The President’s Health Care Predicament

James C. Capretta

First published 3/31/11 on Kaiser Health News

Last week marked the one-year anniversary of President Barack Obama’s health reform law. It’s an appropriate time to take a look back at the events of last year, and what they might mean in 2012 when the president will almost certainly be seeking reelection.

In early 2010, after Republican Scott Brown was elected to the Senate from Massachusetts, Obama had no choice — if he really wanted the health bill enacted — but to turn its passage into a make-or-break moment for his presidency. Nothing else would have worked. He wasn’t winning the public argument over its merits, and wasn’t going to. The balance of public opinion had been solidly against it ever since the first trillion-dollar cost estimates were released in mid-2009. The only way he was ever going to get it across the finish line was by tying the measure’s success to that of his presidency, thus forcing the hand of wavering Democrats, who didn’t want to vote yes on the legislation but were even more squeamish about derailing their own party’s fresh and promising administration. And so he made that his closing argument. As numerous press accounts documented, in private conversations with lawmakers, the president pleaded with his allies to save his presidency by voting yes on the health measure.

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