WASHINGTON — A feisty but occasionally frustrated President Barack Obama tried Wednesday to calm nervous Senate Democrats about their political futures and prospects for passing major legislation, as he urged them to keep pushing hard for solutions to the nation’s most vexing problems. Continue Reading

WASHINGTON — President Barack Obama grappled Wednesday with the fallout from the stunning Republican Senate election in Massachusetts, a stinging loss that could drive him to stay the course in tough times — a la Ronald Reagan in 1982 — or tack toward the center and work more with the Republicans — as Bill Clinton did after 1994.

Whichever course he pursues heading into his second year as president — Wednesday marked the one-year anniversary of his inauguration — the loss of a Democratic-held Senate seat in Massachusetts, and with it his party’s 60-vote super-majority in the Senate, means he has to adapt his governing style if he wants to get things done.

“Successful presidents are able to adjust,” said William Galston, a former aide in the Clinton White House. “But you can’t adjust unless you acknowledge that you’ve made some mistakes. The first question about this very self-confident president is whether he’ll be able to acknowledge mistakes. Not just verbally, but in his mind and his heart.”

Obama and his top aides insisted Wednesday that he would change. But it may be a change only in tactics, not substance.

Senior aides said that Obama still would push to expand health care, his top domestic priority, as well as the rest of his agenda. They said that the White House now would have to rethink how it gets priorities through Congress.

“We … have to take into account what voters were saying yesterday and what we’ve heard from folks around the country,” senior adviser David Axelrod said on MSNBC. “We will take that into account and then we’ll decide how to move forward.”

Obama said Wednesday that he didn’t take the evident voter anger in Massachusetts as a verdict on him or his agenda.

“People are angry, they are frustrated. Not just because of what’s happened in the last year or two years, but what’s happened over the last eight years,” Obama told ABC News.

At least one poll of Massachusetts voters painted a different picture, however.

Obama’s health care proposal was by far the dominant issue on voters’ minds in Massachusetts, according to an election night survey by respected Republican pollster Tony Fabrizio. His poll found 48 percent of voters saying that health care was the top issue that decided their vote and that Brown won because he firmly opposed Obama’s plan. No other issue came close.

Democrats have now lost three straight elections since November — governorships in Virginia and New Jersey, and now the Senate seat in Massachusetts. Obama won all three states in 2008. How Obama reacts to the reversal will say a lot about what he accomplishes for the remainder of his term — and whether he wins a second one.

Several centrist Democrats and Republicans are urging him to move away from the liberal Democratic congressional leadership and toward the political center, much as Clinton did after the Democrats lost control of Congress in 1994.

“The loss in Massachusetts should serve as a wake-up call to the wing of the Democratic Party that wants the federal government to overreach and overspend,” said Sen. Mary Landrieu, D-La., in a statement. “We need to get back to the basics. Senate Democrats must use this setback to increase our efforts to find bipartisan, fiscally responsible solutions that make sense to Americans of all walks of life. ”

Former Commerce Secretary and prominent Chicago Democrat William Daley last month said the party was inviting defeat if it continues along a liberal, big government path. “Either we plot a more moderate, centrist course,” Daley wrote, “or risk electoral disaster not just in the upcoming midterms, but in many elections to come.”

When Reagan found himself in a similar situation at the start of his second year — with a deep recession and high unemployment — he told Congress in his Feb. 8, 1982 budget message to trust that his policies would eventually work and to “stay the course.”

To be sure, Reagan did agree to some tax increases in 1982 that partly offset his big tax cuts of the year before. Still, Reagan managed to keep the core of his program that he’d enacted his first year — deep cuts in the top marginal income tax rates — in place.

“We had put in place all the policies we wanted,” recalled Vin Weber, who was a Republican member of Congress at the time. “It wasn’t like health care, where it hadn’t happened. We had passed the tax cut.”

For Obama, the onset of political woes before he has put his key domestic agenda in place robs him of the luxury of staying the course and waiting for the program to show results.

One alternative, Weber said, would be to try to pass parts of the health care proposal piece by piece, such as the section that would force insurance companies to cover pre-existing conditions.

Another, he said, would be to try to compromise with Republicans. “”If he really wanted to compromise, he’d put Republicans in a difficult position,” he said.

Galston suggested that Obama needs to settle the health care debate one way or another, then focus on jobs.

“He’s got to decide what to do about health care fast. This fish sitting on the counter will not smell any better if it sits there longer,” he said.

“Then he’s got to use his State of the Union speech next week to reset the administration agenda for year two, and make it very clear that he’s gotten the message that year two will be all about the economy.”

