Obama Pushes Congress To Work On Health Care

President Obama is back from his overseas trip and ready to begin a major push for health care legislation. The president wants lawmakers to start voting on it before they go on break in August. He would like a bill on his desk by November.

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Shortly after he took office, President Obama told Congress that this is the year for revamping health care. He wants an achievement this year that has eluded Democratic presidents since the 1940s.

INSKEEP: The president is hoping that Congress will start voting before it takes its August break. That's just weeks away. He's hoping to have a bill on his desk by November. NPR national political correspondent Mara Liasson reports on a president who is trying to slip through the window before it closes.

MARA LIASSON: This week, two Senate committees begin wrestling with the details of a health care overhaul, and the president plans to pitch in with speeches and town hall meetings. Last week, he told a group of Democratic Senators that health care is something they can't afford to put off.

President BARACK OBAMA: This window between now and the August recess, I think, is going to be the make or break period. This is the time where we've got to get this done.

LIASSON: Mr. Obama is also trying to instill a sense of urgency in his grassroots army of supporters with email messages to the 13 million people on his list.

Unidentified Woman: Pardon the interruption, sir. This is the Air Force One operator. I have President Obama online.

LIASSON: Supporters were invited to click a button on the email and link to what's described as an incredible moment, a phone call from the president himself on board Air Force One, urging them to help him push health care over the finish line.

Pres. OBAMA: We got to have you knocking on doors, making calls, educating your neighbors.

LIASSON: But why the big rush? Especially since Congress hasn't even written the health care bill yet. Stuart Altman, a professor of health policy at Brandeis University, says there are good reasons for the president to push the process as hard as he can.

Professor STUART ALTMAN (Health Policy, Brandeis University): If you don't get this done fairly quickly in a president's first term, it becomes very hard. We had this experience with President Clinton. He let it drag on much too long, and by the time he tried to get it done, too many of the forces were against it.

LIASSON: So the lesson for this new president is do it early while you're at the height of your political powers, and do it fast before opposition builds. But over the next seven weeks, there are a lot of big issues to resolve. The president has agreed with Congress that there should be an individual mandate to buy health insurance, with hardship waivers for poor people and small businesses. But there's no agreement on whether there should be a publicly run insurance plan to compete with private plans. Stuart Altman.

Prof. ALTMAN: We have never had that before, nor have any other country. So this is a very new concept, and is very controversial.

LIASSON: The president wants a public plan. So do liberal Democrats and Congress. But moderate Democrats and Republicans do not. Neither do health insurance companies and a lot of health care providers. Then there's the equally difficult problem of paying for the plan, which could cost more than $120 billion a year. The president has told lawmakers he's open to limiting the tax break for employer provided health insurance, even though he slammed John McCain for a similar proposal during the campaign. But if you tax those health benefits, it's almost impossible to raise enough money without raising taxes on people making less than $250,000 a year. And that's something else the president said he'd never do.

Pres. OBAMA: We've made a clear promise that families that earn less than $250,000 a year will not see their taxes increase by a single dime.

LIASSON: That's Mr. Obama on April 15th, repeating the promise he made during the campaign. The pledge seams pretty iron-clad, but when asked about this, his top political advisor David Axelrod is a little squishy, describing the president's commitment not as a read-my-lips promise, but as something more aspirational.

Mr. DAVID AXELROD (Top Advisor to President Barack Obama): Our goal is to do it in a way that it doesn't add to the burdens of the middle class.

LIASSON: Political analyst Norm Ornstein at the American Enterprise Institute thinks that if taxing employer-provided health benefits is the only way to get a health care bill, President Obama is unlikely to let his pledge stand in the way.

Mr. NORMAN ORNSTEIN (Political Analyst, American Enterprise Institute): In the end he's going to make a judgment about what's more important: one campaign promise, or achieving something grand in a major policy area.

LIASSON: But veterans of the health care wars say achieving something grand is far from inevitable, even though the Obama White House has been very skillful at developing a good head of steam behind the health care overhaul this year. Stuart Altman.

Prof. ALTMAN: I've been doing this for a long time. I worked for the Nixon administration. I was involved with the Clintons. We've been debating this since Harry Truman won the presidency. And we ultimately get right down to it where the winners, those of us who have good insurance, begin to look at it and say am I prepared to give up so much for those that need this benefit? And in the past, we've ultimately said no.

LIASSON: And now, President Obama, who ran on the audacity of hope, will see if this time hope can triumph over experience.

Mara Liasson, NPR News, Washington.

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