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Barack Obama, Campaign Manager: How The 2008 Playbook Passed Health Care

Obama

First Posted: 05/13/10 10:09 AM ET Updated: 05/25/11 05:30 PM ET

Shortly before 11 a.m. on a Sunday in mid-December, Senate Majority Leader Harry Reid was driving through Washington D.C. when he received a nervous phone call from one of his trusted deputies, Sen. Chuck Schumer.

Schumer wanted to know if Reid had seen Sen. Joseph Lieberman's comments on "Face the Nation" that morning. "Lieberman seemed to draw a line in the sand," the New York Democrat relayed. "You should check in with him. He seemed to rule out supporting the bill if it has the Medicare buy-in."

Reid immediately called a staffer to get a transcript and find out if Schumer had it right. He did.

"Alright, I'm headed to the Capitol," the Majority Leader told the aide. "See you in half an hour."

A nearly year-long effort to shepherd comprehensive health care reform legislation through Congress faced a crucial hurdle. Throughout the past week, Reid and Schumer had worked with a group of ten Democratic Senators (five progressives and five moderates) to craft a compromise proposal in place of the public option -- the government-managed insurance plan that had proved too controversial to get past a filibuster. Lieberman had been part of that group. And while in the closing days he had been sending a staffer to negotiations in his place, he had given both Reid and the White House assurances that he'd support an alternative plan that would allow people over 55 to buy into Medicare.

Now, suddenly, Lieberman was announcing on national television that he "would have a hard time voting" for the deal even though he didn't know exactly what was in it.

Making his way toward the Capitol, Reid phoned White House Chief of Staff Rahm Emanuel to discuss the news. "You need to come up here. We need to talk," he said. The hyper-energetic Emanuel, who was in a car as well (driving his son home from his bar mitzvah class) told Reid to hold steady for the time being. "I'll be over to your office soon."

By noon, Emanuel had arrived at the Capitol, dressed in blue jeans and with a cup of coffee in hand. Sitting in an office close to the Senate chamber, Emanuel, White House legislative adviser Phil Schiliro, as well as Reid and Sen. Max Baucus laid out the options (Schumer would arrive from New York City shortly). They could go back to Sen. Olympia Snowe, the one Republican who had offered support for reform. But that would require a dramatic restructuring of the bill.

"He just wasn't honest with me," Reid muttered at one point.

Also en route to the Capitol -- at the summoning of Reid -- was Lieberman, a Senator who once stood in line to be the party's vice presidential nominee but now found himself on the outskirts of his own caucus.

The Senate Majority Leader wanted to call Lieberman's bluff, bring the bill to the floor and force him to vote it down. Dare him to be the one to kill reform, the thinking went.

But before it could happen, Emanuel stepped in. "We need to get it done," he told Reid, according to multiple sources briefed on the exchange. The end game was clear: the Medicare buy-in or any other iteration of a public plan would not get in the way of legislative progress.

When Lieberman finally arrived at the office, Emanuel spoke to him just as directly. "Find a way to get to yes," he said, before insisting that if the objectionable provision was dropped, Lieberman would have to get off the fence.

A deal was reached. Health care reform survived.

* * * * *


Months removed from the debate, aides still recall those tense hours on December 13 as one of the clearer illustrations of how the Obama administration attempted to move health care reform through Congress. Over the course of a year, the president had pursued a lawmaking philosophy that was, at once, hands off and reactive, comprehensive and flexible. It was a tack unique to recent presidents. Whereas Bill Clinton viewed Congress as a house of pawns that needed to be massaged and maneuvered, often against their will, and George W. Bush saw his role as ideological compass around which lawmakers united or revolted, Obama seemingly took a hybrid approach. He provided rules of the road but avoided, at all costs, overbearance.

What exactly the president's overarching theory of governance was, however, remained largely a mystery. To this day, actually defining the Obama legislative doctrine is a difficult task, in part because different people have different interpretations. Not everyone, in fact, is sure an actual doctrine exists.

