Obama to begin full-court press on health care

WASHINGTON — Six months into his presidency, Barack Obama may have no greater test of his ability to translate personal popularity into a successful legislative agenda than the upcoming two weeks.

With skepticism about the president's health-care overhaul effort mounting on Capitol Hill — even within his party — the White House has launched a new phase of its strategy designed to dramatically increase public pressure on Congress: all Obama, all the time.

Senior White House aides promise "an aggressive public and private schedule" for Obama as he presses his case for change, including a prime-time news conference Wednesday, a trip to Cleveland and heavy use of Internet video to broadcast his message beyond the reach of traditional media.

"Our strategy has been to allow this process to advance to the point where it made sense for the president to take the baton. Now's that time," senior adviser David Axelrod said. "I don't know whether he will Twitter or tweet. But he's going to be very, very visible."

Another senior White House aide added: "It's time to raise the stakes on this."

But even as Obama returns to full-time campaign mode, he is facing increasing calls to show that his presidency can manage the tough, nitty-gritty of lawmaking by cutting deals with his allies to keep health-care legislation moving in the House and Senate committees.

Conservative Democrats in the House are promising to vote against the legislation as it now stands and are preparing two dozen amendments, including measures aimed at lowering the effort's long-term cost. In the Senate, members from both parties are urging the president to break his campaign promise to preserve the tax-free status of health benefits. And a chorus of weary voices from Capitol Hill is urging him to abandon his demand for passage of bills in the House and Senate by Aug. 7.

"I don't think we should be bound by a timetable that isn't realistic," Sen. Olympia Snowe, R-Maine, a key swing vote on health care, told Obama last week as she reminded him that President Johnson took 1-½ years to pass Medicare.

Obama has not officially budged on the timetable, although he and aides notably have failed to note the August deadline in recent remarks. But Obama is working quietly with conservative, Blue Dog Democrats in the House on an amendment to create an independent panel to govern Medicare reimbursement rates that could help reverse crippling health-care inflation.

Most difficult for Obama is the pressure to accept a tax on health benefits as a way of financing the massive insurance reform he wants.

Speaking on "Fox News Sunday," White House budget director Peter Orszag would not rule out support for the benefits tax, but he continued to promote Obama's preference for limiting deductions for wealthy taxpayers.

Some Democrats close to the negotiations say they think it is only a matter of time before Obama backs off. One proposal that has emerged would tax insurance companies, as opposed to beneficiaries, and is considered a potential compromise approach that Obama may be able to embrace.

Aides said Obama and his team plan a rapid response to new developments, as they did Thursday with a quickly arranged conference call to rebut claims by the Congressional Budget Office that health-care costs would go up, not down, if the Democratic bills pass.

The effort began Friday with impromptu remarks by Obama from the Diplomatic Room even as groups allied with the White House launched political-ad campaigns over the weekend aimed at wavering lawmakers. Today, his advisers say, he will do a round of interviews to drive the narrative for the week. Private meetings with lawmakers will become more frequent and urgent.

The decision to vault Obama to the front carries huge risks.

The decades-long drive to overhaul the health-care system now rests largely on Obama's ability to quell revolts among his Democratic allies, many of whom have spent the past several weeks picking at pieces of his proposals.

If conservative House Democrats succeed in sowing fear of rising deficits, it will be seen as Obama's fault that he could not reign them in. If Democrats in the Senate fail to agree on financing, Obama must explain the failure despite his party's majorities in both chambers.

Obama's top strategists — including Axelrod and chief of staff Rahm Emanuel — have repeatedly defended the administration's ambitious agenda by saying success breeds success — each legislative victory makes the next one easier to accomplish, they insist. The flip side, then, is that a health-care failure could doom the rest of Obama's agenda.

Obama's advisers express confidence that the setbacks of the past week can be overcome, and they insist they have spent "no time" discussing the impact on Obama's political fortunes if health-care legislation fails to pass this year.

"We don't do doom and gloom," Axelrod said.

But top advisers also recognize that the sense of optimism about health-care policy that existed in Washington several months ago has largely evaporated.

Cable news programs now repeatedly declare the president's health-care program "teetering" or "embattled," despite a week in which Obama's proposals were endorsed by the doctors and nurses associations and committees in both legislative chambers passed major bills.

"We're swimming upstream against a culture of failure on health care in Washington," said one adviser who spoke on the condition of anonymity to discuss administration strategy.

The White House decided early in the year that it would take a hands-off approach to health-care legislating.

"Had we put a plan out, the entire debate would have been changes to the plan," said Emanuel, a veteran of the Clinton administration's failed health-care battle. "It would have been how the president is failing or succeeding."