Finally, Obama also may try to bypass Congress altogether on some issues, turning more to executive orders to change policy.

“There are a number of ways to advance the ideals and interests of the American people,” Obama said Wednesday. “Often it’s done through Congress. But it can also be done through what’s called a presidential memorandum.”

Obama was speaking about a new policy blocking government contracts from tax delinquent companies. But he also is using executive powers in other areas as well, such as Environmental Protection Agency regulations on auto emissions. And he could use them on the economy and health care, said Julian Zelizer, a Princeton University historian.

While presidential candidates, Obama included, tend to campaign against excessive use of executive power, Zelizer said, the temptation to use those powers once in office is powerful, especially after losing a key vote in the Senate.

“When they’re in power, they start doing the same tactic,” he said. “It’s the attempt to get what you can’t get through Congress.”

MCT

Television stations, newspapers and the Internet have all been consumed with coverage of Obama’s healthcare reform proposals. With rumors of death panels swirling and hot tempered town hall meetings, it is hard to find what Obama’s proposal is really all about.
With the help of Dr. Michael Morrisey, a professor at the Department of Health Care Organization and Policy and director at Lister Hill Center for Health Organization, a breakdown of the key issues to Obama’s healthcare reform is provided.
Obama’s plan would introduce a health insurance exchange, a marketplace for individuals or employers to shop between private and public insurers. A public health insurance option would compete on the same level as private insurers and be financed only by its premiums. How well private plans will be able to compete with a public option would depend on how the premiums compare to what else is available.
Most individuals will pay some sort of premium to cover their care while low-income individuals would be covered by subsidies.
According to Morrisey, “Whether there is a public or no public option, it’s still the case that if you want to really reduce the 47 million uninsured you’re going to have to provide some significant subsidies to somebody.”
Under this proposal, it will be the government’s responsibility to make sure every American can afford quality health insurance. However, it will be up to the individual to attain and maintain coverage. If an individual chooses not to get coverage, they could face a fine. Morrisey argued that if there is going to be requirements for maintaining coverage there will have to be a form of subsidy mechanism to allow low income individuals the ability to do so.
Some responsibility also lies with the employer who will have the choice of providing health insurance coverage for their employees or donating money on their worker’s behalf.
Morrisey said that unlike the public option, Medicaid is not a program that one can pay a premium and participate in but rather a subsidy program. The proposal looks to expand Medicaid to cover more people. Morrisey suggests this could mean raising the age limit to cover older adults, raise the young age group as well, or raise the income threshold.
Medicaid is a matching program between the federal government and the state. The federal government pays a portion of the bill, and the state pay another portion. The issue with expanding Medicaid is that it would require states to provide their portion at a time when governors are not willing to do so.
Along with other program improvements, the plan looks to eradicate cost sharing through preventive services, fixing physician payments and improving the low-income subsidy. Some worry that Obama’s plan will actually reduce services.
As Morrisey explained, another issue that opponents have concerning Medicare is the effect of comparative effectiveness.
“From a purely research perspective, why don’t we find out which treatments and which procedures work, given that treatment A works and treatment B doesn’t, we’ll pay for A but not for B,” he said.
In the real world, it is not as black and white. One treatment might work better for some but not for others and vice versa. The argument boils down to Medicare recipients fearing that they would be denied care. Dr. Morrisey said that there is no proposal that actually goes that far.
Obama insists that there will be no taxes levied on the middle class but according to some plans, there could be a tax on the rich. Obama has also stated that by eliminating unnecessary treatments could cover some cost of reform.
Morrisey explains one proposal to reduce cost is to eliminate or reduce the tax subsidy to employer-sponsored health insurance. Conservatives would like to see the subsidy eliminated and tax rates dropped for everyone. Liberal would want the subsidy eliminated and use the money earned to pay for subsidies for lower income individuals.
According to Morrisey, the extent to which an average student would be affected depends on whether they are still on their parent’s plan or using the student health service plan.
If students are still under their parent’s coverage, they will not be affected. If their parents switch to the public option plan, their coverage will obviously change.
Concerning the student health service plan, the proposal would allow greater coverage than what is offered now.
However, Morrisey stated that most likely there would be no fundamental changes to come out of Congress. If something were to happen it would be before Christmas; before election season.
“The most we can expect to see are some incremental changes, some tinkering with the existing system. I don’t think you can get enough votes on any one plan,” said Morrisey.
Morrisoy explained that the cost side of health care must be controlled before addressing the non-insured. Unless the cost is controlled, there will not be any subsidies people will be able to afford.