But in more than two-dozen interviews with key negotiators, lawmakers, strategists and White House officials, a common theme did emerge. For the President and his key staff -- many of whom had been with Obama as he plotted his political trajectory years earlier -- the legislative process was derived primarily from the approach they took to electoral politics. The headquarters were different (the West Wing instead of Chicago). And the campaign dealt with a massive piece of domestic policy rather than an actual candidate. But the game-plan came from the same textbook.

"It's having a long-term strategy and working backwards from that," explained Communications Director Dan Pfeiffer during an interview in his West Wing office.

Success would be premised on building blocks. Moving the health care bill through the complicated committee process would be the equivalent of winning the Iowa caucus (necessary, as both were, for at least keeping Obama's prospects alive). Persuading lawmakers to back the bill throughout 2009 would be like the delicate chase for superdelegates in 2008. The final vote, in turn, was Election Day.

The tactics, likewise, were similar. There were core messages designed to appeal to moderates and activists alike (deficit reduction and expanded coverage). There was a clear invocation of this historical nature of the effort. And when presented with a numerical value for success -- in this case, 60 votes in the Senate -- the president and his team relied more on calculated maneuvering than big sells. Instead of pushing the entire caucus behind health care reform, they worked with individual members based on their relevancy to the process. It was the difference between trying to win every primary election and prioritizing states with strategic delegate yield.

More than any other mindset borrowed from the campaign, however, was the sense that politics is a sport of transactions. Handed a political landscape of broad competing interests, the best way to navigate is to offer a broad but concrete goal and jump hurdles. The only thing not to be compromised is success itself, in part because failure would prove so crippling.

"First and foremost, passing health care defined the ability of us as a country to govern ourselves," said Neera Tanden, a domestic policy adviser for the White House throughout most of the health care battle. "People forgot that when we face an imminent disaster this country actually could act."

Over the course of a year, tension-filled negotiations, expletive-laced meetings, and stubborn lawmakers with provincial demands would put this legislative philosophy to a test. But when health care reform was signed into law -- with Vice President Joseph Biden underscoring to the president just what "a big fucking deal" it was -- the close circle of Obama advisers viewed it as a decisive affirmation of their legislative doctrine.

"There were places along the way that people would take a step back and say 'do we need to revisit our assumptions,'" former Communications Director Anita Dunn told the Huffington Post. "But the overall strategy... has basically been confirmed by events."

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Shortly before 11 a.m. on a Sunday in mid-December, Senate Majority Leader Harry Reid was driving through Washington D.C. when he received a nervous phone call from one of his trusted deputies, Sen. C...
Shortly before 11 a.m. on a Sunday in mid-December, Senate Majority Leader Harry Reid was driving through Washington D.C. when he received a nervous phone call from one of his trusted deputies, Sen. C...
 
 
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10:49 PM on 05/27/2010
each of those who betrayed the american people on healthcare and etc will never be forgiven.
11:02 AM on 05/16/2010
http://us-healthcarereform.com
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HUFFPOST SUPER USER
Tom Payned
Card carrying member of ACLU
03:06 PM on 05/14/2010
"compromises are fair game on everything but success itself."

That sums President Obama alright.

And it's that philosophy that makes this president weak.

Yeah, he passed a bill he can call reform.

Boo, it's a heaping pile of excrement, that he campaigned on, he would not have received the kind of support he did in winning the primaries.

I will forever consider this so called "reform" nothing than a burnishing of his legacy, and a sell out to a minority that existed before negotiations were stopped in August, which made the popularity of true reform plummet.

Mr. Obama had a the chance of a time and as this article about how "he" got the health care bill passed, just further enforces the view of many of us on the left, he will continue to sell out to so he can claim a "success".

