Brushfires & Fantasies: How long before health care bill is too big to pass?

November 10, 2009 8:20 AM

ABC News’ Rick Klein reports:

Before we get to the fight at hand -- why not re-fight a battle (on new ground) that's been raging for, oh, about 35 years?

(And get some inspiration from the man who couldn't finish the job 15 years ago?)

In a thousand-cuts kind of bill, some of the cuts are self-inflicted. The bleeding now, over abortion rights, adds to the long list of complications for Democrats who are balancing tricky math on the Hill.

An attempt at healing, though after the fact: "This is a health care bill, not an abortion bill," President Obama told ABC's Jake Tapper in an interview yesterday.

But the president is no longer quite right. The health care bill has become an abortion bill -- and an immigration bill, and a tax bill, and a jobs bill, and a spending bill -- not to mention the most significant re-working of the nation's health care system in half a century.

The growing scope is a consequence of the scope of the president's ambitions, plus the ever-expanding need to attract more votes for something that not everyone agrees is a policy or political winner. (How long before we hear from Republicans that health care reform is simply too big not to fail?)

On the issue of the week -- the Stupak amendment that's roiling the left, and has dozens of liberal House Democrats threatening to sink health care reform over the bill's handling of abortion -- the president is weighing in fairly definitively: It doesn't work for him.

"I want to make sure that the provision that emerges meets that test -- that we are not in some way sneaking in funding for abortions, but, on the other hand, that we're not restricting women's insurance choices," the president told Tapper.

This strengthens the hand of those who are pushing to eliminate or water down the provision. But might we be past the point where presidential proclamations dictate vote totals? (And might there have been a stronger case to make before the House vote?)

Plus, this exchange that Republicans have clipped and saved: "Are you willing to pledge that whatever cuts in Medicare are being made to fund health insurance, one third of it, that you will veto anything that tries to undo that?" Tapper asked.

"Yes," the president said. "I actually have said that it is important for us to make sure this thing is deficit neutral, without tricks."

For Democrats, it's ideology vs. pragmatism: "If the flexibility shown by party leaders on issues like abortion and the proposed government-run insurance plan has kept the legislative process on track, it has also left many liberals off balance and risked alienating the party's base as the midterm elections approach," The New York Times' Adam Nagourney and David Herszenhorn report.

"Democrats are now encountering the complications of that success [in 2006 and 2008], and a task that faced Republicans during periods of both the Reagan and George W. Bush administrations: How to manage an ideologically diverse caucus to produce legislative victories without alienating base voters."

Before we're back to health care, a big presidential moment: The Obamas arrive at Fort Hood, Texas, around 12:50 pm ET, and the president will make remarks at approximately 2 pm ET.

"President Obama and First Lady Michelle Obama will attend the memorial service for those killed in Thursday's shootings at Fort Hood. The Obamas will meet with families of the 13 soldiers and civilians killed at III Corps Headquarters in Fort Hood. Afterward the President will speak at the memorial service to the broader Fort Hood community," per ABC's Sunlen Miller. "In addition the President and the First Lady will also meet with the soldiers wounded in last week's attack who are recovering at Darnall Army Medical Center. 43 people were injured in the attack, according the Fort Hood public affairs office."

The president, on Fort Hood, in the interview with Tapper: "We are going to complete this investigation and we're going to take whatever steps are necessary to make sure that something like this doesn't happen again."

On his decision-making on Afghanistan: "Ultimately when I make a decision, it's going to be based on the overarching view of US national security," the president said. "But I think I would be making poorer decisions if I didn't have to look into the eyes of a family member who had lost a loved one and tell them how grateful we are as a nation... That moment, I think, ensures that I'm making the best possible decisions going forward."

Tapper reports: "Senior administration officials tell ABC News that President Obama at his war council meeting tomorrow will assess five different specific strategies for Afghanistan and Pakistan, the recommendations put forward by Gen. Stanley McChrystal being one of those five strategies."

"At his meeting with the Joint Chiefs of Staff on Friday, October 30, President Obama asked the Pentagon officials to assess in detail the four other strategy options -- missions, troop requirements, cost. All five options increase the levels of US troops in Afghanistan. The president has not yet been presented with those four new assessments," Tapper continues.

Per the AP's Anne Gearan and Steven R. Hust: "President Barack Obama is nearing a decision to add tens of thousands more forces to Afghanistan, though probably not quite the 40,000 sought by his top general there. The White House emphasized that the president hasn't made a decision yet about troop levels or other aspects of the revised U.S. strategy in Afghanistan. Administration officials told The Associated Press on Monday the deployment would most probably begin in January with a mission to stiffen the defense of 10 key cities and towns."

As for Tuesday: "Presidents get elected to run the nation. Some days that means knowing how to heal it," the AP's Ben Feller writes. "For the first time since winning the White House, President Barack Obama faces such a moment Tuesday at Fort Hood. After a shooting that left 13 people dead and 29 wounded on the bustling Texas Army post, it is Obama's job to offer some comfort, if not answers."

