Five Scenarios for Obama's Health Care Summit

WASHINGTON (Feb. 24) -- The stakes couldn't be higher for Thursday's bipartisan health care summit, as President Barack Obama makes one last major effort to pass a sweeping overhaul of the nation's medical insurance system. Here are five ways the Blair House confab could play out from the president's perspective.

Obama's Wildest Dream: A GOP Epiphany
The GOP would need to have a we-realize-the-error-of-our-ways epiphany to give Obama the kind of truly bipartisan consensus that he hoped to achieve a year ago. This, to be perfectly clear, will not happen. Republican leaders Mitch McConnell, John Boehner and Eric Cantor have already panned the president's latest proposal, and they have determined that it is in their best political interest to oppose a far-reaching reform plan at all costs.

A scenario that is slightly -- but only slightly -- more within the realm of possibility is that Obama delivers such a compelling performance, and in the process so embarrasses the GOP, that moderate Republican Sens. Olympia Snowe and Susan Collins have a change of heart and decide to firmly break with the more conservative base of their party. This would allow Democrats to garner 60 votes and pass a final bill without resorting to the risky budget reconciliation process they are now considering. But even a great presidential argument is not likely to be enough. In order to shift the pendulum so significantly, Obama probably needs a GOP meltdown along the lines of a "You lie!" moment to crystallize in the public eye a sense of irrational intransigence on the part of Republicans.

A Realistic Best Case: Democrats Unite
For Obama, a genuine and realistic victory Thursday has nothing to do with Republicans and everything to do with Democrats. His goal is to unify his party. To do so, he must crisply outline the political and substantive urgency of finally passing a bill while demonstrating that Republicans are not negotiating in good faith.

In this regard, the Obama strategy relies on a repeat of his strong performance at the House GOP retreat in Baltimore last month. He will try to highlight the Republicans' weakest arguments, point out their past support for many provisions in the health care bill, and efficiently and smoothly parry their inevitable criticism of the messy process Democrats have used to achieve reform. He'll agree to include a few token Republican ideas -- perhaps tort reform -- but none that will fundamentally alter the bill enough to scare off liberals or persuade Republicans to jump on.

The big risk for Republicans is that if they appear to be heading into the summit carrying a large "No" sign, their strategy could allow Obama's token bipartisanship to appear more significant than it really is, thus handing him a key win in the battle over perception.

Never-Ending Photo-Op: Big Talk, Little Movement
The Blair House summit could turn out to be what leading voices increasingly agree it is: a daylong photo op filled with the same talking points that all parties have been hitting for months. Obama will push his plan with a few new wrinkles and a smile, Republicans will say no with a smile and both parties will decide that the risks are too big to try to knock the other down with a dramatic confrontation. In boxing terms, it would be a fight with all jabs. A tie in this case would go to the GOP, since it would force Democrats to try a complicated combination of legislative maneuvers to pass their bill, all without any added momentum they hope to gain from a summit. An unproductive meeting would also reflect poorly on Obama, reinforcing the notion that he is simply not a strong leader.

Obama Blinks, or Democrats Bicker
Two of the president's most significant vulnerabilities on health care involve the process and disagreements within his own party. Republicans are sure to hammer the president on the fact that even as he pledges a genuine commitment to bipartisanship, congressional Democrats and the White House are plotting to pass a health care bill without GOP support. Obama has already acknowledged mistakes in the process last year, including too many backroom negotiating sessions and allowing sweetheart deals to win over individual Democrats. If GOP leaders can back Obama into a rhetorical corner Thursday and elicit specific concessions from him on the legislative process, such as swearing off the parliamentary reconciliation route in the Senate or breaking the bill into smaller parts, then it would doom a comprehensive bill.

Likewise, Obama could run into trouble if Democratic tensions -- particularly those between House and Senate leaders -- break out into the open at the summit. Will liberals in attendance push once more for the public option, for example? Republicans would be only too happy to sit back and watch Democrats debate with one another, offering a sure sign that even a one-party consensus is out of reach. Either scenario would mean a clear loss for Obama.

The Disaster: Obama Loses It
The biggest risk for the famously unflappable president is that he loses his cool. Throughout a year of setbacks and increasingly vitriolic attacks from his opponents, Obama has maintained a high personal approval rating, rarely exacerbating his political problems by overreacting or lashing out. When Rep. Joe Wilson shouted "You lie!" at him during his September address to Congress, Obama barely flinched, and when Republicans challenged him directly at their retreat in Baltimore, Obama not only kept it together, he came out on top.

But Thursday's test will be even more formidable -- several hours of nationally televised engagement with Republicans who, beyond the pleasantries, will likely criticize him the entire time. If Republicans succeed in provoking Obama during such a high-profile forum, the repercussions could extend far beyond the health care debate, threatening the rest of his already precarious policy agenda and sending his first term into a tailspin.