I'll remember that willingness when he goes on the stump in 2012, and not beleive he has any real commitment to make substantive changes, for he's willing to take cosmetic ones for the sake of a so called success.
01:21 PM on 05/14/2010
I just heard Bernie Sanders say "on his worst day--President Obama is a better President than Bush ever was on his best day". So, it is still our job to make him better. Voting republican or not voting will get us worse than bush. Why? Because the tide has turned, The Theocrats are passing laws in states that two years ago we would have said could never happen. The poor, women, gays, African American, Hispsanics, Asians, unions, unemployment, food stamps,social worker, teachers, government employees and any secular program-- all targets of the regressive christian nationalists.
02:49 PM on 05/14/2010
Voting Democratic will not, however, do anything to REVERSE our current course: at best it will only slow down our rush toward the cliff by a bit. Electing Democratic Congressional majorities in 2006 and even larger ones in 2008 (plus our savior Obama) demonstrated this conclusively to anyone actually paying attention.

Saying "You've GOT to vote Democratic because the Republicans are so bad!" didn't convince some of us even in 2004. Given how disgusted many progressives have become with Obama's overt treachery over health-care 'reform' and continuation of Bush policies over the past 16 months, don't count on it being very effective this year.

The Democratic establishment in Washington, of course, feels differently. And Bernie, liberal speech notwithstanding, is part of that, just as the rest of the nominal 'progressives' there are: when the chips are down, they support the establishment with their votes rather than stand firm for their professed convictions.

If you've got a way to 'make Obama better', by all means do so. Until that happens, however, some of us will indeed be voting Republican to try to throw the establishment Democrats out and unlock the door to electing better representation in the future, despite the resulting short-term pain.
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talilah33
09:23 AM on 05/15/2010
"You've GOT to vote Democratic because the Republicans are so bad!" didn't convince some of us even in 2004."
Yeah, very smart. See into what mess that got you. Given the two party system in America, it's obvious that one of them will win. You say you're disgusted with the Dems, and you think the solution is to "vote republican to throw the establishment Democrats out"?! You've got to be kidding. Instead of bad you'll choose worse? Does that really make sense to you?
And while your side says Obama is "just like Bush", the other side refers to him as "communist" that has "totally changed the America that we knew." So...I don't know about you, but I don't think both at the same time is possible.
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slycolyf
slice of life
11:37 AM on 05/14/2010
I think that Obama needs to work more on getting Americans to believe in his plan for recovery. We need visuals. I want to see this whole economic recovery plan with charts, time lines and phases that summarize where we started in 2009, where we are going, how we get there, and where we are right now in that progress all in a nice visual presentation. If I don't know the vision and the plans to achieve that vision, then how can I relax and know that Obama knows what he is doing and that I can rest assured that there even exists a path that I can follow and believe in that will achieve the promised change? Obama has to show that he knows what the hell he is doing. Obama's biggest mistake is that he over estimates the intelligence of the people. The Republicans have a better understanding of the psychology of the people and are great at manipulating the ignorance of the people to their benefit. And here's the key. Are you ready? REPEAT IT, REPEAT IT, AND REPEAT IT AGAIN. The Republicans know and use the fact that if you repeat it enough, not only will they believe it, they will actually start to repeat it themselves as if it was their own original idea. The Republicans use the repeat method with lies. We must believe and show that when using the same psychological vehicle, TRUTH WINS.
02:54 PM on 05/14/2010
If truth actually DID win, either Nader or Cobb would be well into his second term by now. In the real world, neither major party has any use for truth save for the few cases in which they feel it will serve their interests better than a convincing half-truth or outright lie.
11:37 AM on 05/14/2010
huff fan

Do you seriously believe that Obama care, created and run by the federal government, will accomplish all of the things you've been posting? Don't you realize that millions of the uninsured, under Obama care, will be shifted to our already failing medical welfare program called medicaid?

You post links to sources to educate those of us who doubt you.

How about you try to educate yourself - start by googling "Ezra Klein takes on Paul Ryan and Loses", then move on to Heritage.org and get their take on Obama care.
12:59 PM on 05/14/2010
typical "classy moron" conservative.... Obamacare..... What good one are you going to come up with next, moron??? Go keep drinking your kool aid and listening to Palin....
02:16 PM on 05/14/2010
Nit wit. Thankfully you and your looney ilk are only 30%.
11:28 AM on 05/14/2010
Rethugs: No plans, No Substance, No Ethics, No Class just Lies, Gimmicks, h8 and NO!
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09:51 AM on 05/14/2010
Health care reform didn't survive.

