by Obama Barack
There was a reason, I told Valerie, why Republicans tended to do the opposite—why Ronald Reagan could preside over huge increases in the federal budget, federal deficit, and federal workforce and still be lionized by the GOP faithful as the guy who successfully shrank the federal government. They understood that in politics, the stories told were often as important as the substance achieved.
We made none of these arguments publicly, though for the rest of my presidency the phrase “public option” became a useful shorthand inside the White House anytime Democratic interest groups complained about us failing to defy political gravity and securing less than 100 percent of whatever they were asking for. Instead, we did our best to calm folks down, reminding disgruntled supporters that we’d have plenty of time to fine-tune the legislation when we merged the House and Senate bills. Harry kept doing Harry stuff, including keeping the Senate in session weeks past the scheduled adjournment for the holidays. As he’d predicted, Olympia Snowe braved a blizzard to stop by the Oval and tell us in person that she’d be voting no. (She claimed it was because Harry was rushing the bill through, though word was that McConnell had threatened to strip her of her ranking post on the Small Business Committee if she voted for it.) But none of this mattered. On Christmas Eve, after twenty-four days of debate, with Washington blanketed in snow and the streets all but empty, the Senate passed its healthcare bill, titled the Patient Protection and Affordable Care Act—the ACA—with exactly sixty votes. It was the first Christmas Eve vote in the Senate since 1895.
A few hours later, I settled back in my seat on Air Force One, listening to Michelle and the girls discuss how well Bo was adjusting to his first plane ride as we headed to Hawaii for the holiday break. I felt myself starting to relax just a little. We were going to make it, I thought to myself. We weren’t docked yet, but thanks to my team, thanks to Nancy, Harry, and a whole bunch of congressional Democrats who’d taken tough votes, we finally had land within our sights.
Little did I know that our ship was about to crash into rocks.
* * *
—
OUR MAGIC, FILIBUSTER-PROOF hold on the Senate existed for only one reason. After Ted Kennedy died in August, the Massachusetts legislature had changed state law to allow the governor, Democrat Deval Patrick, to appoint a replacement rather than leaving the seat vacant until a special election could be held. But that was just a stopgap measure, and now, with the election scheduled for January 19, we needed a Democrat to win the seat. Fortunately for us, Massachusetts happened to be one of the most Democratic states in the nation, with no Republican senators elected in the previous thirty-seven years. The Democratic nominee for the Senate, attorney general Martha Coakley, had maintained a steady, double-digit lead over her Republican opponent, a little-known state senator named Scott Brown.
With the race seemingly well in hand, my team and I spent the first two weeks of January preoccupied by the challenge of brokering a healthcare bill acceptable to both House and Senate Democrats. It was not pleasant. Disdain between the two chambers of Congress is a time-honored tradition in Washington, one that even transcends party; senators generally consider House members to be impulsive, parochial, and ill-informed, while House members tend to view senators as long-winded, pompous, and ineffectual. By the start of 2010, that disdain had curdled into outright hostility. House Democrats—tired of seeing their huge majority squandered and their aggressively liberal agenda stymied by a Senate Democratic caucus held captive by its more conservative members—insisted that the Senate version of the healthcare bill had no chance in the House. Senate Democrats—fed up with what they considered House grandstanding at their expense—were no less recalcitrant. Rahm and Nancy-Ann’s efforts to broker a deal appeared to be going nowhere, with arguments erupting over even the most obscure provisions, members cursing at one another and threatening to walk out.
After a week of this, I’d had enough. I called Pelosi, Reid, and negotiators from both sides down to the White House, and for three straight days in mid-January we sat around the Cabinet Room table, methodically going through every dispute, sorting out areas where House members had to take Senate constraints into account and where the Senate had to give, with me reminding everyone all the while that failure was not an option and that we’d do this every night for the next month if that’s what it took to reach an agreement.
