01/25/2012 03:23 pm ET Updated Mar 26, 2012

Why Only 44 Words on Health Reform?

In the State of the Union speech January 24th, President Obama spent exactly 44 words on health reform; in 2010 he spent 570. Is the President backing away from his prized achievement, the Affordable Care Act? How should we interpret the complete lack of attention in the current speech or the backup document "Built to Last"?

The 2012 SOU address focused mainly on the military, manufacturing jobs, education and energy, all important issues to the American public. And although there was a fellow named Adam Rapp in the gallery, who had been able to treat his cancer because he had insurance through his parents' plan, he was never acknowledged publicly.

The Republicans pounced on the lack of mention of health reform, gleefully concluding that the President knew his major initiative was not popular and promising, yet again, to repeal it. They also claimed that the President's brief reference to reforming Medicare and Medicaid gave them license to go after these programs in the name of "saving them." Gov. Mitch Daniels, who gave the Republican response, went directly to the Medicare and Medicaid issue, with the following remarks:

Medicare and Social Security have served us well, and that must continue. But after half and three quarters of a century respectively, it's not surprising that they need some repairs. We can preserve them unchanged and untouched for those now in or near retirement, but we must fashion a new, affordable safety net so future Americans are protected, too....The mortal enemies of Social Security and Medicare are those who, in contempt of the plain arithmetic, continue to mislead Americans that we should change nothing.

In the President's main reference to health reform, which consisted of one sentence, he said:

I believe what Republican Abraham Lincoln believed: That government should do for people only what they cannot do better by themselves, and no more... That's why we're getting rid of regulations that don't work. That's why our health care law relies on a reformed private market, not a government program.

Even this mention of the health care law is not quite accurate. There is a substantial reliance on Medicaid in the Affordable Care Act, and for the many single payer and public option supporters, the reminder of ACA's reliance on private health insurance companies is a stinging rebuke.

I have written here and here and here and about the benefits of the Affordable Care Act to Americans, even now before it is fully implemented. I understand that given the importance of emphasizing the economy and jobs, the President sought to highlight other issues in this particular State of the Union address. The ACA remains somewhat invisible and unpopular with the public at this point and by downplaying it, the President probably hoped to avoid pointed attacks by the Republicans. Unfortunately, he avoided nothing of the sort. "Obamacare" as they call it, was quickly brought back to the front of the debate by candidate Newt Gingrich, who is currently using it to bash Gov. Mitt Romney for his support of a similar approach in Massachusetts.

I believe there is much to be proud of in the Affordable Care Act and I am personally disappointed that the President and his team made the decision to deep six it in this address, even as his Secretary of HHS, Kathleen Sebelius went on The Daily Show to defend it the night before (note: Jon Stewart took her on big time). Was it simply a matter of too many issues and too little time? Was it a backing away from its unpopularity? Whatever the reason, it was a conscious and strategic one, and we might conclude that until the Supreme Court makes its decision on the individual mandate this year, the White House will continue to keep health reform under the radar.