through much of the year to allow Congress to move forward. This was an attempt not to repeat the mistakes of the Clinton administration, which was faulted in 1993 for writing a healthcare bill with too little congressional output.

But Obama has come under criticism himself for ceding too much ground to Capitol Hill, and for not showing more leadership.

On Sunday, senior advisers offered few details on what Obama would say.

White House press secretary Robert Gibbs insisted that Obama will “draw some lines in the sand” on healthcare, but refused to be pinned down on whether the White House sees a public insurance option as essential to healthcare reform.

On ABC’s “This Week,” Gibbs said the public option is a “valuable component” of health insurance reform. On NBC’s “Meet the Press,” White House senior adviser David Axelrod argued that the public option shouldn't consume the entirety of the debate over the health bill.

“He believes the public option is a good tool,” Axelrod said. “Now, it shouldn’t define the whole healthcare debate, however.”

In hindsight, it seems clear the president missed opportunities earlier this summer to take more control of the issue.

The July 22 press conference is best remembered for Obama stepping into another controversy by criticizing Cambridge, Mass., police for their arrest of Henry Louis Gates, a black professor at Harvard detained while breaking into his own home.

Few remember Obama’s comments on healthcare, which were cerebral and focused on policy minutiae. Obama’s approval ratings have dropped since the appearance.

Similarly, Obama failed to recapture control of the debate during his town halls, even when he used personal stories about his mother and grandmother to try to show he understood the problems of the system.

August has raised the stakes for Obama, particularly as a divide has grown within his own party over the importance of a public insurance option.

Obama will disappoint the left with anything but a firm insistence on it. At the same time, the White House has resisted making such statements, likely because it realizes the difficulty of moving legislation with a public option through both chambers of Congress.

The issue exploded after Health and Human Services Secretary Kathleen Sebelius on Aug. 16 said the administration did not see a public option as an essential element to reform. Liberals do see it as essential and are worried the White House is caving to pressure from Republicans, whom the left believes are more interested in injuring the president than finding a compromise.

Republicans argue the public option would cripple private insurers, and centrist Democrats in the House and Senate are wary of voting for legislation that includes it. It’s unclear whether enough votes can be won for a bill in the Senate that includes a public option.

But in the House, legislation may not move without a public option, given the widespread support for it on the left. Speaker Nancy Pelosi (D-Calif.) this week repeated that a public option will be included in a House bill.

Over the last week, the White House has reached out to GOP centrist Sen. Olympia Snowe (Maine), who favors including a “trigger” in legislation that would kick in a public option if private insurers do not hit certain benchmarks. The idea has been criticized by members of both parties, and MoveOn sent an e-mail to its membership on Saturday criticizing it.

The trigger, MoveOn said, “is a trap to kill healthcare reform.”

“Even if the 'trigger' conditions are met years from now, big insurance companies will start the fight all over again to stop the public option from going into effect,” the e-mail read.

Given the fact that neither the House nor Senate has approved a healthcare bill so far, Obama will have to keep some of his cards off the table Wednesday even as he tries to use his bully pulpit to change the debate and spark some momentum.

Axelrod said as much Sunday in previewing the address. He said Obama on Wednesday will say “we agree on 80 percent of this ... let's do the final 20 percent, let's get the job done, and here's how I think we should do it.