It’s clearly crunch time on health care debate: The White House has announced that president Barack Obama will address a special joint session of Congress next Wednesday evening on the issue of health insurance reform. The State of the Union notwithstanding, there is no real precedent for this kind of single-issue major speech (Lyndon Johnson spoke to Congress about race in 1964, Bill Clinton on health care in 1993, and George W. Bush gave one after 9/11). The president can’t just stroll up to Congress, either–at the administration’s request, House Speaker Nancy Pelosi and Senate Majority leader Harry Reid explicitly invited Obama to make remarks.
It’s easy to see how it came to this. Team Obama has tried just about every other avenue for getting their message about affordability and coverage to the American people–seven town halls, one primetime press conference (hijacked by Gates-gate) and countless events around the country through Organizing for America–and nothing seems to have stuck.
Now, as with several tough moments during his presidential campaign, Obama seeks to solve the problem with a speech.
Of course, the White House believes generally in the strength of Obama’s oratory. But the policy position the president might actually articulate is still in the trial balloon stage. Advisers and speechwriters are saying the president will be very specific about what he wants done, enumerating not just broad desires but a clear case for reform, and discrete requirements for any bill that hits his desk.
In theory, this will be helpful to Democratic Congressional leaders now struggling to defend three different visions of reform from three different House and Senate committees. But Congress, like the rest of the country, might have to wait until Wednesday to get a clear signal. Reports of the current state of deliberations in the executive branch split it into two camps. From Ezra Klein:
The first camp could be called “universal-lite.” They’re focused on preserving the basic shape of the bill. They think a universal plan is necessary for a number of reasons: For one thing, the insurance market regulations don’t work without universality, as you can’t really ask insurers to offer standard prices if the healthy and the young don’t have to enter the system. For another, it will be easier to change subsidies or improve the benefit package down the road if the initial offerings prove inadequate. New numbers are easier than new features. Creating a robust structure is the most important thing. This camp seems to be largely headed by the policy people.
The second camp is not universal at all. This camp believes the bill needs to be scaled back sharply in order to ensure passage. Covering 20 million people isn’t as good as covering 40 million people, but it’s a whole lot better than letting the bill fall apart and covering no one at all. It’s also a success of some sort, and it gives you something to build on. What that sacrifices in terms of structure it gains in terms of political appeal. This camp is largely headed by members of the political team.
As usual in Washington, it’s politics versus policy. I think the policy outcomes are likely to be an improvement over the disgraceful status quo no matter what. And that rumors of a plummeting executive approval rating and dire consequences for Democrats in 2010 are a bit overblown. The Wednesday speech, like the whole health care debate, will be far less about the American people and more about Congress. Still, there’s no doubt passing a health care bill is of paramount importance to the political arm of the White House. As one senior official told the NEW YORK TIMES: “It’s so important to get a deal… He will do almost anything it takes to get one.”
I doubt that’s really the best way to negotiate with conservative Democrats in the Senate or with reform-minded Republicans like Sen. Olympia Snowe. But Obama is sticking to the line he whipped out after his first debates with Sen. John McCain in 2008: “Just give me the ball.”