Amid more questions: "U.S. intelligence agencies were aware months ago that Army Major Nidal Malik Hasan was attempting to make contact with people associated with al Qaeda, two American officials briefed on classified material in the case told ABC News," per ABC's Richard Esposito, Matthew Cole, and Brian Ross. "According to the officials, the Army was informed of Hasan's contact, but it is unclear what, if anything, the Army did in response."

This gets bigger -- and the congressional drumbeat for full investigations will make it bigger still:

"Intelligence agencies intercepted communications last year and this year between the military psychiatrist accused of shooting to death 13 people at Fort Hood, Tex., and a radical cleric in Yemen known for his incendiary anti-American teachings," David Johnston and Scott Shane write in The New York Times. "But the federal authorities dropped an inquiry into the matter after deciding that the messages from the psychiatrist, Maj. Nidal Malik Hasan, did not suggest any threat of violence and concluding that no further action was warranted."

More warning signs: "The Army psychiatrist believed to have killed 13 people at Fort Hood warned a roomful of senior Army physicians a year and a half ago that to avoid ‘adverse events,' the military should allow Muslim soldiers to be released as conscientious objectors instead of fighting in wars against other Muslims," The Washington Post's Dana Priest reports.

Said Hasan, in his presentation: "It's getting harder and harder for Muslims in the service to morally justify being in a military that seems constantly engaged against fellow Muslims."

Back on health care -- with President Obama out of town, it's in former President Bill Clinton's hands on Tuesday. He's the lunch guest for the Senate Democratic caucus.

"Clinton, whose own attempt to pass a health reform package fifteen years ago did not pass either House of Congress, was asked by White House Chief of Staff Rahm Emanuel and Senate Majority Leader Harry Reid to make the pep talk, according to an aide familiar with the discussion," per ABC's Z. Byron Wolf. "Clinton is expected to speak to Democratic senators at a closed caucus meeting, urging them to see past differences to pass compromise legislation."

The abortion fight is awkward terrain for Democrats -- and has been for decades. Yet this overwhelming Democratic majority, with its caucus made up overwhelmingly of abortion-rights supporters, is tearing itself up over an abortion restriction it's hard to imagine passing in the Bush era?

All the lobbying energy now is focused on keeping the Stupak language out of the Senate bill. Then it's on to conference and -- who knows.

 "Abortion rights supporters are now fighting back, vowing to keep Stupak's amendment from being a part of the final legislation which ultimately reaches President Obama's desk," per ABC's Teddy Davis. "Although liberal House Democrats voted over the weekend for the health-care bill with the Stupak amendment, Rep. Diana DeGette, D-Colo., is collecting signatures from colleagues who are vowing to oppose any conference report that includes the Stupak restriction."

"At least 40 House members pledged to reject the final bill if the abortion provision survives in the Senate and the conference that joins the Senate and House versions into a single piece of legislation," the Los Angeles Times' James Oliphant and Kim Geiger report. "The tumult over abortion now travels to the Senate, where it promises to cause headaches for Democrats still wrestling with fundamental issues of cost, coverage and revenue in their version of the health bill."

Do threats like this sound familiar? "The flurry of letter-writing and threats to bring down the bill over the abortion issue mirrored an earlier battle over the public insurance option. And in that debate, liberals vowed to vote down any version of the plan not based on Medicare rates only to later vote en masse for a weaker version," Roll Call's Tory Newmyer and Steven T. Dennis report.

Wasn't this better fought on the House floor? "It wasn't a surprise; the only people it apparently surprised are NARAL and Planned Parenthood," FireDogLake.com's Jane Hamsher said on ABCNews.com's "Top Line" Monday.

Asks The New Republic's Jonathan Cohn: "The Abortion Amendment: Could Obama Have Done More?"

Look who's talking primaries now: "There's elections coming up in 2010. We will know who stood with us and who stood against us," NARAL president Nancy Keenan tells Jill Lawrence, of Politics Daily. "Nothing's off the table. ... It's a new day and I'm here to tell you we're going to hold those accountable who voted against us."

The argument for keeping Stupak language: "By essentially sacrificing abortion and immigrant rights to get conservative Democrats to vote for expanded health care coverage, House Speaker Nancy Pelosi restored the old order within the party -- an order that had helped Democrats establish dominance on Capitol Hill for decades," Peter Beinart writes for The Daily Beast. "Today, to a degree we haven't seen in a long time, the Democratic Party is about economic protection first, and cultural freedom second. Her action was a long time in coming."

Repercussions in the Senate:  "If it doesn't make it clear that it does not pay for abortion, you can be sure I will vote against it," Sen. Ben Nelson, D-Neb., tells The Wall Street Journal's Naftali Bendavid and Janet Adamy.

Plus: "Other key moderates didn't go quite that far, but at least two others -- Sens. Kent Conrad of North Dakota and Mary Landrieu of Louisiana -- said they, too, want to ensure that the Senate bill prevents federal dollars from paying for abortion," Politico's Carrie Budoff Brown and Jonathan Allen report.