What passed was the mandate to buy insurance from for-profit corporations with no cost controls and no limit to exclusions. Call this a victory is Orwellian.
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Teresa Welby
disenchanted democrat since 5-31-2008.
10:00 AM on 05/14/2010
yup... he passed the same plan the republicans proposed in answer to the Clinton health-care proposal of the early 90s. He passed the republican's plan without a single republican vote. That takes talent and I have to give the man credit for bringing both sides together. Both sides hate the legislation in about equal numbers.
11:22 AM on 05/14/2010
LIAR!

Republicans trying to SPIN Health Care Reform into their baby!
11:26 AM on 05/14/2010
Lack of knowledge is a dangerous thing!

People with preexisting conditions will be able to get insurance.

Students NOW can stay on their parents insurance until age 26.

Insurance companies cannot drop you because you are sick.

Insurance companies cannot put a cap on your coverage - and the list goes on!

SPOT CRYING ALREADY!
11:52 AM on 05/14/2010
All this, and your premiums will not go up!

If you believe this I've got a bridge to sell you.
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texgal7
Under starry skies....
09:37 AM on 05/14/2010
Obama's the man! This was a great article, helped me appreciate Pelosi more.
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09:23 AM on 05/14/2010
The more I hear about health care reform, the more I see. Ah, hey we forgot to tell you.........
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lstl4
09:20 AM on 05/14/2010
We got a piss poor health care bill and I blame the conservative dems as much as I do the republicans. All of our representatives were bought off by insurance companies and pharma. If we would have had the democrats all sticking together and backing the public option, I would say we got a good bill. I am so sick of our representatives getting paid off by big business. Putting republicans back in Congress is not the answer. I say we stop all campaign funds from big business and go with public funding only from everyday Americans. Our govt is no longer working for the people, but instead, working for corporations who already have all of our money. We have to change the way we elect our officials. When push comes to shove, I will still vote for a democrat anyday.
EnterUsernameHere
The left is wrong because they are not right.
09:45 AM on 05/14/2010
>>Putting republicans back in Congress is not the answer.

As a leftnut, you are once again not right.
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mrm3
11:43 AM on 05/14/2010
Disagree. Constituents from both sides desperately wanted the public option (look at opinion polls - and I'm not talking about idiot fringe Tea Partiers) but Republican lawmakers unanimously rejected that idea.
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Teresa Welby
disenchanted democrat since 5-31-2008.
10:05 AM on 05/14/2010
there is an easy way to make all elections publicly funded. Get one or two states with important electoral votes to pass legislation that anyone running for office in their state must use public financing only. So when Joe Schmuck is running for President and he has to be publicly financed to get on the ballot there, otherwise passing up electoral votes he can not win without, that is the end of corporately controlled candidates.
Then we reform the media. I am in favor of news companies being only owned by News Companies. No more NBC being owned by GE.
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johngary66
Accused of heresy and decided to go with that.
03:47 AM on 05/16/2010
The problem with your idea Teresa is that it makes to much good sense, Both parties would probably fight it to protect the status quo. I would certainly support it though. Keep blogging about it. Another thing that would help is IRV. Which is instant run off voting. It gives third parties a fighting chance because you rank your choice for candidates and don't have to worry about wasting your vote. Minneapolis used it in it's city elections this year with almost no problems. St Paul will use it this fall.
09:06 AM on 05/14/2010
My monthly health insurance premium went from $1075 to $1228 in April. Calling the health care law reform is a stretch. It's about time for all Americans to realize that a progressive movement is the only hope that they have to survive the onslaught to our standard of living that the corporatocracy has brought.
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Teresa Welby
disenchanted democrat since 5-31-2008.
10:26 AM on 05/14/2010
I saw a poll that showed both left and right wanted a public option and cost controls. The problem is NOT that they "passed what they could get", the problem is that they do not work for us. Obama doesn't care what we want or need, he only cares about the appearance of doing something for us when in reality he was making back room deals with his corporate supporters. Not all politicians are like that but many are. The problem is that Obama has no conscience and he has perfected the game to an art.
Anyone who still thinks he was nominated by the grass roots and small donors needs to take a life changing vacation to the funny farm.
HUFFPOST SUPER USER
The Power To Unelect
Corruption Is Destroying The Nation
12:01 PM on 05/14/2010
Exactly