Though progress was slow, I felt pretty good about our prospects. That is, until the afternoon I stopped by Axelrod’s small office and found him and Messina leaning over a computer like a pair of doctors examining the X-rays of a terminal patient.
“What’s the matter?” I asked.
“We’ve got problems in Massachusetts,” Axe said, shaking his head.
“How bad?”
“Bad,” Axe and Messina said in unison.
They explained that our Senate candidate, Martha Coakley, had taken the race for granted, spending her time schmoozing elected officials, donors, and labor bigwigs rather than talking to voters. To make matters worse, she’d taken a vacation just three weeks before the election, a move the press had roundly panned. Meanwhile, Republican Scott Brown’s campaign had caught fire. With his everyman demeanor and good looks, not to mention the pickup truck he drove to every corner of the state, Brown had effectively tapped into the fears and frustrations of working-class voters who were getting clobbered by the recession and—because they lived in a state that already provided health insurance to all its residents—saw my obsession with passing a federal healthcare law as a big waste of time.
Apparently neither the tightening poll numbers nor nervous calls from my team and Harry had shaken Coakley out of her torpor. The previous day, when asked by a reporter about her light campaign schedule, she had brushed the question off, saying, “As opposed to standing outside Fenway Park? In the cold? Shaking hands?”—a sarcastic reference to Scott Brown’s New Year’s Day campaign stop at Boston’s storied ballpark, where the city’s hockey team, the Boston Bruins, were hosting the annual NHL Winter Classic against the Philadelphia Flyers. In a town that worshipped its sports teams, it would be hard to come up with a line more likely to turn off large segments of the electorate.
“She didn’t say that,” I said, dumbfounded.
Messina nodded toward his computer. “It’s right here on the Globe website.”
“Nooooo!” I moaned, grabbing Axe by the lapels and shaking him theatrically, then stomping my feet like a toddler in the throes of a tantrum. “No, no, no!” My shoulders slumped as my mind ran through the implications. “She’s going to lose, isn’t she?” I said finally.
Axe and Messina didn’t have to answer. The weekend before the election, I tried to salvage the situation by flying to Boston to attend a Coakley rally. But it was too late. Brown won comfortably. Headlines around the country spoke of a STUNNING UPSET and HISTORIC DEFEAT. The verdict in Washington was swift and unforgiving.
Obama’s healthcare bill was dead.
* * *
—
EVEN NOW, it’s hard for me to have a clear perspective on the Massachusetts loss. Maybe the conventional wisdom is right. Maybe if I hadn’t pushed so hard on healthcare during that first year, if instead I’d focused all my public events and pronouncements on jobs and the financial crisis, we might have saved that Senate seat. Certainly, if we’d had fewer items on our plate, my team and I might have noticed the warning signs earlier and coached Coakley harder, and I might have done more campaigning in Massachusetts. It’s equally possible, though, that given the grim state of the economy, there was nothing we could have done—that the wheels of history would have remained impervious to our puny interventions.
I know that at the time all of us felt we’d committed a colossal blunder. Commentators shared in that assessment. Op-ed pieces called for me to replace my team, starting with Rahm and Axe. I didn’t pay much attention. I figured any mistakes were mine to own, and I t
ook pride in having built a culture—both during the campaign and inside the White House—where we didn’t go looking for scapegoats when things went south.
But it was harder for Rahm to ignore the chatter. Having spent most of his career in Washington, the daily news cycle was how he kept score—not just on the administration’s performance but on his own place in the world. He constantly courted the city’s opinion makers, aware of how quickly winners became losers and how mercilessly White House staffers were picked apart in the wake of any failure. In this case, he saw himself as unfairly maligned: It was he, after all, who more than anyone had warned me about the political peril in pressing ahead with the healthcare bill. And as we’re all prone to do when hurt or aggrieved, he couldn’t help venting to friends around town. Unfortunately that circle of friends turned out to be too wide. About a month after the Massachusetts election, Washington Post columnist Dana Milbank wrote a piece in which he mounted a vigorous defense of Rahm, arguing that “Obama’s greatest mistake was failing to listen to Emanuel on health care” and outlining why a scaled-back healthcare package would have been the smarter strategy.
