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What the White House will fight for


Obama is meeting with union officials in the next few days to sell them on the excise tax, or some compromise on the excise tax, or at least make them feel heard on their complaints about the excise tax. It's hard to say what the practical outcome will be, as it's not clear what Obama has to offer in return for support on the excise tax (though a firm promise of action on labor law reform might be appealing, if the union officials believed it). But the message is clear: Obama is going to fight for this one. Compare it, for instance, to the public option, which Joe Lieberman said the administration never brought up in their conversations.

This is one thing that the Obama administration doesn't get enough praise or criticism for. The only ideas they've introduced into the debate, and the only ideas they've really stood and fought for against serious opposition, are cost-control ideas. Namely, the excise tax, the Medicare Commission, the insistence on deficit neutrality and the $900 billion price tag, none of which have a natural majority on the Hill, and all of which the Obama administration has kept in the game through direct advocacy.

Maybe that's to be expected, given that the administration is functionally run by economists. Either way, there's nothing comparable on the coverage side: The White House has not shown a preference for the improved subsidies or expanded coverage or employer mandate preferred by the House. That's not stopped them from getting hammered by the Republicans and some in the media for being spendthrifts, of course.

Photo credit: By Gerald Herbert/Associated Press

By Ezra Klein  |  January 8, 2010; 4:50 PM ET
Categories:  Health Reform  
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Next: The difficulty of selling financial reform


probably unfair, but I sometimes think of Rahm Emanuel as Rahmbert Embert, Naobamakov's Unreliable Negotiator. ("I tried to get the progressive amendment, honest, but there just weren't the votes. . .")

Posted by: roublen | January 8, 2010 5:16 PM | Report abuse

"The only ideas they've introduced into the debate, and the only ideas they've really stood and fought for against serious opposition, are cost-control ideas. Namely, the excise tax, the Medicare Commission, the insistence on deficit neutrality and the $900 billion price tag, none of which have a natural majority on the Hill, and all of which the Obama administration has kept in the game through direct advocacy."

100% agreed. I've been very hard on them for a number of things, including overselling their proposals on cost control and being too tentative on real delivery system reforms that includes strong cost control sooner. But all that said, what Ezra says here is very true and deserves recognition.

Posted by: wisewon | January 8, 2010 5:18 PM | Report abuse

Gee, it's almost like he doesn't care about the coverage at all, isn't it? Let alone good, affordable coverage. And you know what's really weird? Good, affordable coverage is just about the *only* thing the people who voted for him wanted, in terms of health care reform.

Posted by: KarenJG | January 8, 2010 5:26 PM | Report abuse

Administration does not have to worry for the 'coverage side'. As water moves from height to depth, Dem House will take care off that.

I am not sure whether it makes much sense to praise WH so early. Clearly it could have been worse and they would given up on these meager cost controls. But then again we do not praise Obama for not being 'Bush'. Come on Ezra, 'yes, we can' revolution has not so much dilapidated that President has to fish for compliments for not being Bush....

The praise is withhold for the simple reason that the proof of the pudding is in eating. When all these measures remain intact in the final bill to be passed by Congress, we will raise 'hosannas' for the President.

But the other issue is WH is entering with Union on weaker wicket. With job increasing program in disarray, Administration is really on the weaker ground. Frankly, American people and Labor would love Unions to meet our President for increasing jobs, but they are meeting him for tax increase! (though I support Excise Tax) Talk about 'cognitive dissonance'...

And there is a suspicion that had Admin involved in getting those clauses early on in both House and Senate bills; we would not had WH on back foot defending already weak cost control measures in this bill.

Dems are talking HCR clearly at the cost of ways to improve economy and even that HC Reform is not going well. All along we are losers here from all sides.

Posted by: umesh409 | January 8, 2010 5:28 PM | Report abuse

But you told me Obama was at the mercy of those mean Senators! Now you say he has a voice?

Posted by: endaround | January 8, 2010 6:00 PM | Report abuse

I think a fair compromise on the excise tax would be to retain it in its entirety, but have the House's rating rules (2:1 age, no smoker rating), and apply them to *all* markets so those who are in high-risk professions aren't affected, and organizations with older workforces are minimally affected. Then due to the 8% income exemption and more young people qualifying for this exemption, this income exemption should be increased to 13-15% so some of the effects of making health insurance more affordable to older adults aren't blunted with young people going bare, and not providing their generational subsidy to make health insurance more affordable to older adults.

That's just my take as a progressive and an actuary.

Posted by: BradGabel2002 | January 8, 2010 6:08 PM | Report abuse

As President, President Obama has unlimited access to health care, the value of which must be upwards of $100,000 or more. If I were a union member I would want to know if he will be subject to a 40% tax on those benefits.

Posted by: cdmudas | January 8, 2010 6:14 PM | Report abuse

Also, it's hard to believe even a $600 billion bill had a natural majority in either chamber. I doubt someone like Gerry Connolly would vote to spend that kind of money without the President covering his behind.

I wish the President hadn't limited the bill's cost to $900 billion, but if he had not given a number, or said a number over $1 trillion, many in the House and the Senate would have said, "Let's move on to financial regulations."

Posted by: BradGabel2002 | January 8, 2010 6:45 PM | Report abuse

Sorry, should have used the names Mark Warner, Jim Webb, Evan Bayh, or Jon Tester instead of Gerry Connolly.

Posted by: BradGabel2002 | January 8, 2010 6:48 PM | Report abuse

Sickening. They don't give a damn about people.

