What Fence-Sitters Need to Hear on Health Care

WASHINGTON (March 3) -- President Barack Obama will go before the cameras yet again this afternoon to outline a path for health care reform. Unlike past speeches, Obama's real audience this time is relatively narrow: wavering congressional Democrats and independent voters. The president is expected to make the case for pushing forward with a comprehensive bill, despite a lack of Republican support.

Obama needs the backing of most Democrats in the Senate to win approval for a simple-majority, 51-vote reconciliation bill. In the House, it may be even tougher. While Democrats have a huge edge, the health care bill barely passed the first time around, in November, as 39 Democrats voted against the measure.

Because of vacancies that have occurred in the months since, House Speaker Nancy Pelosi will have to win over Democrats who opposed the bill originally. That's where Obama comes in. His sales pitch must make a dent with these Democrats, who will also be watching the polls for signs that voter support for the increasingly unpopular legislation is picking up.

Here is what the fence-sitters need to hear.

I Tried

For independent voters and centrist Democrats, Obama's biggest liability has been his failure to win any semblance of bipartisan support for his health care initiative, despite more than a year of trying. He will need to make a convincing case that he's done all he could and that a lack of support from Republicans is not his fault.

"It's an approach that has been debated and changed and I believe improved over the last year," Obama will say, according to excerpts of his speech released today. The White House telegraphed this effort by releasing a letter Tuesday from Obama to congressional leaders outlining GOP ideas from last week's seven-hour summit that he wants to incorporate into the bill. It also emphasized that the president had scrapped special deals in the bill that had drawn scathing criticism, like the so-called "Cornhusker Kickback" for Nebraska and a Medicare exemption for Florida.

That was a good start, said Democratic strategist Dan Gerstein. "It shows the president being responsive and trying to lead and forging common ground," he said. The letter sends the message that "this isn't a 'my way or the highway' type of bill," Gerstein added.

Baby Steps Won't Work

Obama has already rejected the "start-over" approach pushed by Republicans. Now he is arguing against the idea of passing health care reform in bite-size pieces of broadly popular items, like insurance market reforms. "I also believe that piecemeal reform is not the best way to effectively reduce premiums, end the exclusion of people with pre-existing conditions or offer Americans the security of knowing that they will never lose coverage, even if they lose or change jobs," Obama wrote in his letter.

This is a key distinction, because polls show a disparity between support for individual parts of the health care plan, which are popular, and the 2,000-page bill as a whole, which is not.

It's the Last Chance

The president used to emphasize that now was "the best chance" to achieve far-reaching reform. Well, that time has come and gone, right along with the Democratic supermajority in the Senate. Obama's new message to those on the fence can be boiled down to: It's now or never. And he will expand his argument to address the broader issue of Washington dysfunction.

"At stake right now is not just our ability to solve this problem, but our ability to solve any problem," Obama will say, according to speech excerpts released by the White House. "The American people want to know if it's still possible for Washington to look out for their interests and their future. They are waiting for us to act. They are waiting for us to lead."