Fanned
01:08 PM on 05/14/2010
shut up, you dumb bagger!
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Veratruth
08:11 AM on 05/14/2010
NOW STOP INSURANCE COMPANIES from HIKING premiums and deductibles for DRUGS. Many seniors will be paying MORE after healthcare reform. SENIORS VOTE....
07:29 AM on 05/14/2010
My significant other works for a NOT for profit business. They receive their benefits via a NOT for profit insurer. Due to the companies not for profit status, their financial year just began this month. The CEO and insurance rep. explained to the spouse and other workers how they were going to have to double the price the employees pay.

Of course there was a great gnashing of teeth, who ever wants to hear the cost of something has doubled. One employee (during question and answer portion) accused the insurance company of gouging the people. The CEO stepped in and told the associate that this action is because of the new HC legislation......

I know many here will try to dismiss my account. Go ahead and dismiss it if you like, I know my spouses paycheck will be smaller. Most businesses run their fiscal year to end in January, so I guess you have a few months of delusion left.

You know what I find funniest, during the HC push the proponents of this bill spoke disparagingly about for profit insurers...... Those same people then passed a law which mandates we buy policies from the insurers who are so bad.

I fail to see the logic.
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HUFFPOST SUPER USER
QueenTiye
08:29 AM on 05/14/2010
The American Society of Association Executives has pointed out repeatedly that small nonprofits are getting the wrong end of the deal here, and have been lobbying congress to allow small nonprofits to a compensatory measure equivalent to the tax credit small BUSINESSES are getting. The problem is that nonprofits don't pay taxes, and so don't see the benefit of a tax credit extended to small businesses.

No bill is ever perfect (for some reason our congresscritters seem immune to creating perfect solutions, preferring to water down and wittle at the bill until it changes as little as possible), so this nonprofit trap is a casualty of the effort. Hopefully it can be addressed in amendments.
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10:12 AM on 05/14/2010
Does The American Society of Association Executives point out that the for profit insurance companies have been robbing the American public?

I didn't think so.
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Teresa Welby
disenchanted democrat since 5-31-2008.
10:29 AM on 05/14/2010
it is all smoke and mirrors. With Obama in particular you can not believe what he says, you must watch what he does.
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dragonmaster
06:21 AM on 05/14/2010
The Bill that passed in March is a right of center reform for HC- after all its nearly identical to the GOP bill in 1994 that was an alternative to 'Hillarycare'

For true health care reform- what will be needed is a European model- A way of raising revenue for single payer for all in the end is the only real solution-

The current bill is a step toward universal reform- but does little to control costs and control the Nasty empire the Insurance companies have been allowed to build- mostly by lobbyists and the GOP.
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HUFFPOST PUNDIT
flossophy
the unfamous anti-establishment classical liberal
08:06 AM on 05/14/2010
The European model is unsustainable... just like Medicare.

We're smarter than that. Get government out of the health care industry and you'll see costs go down and quality go up... as it does in any industry that isn't meddled with by government.

It has been the work of both parties to distort the health care industry over the last 5 decades.
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dragonmaster
08:20 AM on 05/14/2010
Smarter then what? Please

and have the 'Fascists' in the health care industry dictate to us- while their fat and hugely overpaid CEO's make 30 a MIL a year- while decent Americans cannot see a Doctor

guess what- if it quacks like a duck and acts like a duck- its a fascist- some should go look in the mirror- hint hint.
considerthis
I try my best
09:17 AM on 05/14/2010
.".. as it does in any industry that isn't meddled with by government."

Sure, just like the financial industry. How'd that work out for us?
Oh yeah, and the oil industry too. great idea --- not