Repercussions in the only Senate race pending: "Opening up a major fissure in the US Senate race, Attorney General Martha Coakley said yesterday that she opposes the landmark health care bill approved by the House Saturday because it contains a provision restricting federal funding for abortion," The Boston Globe's Matt Viser reports.

Said Coakley: "To pretend that now the House has passed this bill is real progress - it's at the expense of women's access to reproductive rights."

Said her chief rival, Rep. Michael Capuano, D-Mass. (calling the statement "manna from heaven" for his campaign): "She claims she wants to honor Ted Kennedy's legacy on health care. It's pretty clear that a major portion of this was his bill.''

More broadly -- where's the reform in health care reform? "As health care legislation moves toward a crucial airing in the Senate, the White House is facing a growing revolt from some Democrats and analysts who say the bills Congress is considering do not fulfill President Obama's promise to slow the runaway rise in health care spending," Sheryl Gay Stolberg reports in The New York Times.

What of the price tag? "The official $1.1 trillion price tag for the House Democrats' health care bill excludes dozens of unfunded programs that could drive up costs when future congresses look to fund them," Stephen Dinan writes for the Washington Times. "Republicans said the health care bill includes two dozen programs whose funding is listed as ‘such sums as may be necessary.' That amounts to legislative jargon, they said, for ‘We'll bill you later.' "

Losing focus? "Reforming the chaotic and unfair health care system in the U.S. is an important issue. But in terms of pressing national priorities, the most important are the need to find solutions to a catastrophic employment environment that is devastating American families and to end the folly of an 8-year-old war that is both extremely debilitating and ultimately unwinnable," Bob Herbert writes in The New York Times.

Good luck trying to tug the health care bill leftward from here: "The House vote does nothing to change the thus-far intractable public option math in the Senate: There are, at best, 57 to 58 votes for any form of the public option," per Politico's Glenn Thrush.

The American Medical Association remains on board -- beating back a challenge from within its own ranks. From the AMA release: "The AMA reaffirmed its support for health system reform alternatives that are consistent with AMA policies concerning pluralism, freedom of choice, freedom of physician practice and universal access for patients. It also outlined specific elements it will actively and publicly support and oppose as the health system debate continues.  The AMA's support for H.R. 3962 and H.R. 3961 remains in place."

On financial reform, the wait is over: "Senator Christopher Dodd will propose creating a single U.S. regulator that would strip the Federal Reserve and Federal Deposit Insurance Corp. of bank- supervision authority," Bloomberg's Alison Vekshin reports. "Dodd, chairman of the Senate Banking Committee, would eliminate the Office of the Comptroller of the Currency and the Office of Thrift Supervision and fold the Treasury Department units into the new bank regulator.... The Connecticut Democrat is scheduled to release a draft of his financial-regulation overhaul plan today in Washington."

ABC's Matthew Jaffe: "Under Dodd's bill, the Federal Reserve and the Federal Deposit Insurance Corporation would lose many of their bank supervisory powers, a source in the financial industry told ABC News. In their place, a single bank regulator would be charged with monitoring all banks and bank holding companies, closing loopholes that allowed banks to shop around for their preferred regulator."

It's on, in Florida: "The conservative Club for Growth is endorsing former Florida House Speaker Marco Rubio (R) over Florida Gov. Charlie Crist (R) in next year's Florida Senate race, citing Rubio's more conservative record on the stimulus, taxes, and cap-and-trade," ABC's Teddy Davis reports.

"Crist is overwhelmingly beating Rubio in statewide polls and money-raising, but the contest is drawing national attention as the highest-profile example of the moderate vs. conservative battle within the GOP," Adam Smith reports in the St. Petersburg Times. "The influential Club for Growth, which helped push Pennsylvania Sen. Arlen Specter into the Democratic Party and recently spent about $1 million to defeat a liberal Republican in an upstate New York congressional election, on Monday formally endorsed Rubio."

A big Democratic opportunity (and maybe good news for Sen. Chris Dodd, D-Conn.?): "An emotional Gov. M. Jodi Rell announced Monday that she will not seek re-election next year, signaling the end of a tenure that brought her the highest popularity ratings in Connecticut history and setting off a scramble to replace her when she steps down in January 2011," Christopher Keating and Jon Lender write in the Hartford Courant.

Book your tickets now (remembering that Sioux Falls isn't the easiest Iowa destination to reach): Sarah Palin will be signing copies of her forthcoming memoir, "Going Rogue," at the Barnes & Noble in Sioux City, Iowa, on Sunday, Dec. 6, according a list of tour dates posted by the bookstore chain.


The Kicker:

"What's the alternative? To remain in the minority? I tried that for 12 years, and this is much better, whatever the makeup of the caucus." -- Rep. George Miller, D-Calif., on the diversity of views inside the Democratic caucus.

"My name's a verb now." -- Dede Scozzafava, to The Washington Post, now that it's possible for candidates to get "Scozzafaved."


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