Obama seeks to close the deal on healthcare reform in new year

President Barack Obama’s role in healthcare reform will change from cheerleader to closer in the coming weeks.

Obama, who has largely deferred to congressional leaders on healthcare reform, is expected to play a major role in ironing out differences between the House and Senate in order to sign a bill early next year.

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House and Senate Democrats have already started to play the leverage game, with both factions pointing out they have little to no ground to give. The House passed its version 220-215, while Senate Majority Leader Harry Reid (D-Nev.) needed to convince every member of his conference to overcome a 60-vote legislative hurdle on Monday morning.

While the White House has repeatedly insisted that Obama has been very involved in the evolving legislation, many Capitol Hill Democrats have said the president needs to do more.

During a Monday interview on MSNBC’s “Morning Joe,” Rep. Elijah Cummings (D-Md.) called on Obama to play a defining role in the conference discussions to ensure that a public option is included in the final bill.

Yet Obama’s strategy of allowing the lawmakers to legislate has yielded results; Congress is closer to overhauling the nation’s healthcare system than it ever has been.

White House aides, including Rahm Emanuel, Phil Schiliro and Nancy-Ann DeParle, have been actively involved in the knock-down, drag-out process, even as they acquiesced to lawmakers on legislative details.

Still, over the next several weeks, Obama's team behind closed doors will probably have to take a clearer position on specific provisions if the White House hopes to find a finished product palatable to both chambers.

But White House press secretary Robert Gibbs said on Tuesday that Obama's role will not change as the legislation moves to conference.

"The president and his team will continue to play the role that they have throughout this process, and that is working with leaders in the House and the Senate, discussing with them policy options," Gibbs said.

Gibbs said the role the president "and his team have played up to this point has gotten us to the point where, in all honesty, healthcare is not a matter of 'if.' Healthcare reform now is a matter of 'when.'"

He dismissed the criticism of some Democrats who have said that Obama has been too hands-off during the process.

"He's been criticized for being too active and over- — you know, the one thing the president has resolved in the new year is not to let any of the criticism bother him," Gibbs said.

Aside from the public option, the White House will need to referee House/Senate differences on abortion, immigration and tax increases, among many other issues.

Ross Baker, a professor at Rutgers University and an expert on the presidency, said Obama’s role will end up being more healer than arm-twister, noting that the conference will almost certainly have to adopt most of what the Senate has adopted.

Though Rep. Dennis Kucinich (D-Ohio) is the only progressive in Congress to formally reject the House or Senate healthcare legislation, many liberals are fuming and threatening to reject what comes out of the House-Senate talks.

They were outraged by heavy restrictions on abortion that were included in the House bill, and the Senate’s rejection of a public option has increased their ire.

House leaders have stressed they will not take up the more centrist Senate legislation, but it is hard to envision the conference bill making a major move to the left.

Given the difficulty of winning 60 votes in the Senate, liberals are unlikely to win concessions on these issues in a conference. That means Obama and his aides will have to convince them that what is left of their hopes for healthcare reform is worth moving.


Obama's chief task will be “assuaging the hurt feelings” of liberals, Baker said. “I think he's got to be prepared to act in his pastoral role,” he added.

The president has already been playing that role, to a degree.

In recent months, Obama has not drawn a line in the sand on the public option, nor on other hot-button issues. Instead, he has implored Democrats to unite and focus more on the end result of covering the uninsured and less on the means of how to do it.

On Monday, he emphasized the inclusion of a patients' bill of rights in the Senate legislation and described the early-morning procedural vote to move it forward as historic.

Speaker Nancy Pelosi (D-Calif.) saved the public option from dying this summer, though at a press conference last week, she did not insist on it being in the final measure.

“Our priority on the public option, the emphasis was not on ‘public,’ ” she said. “The emphasis was on ‘option,’ on ‘something other than.’ ”

Pelosi has also shown a willingness to bow to centrists in order to move healthcare reform.

In order to attract votes in the House this fall, Pelosi at the last moment discarded a more liberal public option and allowed a vote on an anti-abortion amendment, which passed easily.

Reid has also shown a willingness to change the Senate bill to seize political momentum.

Just over the past two weeks, he jettisoned the public option and scrapped a Medicare buy-in proposal touted by liberals in order to win support from centrists such as Sens. Joe Lieberman (I-Conn.) and Ben Nelson (D-Neb.).