Posted by: janinsanfran | January 8, 2010 11:25 PM | Report abuse

Obama has clearly shown he has no interest in a true health care reform bill being passed. He has been obsessed with reducing health care costs, not providing high quality health care to all people legally in this country.

His support for the excise tax is another broken campaign promise. The tax will result in many workers within ten years having worse health care benefits. I thought Obama promised no one's existing benefits would be changed. Union leaders should not support a bill that will have detrimental effects on workers. They should insist the excise tax be taken out of the bill.

Posted by: Aprogressiveindependent | January 9, 2010 1:38 AM | Report abuse

Obama has proved that he is a 'kiss up, kick down' kind of guy. If you are powerful, you get what you want. Not so much, then you get to pay for it. As a union member, I have voted on contracts in which I gave up wage increases in exchange for health benefits. So now Obama wants me to lose even what I have paid for. I have been betrayed. The question: is it by the Democratic Party or by Obama personally? Or both?

Posted by: missmotomama | January 9, 2010 8:57 AM | Report abuse

"Obama is meeting with union officials..."

Obama always meets with "union officials". Andy Stern is the most frequent visitor to the white house. That is simply a fact.

The unions wrote the healthcare bill and Obama's job is to be the sockpuppet of the unions and other special interests.

Bottom line, it's not news that Obama is "meeting with union officials".

Should be a crime, not 'news'.

Posted by: WrongfulDeath | January 9, 2010 9:19 AM | Report abuse

The problem is that I don't believe Obama or the House leaders. They have repeatedly promised fiscal responsibility (bending the cost curve) on this Health Care bill, but it's all smoke & mirrors. The bill will explode the debt in 10 years. All of the cost cutting measures in the bill are typical of those great sounding ideas that just never quite seem to get implemented.

Posted by: JohnR22 | January 9, 2010 10:01 AM | Report abuse

Ezra Klein writes, "given that the administration is functionally run by economists..."

Who is this kid Klein trying to kid? This administration is composed of political hacks. The number of people that have held real jobs in the real world is minimal. Obama has never held a real job in the real world.

This healthcare bill is being constructed behind closed doors. People like Klein would cheer that. Closed-door dictatorship is never far away from liberal's intention.

The facts are that this healthcare bill will reduce personal freedom, deliver less healthcare for more money, and bankrupt the country. The entire bill is couched in lies and obscurities. THAT is why it is being completed behind closed doors.

Posted by: wilsan | January 9, 2010 11:26 AM | Report abuse

Finally Obama is willing to fight on behalf of the insurance companies: the ones most likely to gain from this Cadillac Tax, (forces people to opt for high deductibles). He has amply demonstrated during his first year that he is willing to take lumps on behalf of the banking industry, the health insurance industry and the other mighty and powerful such as the military industrial complex. But he is more than willing to negotiate away any and everything that might benefit the middle class. Not surprised one bit. Not any more. I was initially very enthusiastic about the health care reform. Now I fervently wish the reform would die-I am counting on the progressives in the house. If this miserable bill is brought down by the house democrats, I will probably vote for them again, if not I will become one of the apathetic voters and will only vote when a suitable independent appears. This coming from a staunch Obama supporter during the Presidential campaign and I am noticing a larger and larger number of voters becoming disgruntled with this administration. Check out the comment sections of Huffington post. Where once you could find innumerable Obama fans, there are hardly any. The next election is going to be a rout for the Democrats-mark my words.

Posted by: ns3k | January 9, 2010 12:03 PM | Report abuse

President Obama has access to information telling him what is obvious to most of us. Cost control is vital because the nations finances are in a very, very precarious position. He may have campaigned as a politician who would hand out cash to the masses, but he has learned quickly that is impossible. I love it when politicians are forced to confront reality.

Posted by: lancediverson | January 9, 2010 12:40 PM | Report abuse

Yeah, okay whatever. Don't care.

The sooner Congressional Dems pay a political price for supporting this idiotic Bill and the sooner this Administration loses power the better. Dorgan and Dodd have already left the sinking ship, hopefully there will be more to follow. No loss.

Posted by: websterr1 | January 9, 2010 12:50 PM | Report abuse

Its too bad that this administration and congress don't care about or realize who voted them in and why they got a landslide. Without caring about or fighting for what happens to people on the coverage end they are making an arrogant mistake which will lose them all sorts of support. People in the middle are struggling and this "reform" bill sadly will help us very little and it will take way too long to do what they claim it will do. Everything points to it being a give away to insurance companies with the middle class picking up the tab as usual for expanding coverage somewhat limitedly without any effective consumer controls or effective price control. It is really obvious that special interests and government got everything they wanted but the people, not so much. Democrats have done a spectacular job in 2009 of showing how badly and just how corruptly they govern. They spoke about change and went right back to the dirty tricks, political theatre, the secret agreements and every stunt they mistakenly think the people are too stupid to notice. I guess they figure after Bush this nation is used to, and accepting of such warped government. I wanted health reform but this is not a good bill for me. Democrats will not get another cent or vote out of me.

Posted by: motodude | January 9, 2010 3:20 PM | Report abuse

Obama is the kind of guy who would bring a photographer to Arlington cemetery to document him kicking at gravesites. He looks out at us little people and thinks we are children.

Posted by: bmull | January 9, 2010 4:37 PM | Report abuse

The public option was a cost-control measure.

Posted by: boloboffin1 | January 11, 2010 12:37 AM | Report abuse

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