Having your chief of staff appear to distance himself from you after you’ve been knocked down in a fight is less than ideal. Though I wasn’t happy with the column, I didn’t think Rahm had deliberately prompted it. I chalked it up to carelessness under stress. Not everyone, though, was so quick to forgive. Valerie, ever protective of me, was furious. Reactions among other senior staffers, already shaken by the Coakley loss, ranged from anger to disappointment. That afternoon, Rahm entered the Oval appropriately contrite. He hadn’t meant to do it, he said, but he’d let me down and was prepared to tender his resignation.
“You’re not resigning,” I said. I acknowledged that he’d messed up and would need to square things with the rest of the team. But I also told him he’d been a great chief of staff, that I was confident that the error would not be repeated, and that I needed him right where he was.
“Mr. President, I’m not sure—”
I cut him off. “You know what your real punishment is?” I said, clapping him on the back as I ushered him toward the door.
“What’s that?”
“You have to go pass the goddamn healthcare bill!”
That I still considered this possible wasn’t as crazy as it seemed. Our original plan—to negotiate a compromise bill between House and Senate Democrats and then pass that legislation through both chambers—was now out of the question; with only fifty-nine votes, we’d never avoid a filibuster. But as Phil had reminded me the night we’d received the Massachusetts results, we had one remaining path, and it didn’t involve going back to the Senate. If the House could just pass the Senate bill without changes, they could send it straight to my desk for signature and it would become law. Phil believed that it might be possible to then invoke a Senate procedure called budget reconciliation—in which legislation that involved strictly financial matters could be put up for a vote with the agreement of a simple majority of senators rather than the usual sixty. This would allow us to engineer a limited number of improvements to the Senate bill via separate legislation. Still, there was no getting around the fact that we’d be asking House Democrats to swallow a version of healthcare reform they’d previously rejected out of hand—one with no public option, a Cadillac tax the unions opposed, and a cumbersome patchwork of fifty state exchanges instead of a single national marketplace through which people could buy their insurance.
“You still feeling lucky?” Phil asked me with a grin.
Actually, I wasn’t.
But I was feeling confident in the Speaker of the House.
The previous year had only reinforced my appreciation for Nancy Pelosi’s legislative skills. She was tough, pragmatic, and a master at herding members of her contentious caucus, often publicly defending some of her fellow House Democrats’ politically untenable positions while softening them up behind the scenes for the inevitable compromises required to get things done.
I called Nancy the next day, explaining that my team had drafted a drastically scaled-back healthcare proposal as a fallback but that I wanted to push ahead with passing the Senate bill through the House and needed her support to do it. For the next fifteen minutes, I was subjected to one of Nancy’s patented stream-of-consciousness rants—on why the Senate bill was flawed, why her caucus members were so angry, and why the Senate Democrats were cowardly, shortsighted, and generally incompetent.
“So does that mean you’re with me?” I said when she finally paused to catch her breath.
“Well, that’s not even a question, Mr. President,” Nancy said impatiently. “We’ve come too far to give up now.” She thought for a moment. Then, as if testing out an argument she’d later use with her caucus, she added, “If we let this go, it would be rewarding the Republicans for acting so terribly, wouldn’t it? We’re not going to give them the satisfaction.”
After I hung up the phone, I looked up at Phil and Nancy-Ann, who’d been milling around the Resolute desk, listening to my (mostly wordless) side of the conversation, trying to read my face for a sign of what was happening.
“I love that woman,” I said.
* * *
—
EVEN WITH THE SPEAKER fully on board, the task of rounding up the necessary votes in the House was daunting. Aside from having to drag progressives kicking and screaming to support a bill tailored to the sensibilities of Max Baucus and Joe Lieberman, the election of Scott Brown less than a year before the midterms had spooked every moderate Democrat who would be in a competitive race. We needed something to help shift the doom-and-gloom narrative and give Nancy time to work her members.
