Obama fights to recapture health care initiative

Olivier Knox

After an initial phase of shell-shocked damage control, President Barack Obama’s efforts to save his signature health care law — and with it his second term and his place in U.S. history — are taking on an aggressive tone.

“Let’s face it, a lot of us didn’t realize that passing the law was the easy part,” Obama told scores of supporters late Monday at a posh Washington hotel.

The new approach — emphasizing Affordable Care Act benefits that are already in effect and don’t require navigating a botched website, promoting the law’s success stories, blaming Republicans and the news media in equal measure for the bad news — also comes with a renewed focus on issues that helped unite the winning coalition of his 2012 re-election campaign.

The president has stepped up calls for Congress to pass, by year’s end, legislation overhauling America’s immigration policy. On Tuesday, he’ll meet with top executives to make the argument that doing so would help the economy.

And the Democratic-held Senate voted 61-30 late Monday to advance a bill to outlaw workplace discrimination based on sexual orientation, with seven Republicans breaking ranks to side with the majority. “Common sense,” Obama told activists backing his Organizing for Action group at the St. Regis Hotel.

Amid headlines screaming out Obamacare’s setbacks, White House press secretary Jay Carney told reporters Monday that the president’s “No. 1 priority has and will be economic progress.”

That's two issues that rally pivotal segments of the public behind the Democratic position, while dividing Republicans, and one that remains atop the list of voter concerns. Is the president in campaign mode one year after his re-election and one year before the 2014 midterms?

“I just promise that in November of 2013 I haven't had a single conversation about 2014,” Carney insisted Monday.

Riiiiiiight. The White House has said that the president will travel to Dallas on Wednesday for an event with health care volunteers — and then fundraising for the Democratic Senate campaign fund. On Friday, after a stop in New Orleans to discuss export growth, Obama will head to Miami for more Democratic fundraisers.

And somehow neither the president nor Vice President Joe Biden mentioned the Affordable Care Act directly when they headlined separate rallies for Virginia gubernatorial candidate Terry McAuliffe on Sunday and Monday. His GOP opponent, Ken Cuccinelli, has bet his chances for an upset win on opposition to the health care law.

But for the first time in its brief history, the Patient Protection and Affordable Care Act’s fate isn’t up to congressional arm-twisters, or White House negotiators or even the voters. It’s up to a phalanx of experts (affectionately dubbed “the nerds” by some in the West Wing) doing surprisingly literal damage control, trying to fix HealthCare.gov

Democrats and Republicans alike say that repairing the site by the administration’s self-imposed early December deadline could dramatically reshape the Obamacare battlefield.

“It comes down to the website, which has really been a manifestation of people’s fears. It validates people’s concerns about the law,” a top aide to a Democratic senator up for re-election in 2014 told Yahoo News.

“The best thing that could happen for us is for the fix to be good enough, the enrollment drive good enough, that it makes what happened in the last two months seem like it never happened,” said the aide, speaking anonymously to discuss the situation candidly. “We need this law to work.”

After that, Democrats say, the law could benefit from steadily growing numbers of Americans getting benefits.

But “this fix, the website, the enrollment drive that comes next, it has got to dwarf what came before, make it look like a campaign for elementary school class treasurer,” the Democratic aide said.

“I won’t say that fixing the website two months after it launched is a huge victory, but the website was an obvious, easily understood failure we had nothing to do with,” one Republican congressional aide told Yahoo News. “We’ll still push on the job losses and the ‘if you like your plan, you can keep it.’”

Republicans have seized on Obama’s refrain as evidence of dishonesty. Major news outlets have highlighted the many thousands of people losing their existing health care coverage because it does not meet the law’s more generous requirements.

On Monday, Obama himself tried to retroactively add a little fine print. “What we said was, you could keep it if it hasn’t changed since the law was passed,” he told supporters.

That was in the legislation — plans that existed before it became law (and remained unchanged) were grandfathered in. New plans or those that underwent modifications had to adhere to the ACA’s tougher standards.

The White House points out that plans disappeared all the time before the Affordable Care Act — and that many of those vanishing now offer precious little actual coverage. Obama aides also underline that the higher cost of options provided under the new law reflect more generous benefits, while emphasizing that many Americans will qualify for subsidies to make it easier to buy health insurance.

But those qualifiers weren’t in Obama’s public campaigning.

“Nobody is changing what you’ve got if you’re happy with it,” the president said the day he signed the measure into law. “If you like your doctor you will be able to keep your doctor.”

The White House also has deployed more standard weapons — an array of what it calls “fact checks,” positive anecdotes to counter the (frequently dubious) horror stories, and links to positive coverage.

Outreach to worried congressional Democrats has been uneven. After the problem-plagued Oct. 1 rollout, it wasn’t until Oct. 30 that all Senate Democratic offices received their first White House-drafted talking points — a delay one Democratic leadership aide blamed on the two-week government shutdown.

(UPDATE: Another Senate Democratic leadership aide wrote in to dispute that account, saying that all Senate Democratic offices “were provided with message guidance and talking points consistently, both from the White House and HHS [Department of Health and Human Services], throughout October.”)

At the same time, the administration has held at least 20 briefings this year for lawmakers of both parties, and 10 more for staff.

“These briefings, were both offered proactively to and done at the request of lawmakers from both sides of the aisle, and are in addition to regular, constant outreach conducted at the staff level between White House staffers and Hill staffers on a daily basis,” said White House spokesman Eric Schultz. “They also are in addition to four meetings the president himself had in early October with House Democrats, House Republicans, Senate Democrats and Senate Republicans. “

Obama aides have taken the president’s lead and adopted a freshly combative tone — but that may be in part because they know things will get worse before they get better.

In mid-November, the administration is due to release the number of Americans who have successfully enrolled in health insurance plans under the Affordable Care Act.

Even with day-by-day improvements to HealthCare.gov, administration officials expect that number to be low, touching off a fresh round of criticisms.

“We're only one month into a six-month open enrollment period,” Obama said Monday. “It’s not as if this is a one-day sale or something. So we've just got to keep on working.”