Health Care Bill Returns From The Dead

Not so long ago, the health care bill was dead and the Obama presidency was badly hurt by it. Not anymore. On Tuesday, President Obama will sign into law a health care law nearly a century in the making. NPR's Mara Liasson looks at how the bill was resurrected and how the president sells it from here.

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Not so long ago, it looked like the Democrat's health-care ambitions were dead, and that the Obama presidency would be badly hurt by the loss. Well, no more. Tomorrow, President Obama will sign into law a health-care overhaul nearly a century in the making. Republicans insist the bill will hurt average Americans, but the White House says otherwise.

NPR's Mara Liasson looks at how the bill was resurrected, and how the president sells it from here.

MARA LIASSON: The health-care bill that achieved final passage in the House of Representatives last night had so many near-death experiences that this morning, top White House aides like Nancy-Ann DeParle, the director of the president's Office of Health Reform, are marveling at all that's happened over the past 14 months.

Ms. NANCY-ANN DEPARLE (Director, Office of Health Reform): Yeah, there were a couple moments when I thought it might not happen. One was after the Massachusetts election; that would be the most recent one.

LIASSON: That was a big one. Republican Scott Brown shocked the Democrats by winning the late Ted Kennedy's Senate seat, and he did it by campaigning against the health-care bill.

Senator SCOTT BROWN (Republican, Massachusetts): One thing is very, very clear as I travel throughout the state: People do not want the trillion-dollar health-care plan that is being forced...

(Soundbite of crowd)

Sen. BROWN: That is being forced on the American people.

LIASSON: Brown became the 41st Republican senator, denying the Democrats a filibuster-proof majority. As DeParle remembers it, the White House, just about to finally finish the bill, was knocked back on its heels.

Ms. DEPARLE: We had spent two weeks working, you know, night and day with House and Senate staff, and the president in the room leading the charge towards merging the two bills. And a lot of energy, a lot of emotion, a lot of, you know, investment in that product, that would require 60 votes in the Senate. And realizing that we probably couldn't get 60 votes in the Senate, so how would we go forward?

LIASSON: Right after Massachusetts, the president seemed to suggest he was willing to scale back his ambitions. And there was talk in the White House about a skinny bill. But that idea was abandoned quickly, and President Obama returned to his original goal: bold, comprehensive reform. He took personal control of the legislation for the first time, and issued his own plan. And he went into high gear.

There was the bipartisan summit at Blair House, 94 one-on-one conversations with wavering Democrats, and a last minute executive order on abortion that pushed the bill over the finish line yesterday. There was also a grassroots campaign, overshadowed at times by the louder voices of the opposition. But White House officials from the president on down say its support helped keep the Democrats in the hunt for votes.

President BARACK OBAMA: To the untold numbers who knocked on doors and made phone calls, who organized and mobilized out of a firm conviction that change in this country comes not from the top down but from the bottom up, let me reaffirm that conviction. This moment is possible because of you.

LIASSON: But this wasn't the way it was supposed to be. The process took so much longer than expected, the delays and missed deadlines were nearly fatal. The public was disgusted by the parliamentary maneuvers and the special deals. Although at the time, the deals for individual lawmakers seemed necessary to get the votes, DeParle agrees, their net effect was damaging.

Ms. DEPARLE: I think the president's been clear that he would've preferred not have them in there. He asked them to take them out.

LIASSON: Now, President Obama will try to reverse the public's negative opinion of the health-care bill. He'll take a victory lap that's really a sales campaign. While Republicans mount an effort to repeal the bill, calling attention to its new taxes and fees, the president will focus on those popular elements of the bill that go into effect right away, like a prohibition on insurance companies denying coverage to children with pre-existing conditions.

Pres. OBAMA: So this isn't radical reform, but it is major reform. This legislation will not fix everything that ails our health-care system, but it moves us decisively in the right direction. This is what change looks like.

LIASSON: In the seven months between now and Election Day, you'll hear President Obama make that argument over and over again, as the second phase of the great health-care debate begins.

Mara Liasson, NPR News, Washington.

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