As it turned out, our opposition gave us exactly what we needed. Months earlier, the House Republican caucus had invited me to participate in a question-and-answer session at their annual retreat, scheduled for January 29. Anticipating that the topic of healthcare might come up, we suggested at the last minute that they open the event to the press. Whether because he didn’t want the hassle of dealing with pushback from excluded reporters or because he was feeling emboldened by the Scott Brown victory, John Boehner agreed.
He shouldn’t have. In a nondescript Baltimore hotel conference room, with caucus chair Mike Pence presiding and the cable networks capturing every exchange, I stood on the stage for an hour and twenty-two minutes fielding questions from Republican House members, mostly about healthcare. For anyone watching, the session confirmed what those of us who’d been working on the issue already knew: The overwhelming majority of them had little idea of what was actually in the bill they so vehemently opposed, weren’t entirely sure about the details of their proposed alternatives (to the extent that they had any), and weren’t equipped to discuss the topic outside the hermetically sealed bubble of conservative media outlets.
Returning to the White House, I suggested that we press our advantage by inviting the Four Tops and a bipartisan group of key congressional leaders to come to Blair House for an all-day meeting on healthcare. Once again, we arranged to have the proceedings broadcast live, this time through C-SPAN, and again the format allowed Republicans to make whatever points or ask whatever questions they wanted. Having been caught off guard once, they came prepared with a script this time. House GOP whip Eric Cantor brought a copy of the House bill, all 2,700 pages of it, and plopped it on the table in front of him as a symbol of an out-of-control government takeover of healthcare. Boehner insisted that our proposal was “a dangerous experiment” and that we should start over. John McCain launched into a lengthy harangue about backroom deals, prompting me at one point to remind him that the campaign was over. But when it came to actual policy—when I asked GOP leaders what exactly they proposed to help drive down medical costs, protect people with preexisting conditions, and cover thirty million Americans who couldn’t otherwise get insurance—their answers were as threadbare as Chuck Gr
assley’s had been during his visit to the Oval months before.
I’m sure that more people watched bowling that week than caught even five minutes of these conversations on TV, and it was clear throughout both sessions that nothing I said was going to have the slightest impact on Republican behavior (other than motivating them to bar TV cameras from my future appearances before their caucuses). What mattered was how the two events served to reinvigorate House Democrats, reminding them that we were on the right side of the healthcare issue, and that rather than focusing on the Senate bill’s shortcomings, they could take heart in how the bill promised to help millions of people.
* * *
—
BY THE BEGINNING of March, we had confirmed that Senate rules would allow us to clean up parts of the Senate bill through reconciliation. We enhanced the subsidies to help more people. We trimmed the Cadillac tax to placate the unions and got rid of the twin embarrassments of the “Cornhusker Kickback” and “Louisiana Purchase.” Valerie’s public engagement team did great work lining up endorsements from groups like the American Academy of Family Physicians, the American Medical Association, the American Nurses Association, and the American Heart Association, while a grassroots network of advocacy groups and volunteers worked overtime to educate the public and keep the pressure on Congress. Anthem, one of America’s largest insurers, announced a 39 percent rate hike, conveniently reminding people of what they didn’t like about the current system. And when the United States Conference of Catholic Bishops announced that it couldn’t support the bill (convinced that the bill’s language prohibiting the use of federal subsidies for abortion services wasn’t explicit enough), an unlikely ally arrived in the form of Sister Carol Keehan, a soft-spoken, perpetually cheerful nun who headed up the nation’s Catholic hospitals. Not only did the sixty-six-year-old Daughter of Charity break with the bishops by insisting that passage of the bill was vital to fulfilling her organization’s mission of caring for the sick; she inspired the leaders of Catholic women’s orders and organizations representing more than fifty thousand American nuns to sign a public letter endorsing the bill.