Barack Obama has reached the put up or shut up moment of his presidency—and he appears to get it. His Labor Day speech was described as feisty; he even trotted out that old “fired up” anecdote. No doubt he’ll come on strong in addressing Congress tonight, too. But here’s what Hillary Clinton got right during the primary campaign: breaking the grip of entrenched special interests like the health care industry will take more than inspiring words. From here forward, meaningful health reform will demand the president engage an ugly, old-fashioned Beltway showdown over who's really in charge—the president or the band of senators he’s thus far made into little kings.

Never mind the absurdist controversies-of-the-week, from Van Jones to Obama’s schools speech. It’s all beside the point right now. And never mind the so-called Gang of Six (or however many of them can still credibly claim to be working on a bipartisan bill). They aren’t the point either. All that matters now is presidential leadership. Obama must either spend his still ample political capital to shove a meaningful health reform bill through the Senate or sacrifice his reformist-in-chief mantle.

Judging from Sen. Max Baucus’ afternoon press conference, the White House has in fact begun muscling up. After allowing Baucus to hold the conversation hostage for months, the White House has clearly told Baucus his GOP-wooing gig’s up. The Montana senator declared today that his Finance Committee will roll out a bill next week, with or without Republican support. There is, however, reason to believe Baucus and the White House still hope to win over Maine Republican Olympia Snowe—which is why Baucus’ bill will not include a public option.

Politico’s Mike Allen reports that Obama won’t demand a public option tonight, either. Allen writes,

President Barack Obama plans to give a strong endorsement of a public option – or government health-insurance plan – in his remarks to Congress on Wednesday night but will stop short of an ultimatum, leaving wiggle room for negotiation as the bill moves through Congress, according to sources familiar with his remarks.

Meaning Obama’s not planning to change his negotiating tack, but rather aims to wrest control of the public discussion after a chaotic August.


Josh Marshall and Brian Beutler at Talking Points Memo have been piecing the administration’s moves together and point to this end game: Get a bill that includes a public option, but one that kicks in down the road only if private insurers don’t meet certain reform goals—namely, reducing costs and covering more people. That’s a bill Snowe appears ready to join, allowing a win-win inside the fractured Democratic caucus—progressives get to claim a public option and conservatives can tout a bipartisan compromise on the 2010 campaign trail. House Speaker Nancy Pelosi sounds ready to live with this as well.

So if momentum’s building toward a delayed-onset public option—and the idea makes a good deal of political sense, at least—get ready for the next raging debate: What’s the standard for triggering the public option? And how long do private insurers get to prove their mettle?

As public policy goes, the so-called “trigger” mechanism is nonsense. If private insurers were willing or able to reduce costs and cover everybody on their own they would have already done so. That’s how the health-reform cat got out of the bag on them in the first place. The real fight, then, will be to make sure industry lobbyists don’t de-claw reform by making it ridiculously difficult for the public option to kick in. As former Clinton Labor Dept. chief Robert Reich put it, "Washington is a vast cesspool of well-paid specialists who know how to stop anything resembling a 'trigger.' Believe me, they will."


Which brings us back to Obama’s put up or shut up moment.

There’s little reason to doubt Obama will make the politics of this thing come out right—a bill will pass, he’ll be able to call it an historic victory and the Democrats will be set up to pound Republicans as obstructionist crazies in 2010. The bigger question is whether Obama will manage real reform. It’s entirely achievable, more so now than perhaps ever before. But we will get it only if Obama stands up to the bullies that have thus far kept him running scared: conservative Democratic Senators and the health industry's deep-pocketed lobby. Neither will stop working to brand the status quo as change. So will Obama do the job we hired him for and knock them out of the way of change we can believe in?