Fighting to overcome the impression of high spending and backroom deals, President Obama has honed his health care message to highlight his bill’s benefits to consumers — from better Medicare prescription-drug coverage for seniors to guaranteeing insurance regardless of pre-existing conditions.
Supporters say the White House’s public relations offensive has breathed new life into Democrats’ last-ditch effort to pass the legislation by next week.
“So much of his activity in the last few weeks has been around health care,” said Karen Davenport, director of health policy at the liberal Center for American Progress. “And I think the power of the presidency drives the stories and makes a huge difference.”
After months of drift, with the House and Senate arguing over competing bills, Mr. Obama has taken control of the debate, combining the two bills into a grand compromise, adding Republican ideas and dubbing it bipartisan. On Monday, both he and Democratic leaders said they were very optimistic it would become law.
Mr. Obama took his health care pitch on the road Monday for the third time in one week, traveling to Ohio to again make his case that Congress should ignore the political implications of supporting his bill and vote for it because it’s the right thing to do.
“The American people want to know if it’s still possible for Washington to look out for these interests, for their future,” Mr. Obama told a crowd in Strongsville.
“So what they’re looking for is some courage. They’re waiting for us to act. They’re waiting for us to lead. They don’t want us putting our finger out to the wind. They don’t want us reading polls.”
Democrats don’t yet have the 216 votes required to pass the bills, but House Speaker Nancy Pelosi reaffirmed Monday that they will collect them, dismissing the concerns of some House Democrats about federal funding of abortion, Medicaid funding, Medicare reimbursement rates and the exclusion of protections for illegal immigrants. She called them unfounded.
“When we bring a bill to the floor, we will have the votes,” she said at a press conference while surrounded by more than a dozen babies and representatives of children’s groups that support the health care reform plan.
The yearlong push for health care has seen a series of starts and missteps, culminating with Republican Sen. Scott Brown’s surprise victory in a special election to fill the seat of the late Sen. Edward M. Kennedy, Massachusetts Democrat. That victory denied Democrats their filibuster-proof majority in the Senate, and gave backers in both chambers pause.
After that setback, Mr. Obama blamed bad deal-making, such as the so-called “Cornhusker kickback” to aid Nebraska’s Medicaid payments, or the “Louisiana purchase” to help that state’s Medicaid program, for helping sour the public.
To fight back, the president convened a White House summit, demanded Republicans offer ideas, and incorporated some of those into the package of fixes he wrote and submitted to Congress. He also stripped some of the sweetheart deals, such as expanding the Nebraska Medicaid payments to all states.
Along the way he’s sharpened his own focus, stressing several key reforms in the bill, such as a prohibition on insurance companies denying coverage to those with pre-existing medical conditions; a requirement that all new insurance plans offer free preventive checkups; and allowing young adults to stay on their parents’ insurance until they’re 26 years old.
Mr. Obama also has taken to using personal stories to make the case for his push — on Monday pointing to the case of a 50-year-old woman named Natoma Canfield, a cancer survivor who can no longer afford to pay her insurance premiums. Her sister Connie attended the speech in her place because she is in the hospital with leukemia.
“The reason Natoma is not here today is that she’s lying on a hospital bed, suddenly faced with this emergency — suddenly faced with the fight of her life,” Mr. Obama said. “So, you want to know why I’m here, Ohio? I’m here because of Natoma.”
But Republicans said Ms. Canfield would have to wait for help until 2014 — the year most of the benefits in the president’s plan would take effect. By contrast, the GOP said she could immediately buy into a state high-risk pool under their plan, which would give those with high insurance costs easier access to coverage.
“Ironically, this is exactly the sort of person who would benefit most from House Republicans’ reforms, which would lower costs in the individual market by up to 10 percent, unlike the president’s plan, which would raise premiums by up to 13 percent,” said Michael Steel, spokesman for House Republican Leader John A. Boehner.
In writing a single bill and taking control of the public messaging, Mr. Obama has also helped Democrats get past the parade of personalities that was sinking the bill, said Sean Gibbons at Third Way, a progressive think thank.
“For a long time during the process, the story of health care reform was about personalities. For a while, it was about [Senate Finance Committee Chairman] Max Baucus, for another period of time it was about Sarah Palin, then it was about Blue Dog Democrats,” he said.
“It’s stopped being about personalities sometime in the last few weeks, and it started being about what this bill is going to deliver to the middle class.”
On Monday, the House Budget Committee voted 21-16 in the first procedural move to pass Mr. Obama’s health care overhaul through reconciliation, a complex parliamentary tool that circumvents a filibuster in the Senate.
Democratic Reps. Allen Boyd of Florida and Chet Edwards of Texas, who both voted against the House version in December, joined all Republicans in voting against it. Democrats voted to move forward on what is merely a “shell” bill — legislation that will be completely replaced once it moves to the House Rules Committee for another procedural vote.
Rep. Paul D. Ryan of Wisconsin, ranking Republican on the panel, slammed the move as dishonest, calling it a “legislative Trojan horse” to a government takeover of the health system.
The new bill text hasn’t been released, but it contains the changes Mr. Obama has proposed to the Senate’s bill and is expected to come in at about 100 pages, White House aides told House Democrats last week.
Mrs. Pelosi said leaders also are considering passing the Senate bill and the companion repair bill as one package, another procedural move that Republicans say isn’t justified.
Democrats would combine the bills to help nervous rank-and-file members avoid having to say they voted directly for provisions in the Senate bill they don’t like, such as the Nebraska Medicaid funding.
Republicans say the move would be a violation of the clean “up and down” vote Democrats have been arguing for.
The reform bill “deserves a much more open process than we are getting here,” said Rep. David Dreier of California, ranking Republican on the House Rules Committee, where the bills would be combined.
Democrats have argued that they need to pass the companion bill through reconciliation, a procedural tool that circumvents a Republican filibuster, because Republicans won’t let them have a simple majority vote on their health reform bill.
Passage of the plan would provide health insurance coverage to 30 million more Americans and give President Obama his most significant legislative victory.
• Jennifer Haberkorn contributed to this report.