Obama's Health Bill Success Eclipses Presidents Past

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The president left for his Hawaiian holiday vacation with a hard-fought victory in his pocket. On a party-line vote, the Senate approved legislation to overhaul the nation's health care system. The bill must be reconciled with the House version, but still, this president has gone further than any of his predecessors on health care.


And today, President Obama said this about the challenge that lies ahead.

BARACK OBAMA: We are now incredibly close to making health insurance reform a reality in this country. Our challenge then is to finish the job. We can't doom another generation of Americans to soaring costs and eroding coverage and exploding deficits.

SIEGEL: The president observed that seven presidents before him, Democrats and Republicans, have pushed for broader access to health care and failed. His effort, while not a done deal, has gone farther than any of his predecessors.

Joining us to talk about what this means for President Obama and what it has cost him is NPR's Mara Liasson. Mara, a big win for the president.

MARA LIASSON: It's a huge win for the president, Robert. He staked a lot on this. This was his top domestic priority. As he said, this was the biggest piece of social legislation passed since Social Security. If he hadn't passed this bill, the damage to him is almost immeasurable.

SIEGEL: What does he do now to help push this bill toward final passage?

LIASSON: Well, first of all, his staff works closely with the leadership in the House and Senate as they try to reconcile the two versions of the bill. But also the president himself gets out there and sells health care reform. Now there's specifics that he can talk about.

The White House believes that they have a chance to turn these polls around. Right now the legislation is very unpopular. They say, well, Medicare also was unpopular when it first passed. And the president believes that there's a lot in the bill that people will like if they can learn about it, like insurance reforms, the ban on denying coverage for pre-existing conditions, portability. So he's going to have a big, big selling job.

SIEGEL: So 2009, looks like it'll end with the big win for President Obama. When you look back at the entire year, first year of his presidency, how did he do?

LIASSON: Well, compared to other presidents' first years, he put a lot of points on the scoreboard. He passed a lot of legislation and he kept his coalition together, despite a lot of fractures and tensions. But he had to spend a lot of political capital to do it. He had a more precipitous fall in public approval ratings than any other president, partially because he started to so high and expectations for him were so inflated. But he does end the year with his approval rating under 50, and that's a problem.

SIEGEL: Now comes an election year, with all of the House and a third of the Senate up. His approval ratings have dropped in some polls below 50 percent. He is not as popular, certainly, as he was when he was on the ballot a year ago. How does ha avoid big losses for the Democrats in November?

LIASSON: Well, first of all, he tries to get his approval rating back up above 50, because that's a very important indicator of how a president's party does in the midterms. But also, he's not going to make his party walk the plank anymore on tough votes like cap-and-trade. He's also going to make a hard pivot, as they say in the White House, to a more exclusive focus on jobs and the economy. He wants to lay out a credible plan for reducing the deficit, not necessarily doing anything to reduce the deficit until the economy gets better, but having a credible story to tell on the deficit.

The White House believes that should help him get independents back. Independent voters deserted the Democrats in droves in the off-year elections this November. And I also think just working with his party to focus on jobs, to focus on things that people really care about, that's what the White House is going to be doing the try to mitigate their losses next November. They know they're going to take some. They just want to keep them as small as they can.

SIEGEL: And you don't expect to vote on cap-and-trade between now and the November election.

LIASSON: Everything that I'm hearing sounds like it's highly unlikely.

SIEGEL: Thank you, Mara. That's NPR's national political correspondent, Mara Liasson.

LIASSON: Thank you, Robert.

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