Obama will try to salvage U.S. health care bill

Wednesday, January 27, 2010 | 4:52 p.m. CST

WASHINGTON — President Barack Obama had hoped a historic victory on health care would be the centerpiece of his State of the Union speech Wednesday. Instead, he will be appealing to jittery Democrats to save what was once his top domestic initiative, now stalled in the U.S. Congress.

The loss of their 60th Senate seat in a Massachusetts special election last week cost Democrats their ability to override Republican opposition in Congress, leaving them with no clear path to finish Obama's sweeping health care bill when it was on the verge of passage.

Before the election, Democrats in Congress and at the White House were envisioning the ultimate Washington photo-opportunity: a beaming president striding into the House chamber to give his speech following a final vote to pass health care overhaul.

"That didn't happen," said Rep. George Miller, a Democrat and one of the authors of the House bill. "That's the legislative process."

Although Miller thinks Democrats will, in the end, pull together and pass comprehensive legislation to expand coverage to millions of uninsured Americans and try to control costs, other lawmakers worry they will have nothing to show voters in November for more than a year of grueling work. They want Obama to restore the sense of open-ended possibilities that accompanied his election.

"The president is a strong persuader, and I think it makes an awful lot of difference, and I think he will bring everybody together," said Rep. John Larson, a Democrat. "Obama's gotta be Obama."

Until now, Obama has not been able to make a convincing case that the 2,000-page Democratic bills will improve the lot of average working families already covered by health insurance.

The president previewed his message last week in the recession-weary state of Ohio, when he told an audience of workers and business people it is not possible to deliver popular reforms such as eliminating insurance denials for pre-existing medical problems unless nearly all Americans are covered. The U.S. would be better off with a big bill that makes deep changes in the health care system, he argued, rather than scaled-back legislation which borrows from a menu of political consensus items.

White House communications director Dan Pfeiffer told congressional staff that Obama will use his speech to recommit to an ambitious health care remake, similar to the vision he outlined last September after critics seized the momentum during a summer of angry political meetings. There will be some new specifics on his health care goals, but lawmakers do not expect a detailed blueprint for breaking the legislative impasse.

The leader of the House, Speaker Nancy Pelosi, a Democrat, said Wednesday that giving up is not an option. "I don't see that as a possibility," she said. "We will have something."

It might not be the $1 trillion, 10-year bills that House and Senate Democrats have passed, which would provide coverage to more than 30 million Americans who would otherwise be uninsured, and make hundreds of changes affecting hospitals and doctors, seniors and business owners.

Neither of two remaining routes to get legislation on Obama's desk are easy. One involves Senate Democrats using a special budget-related procedure that requires only 51 votes to make changes in the bill acceptable to the House. Two centrist senators have already said they would oppose the maneuver. Such a move would be certain to enrage critics of the legislation.

The other solution would be to lower expectations and pass a bill that might attract support from Republicans and political independents. It would not come close to covering all Americans, but it could smooth some of the rough edges of today's coverage problems, and provide help for small businesses to get and keep health insurance. Republicans, however, are unlikely to help.

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