President Obama used a sweeping address Wednesday to a joint session of Congress to try to quiet critics and salvage the signature issue of his nascent presidency, saying some opposition was based on lies and invoking the name of the late Sen. Edward Kennedy, D-Mass., to try to regain momentum in the healthcare debate.
The 47-minute speech covered little new ground but allowed the president to focus on key points of his initiative that Republicans have been chipping away at and some Democrats have grown wary of.
In one of the most pointed sections of the speech, he tried to undercut critics who say his plan was too expensive by saying his $900 billion healthcare plan would actually cost less than America has spent on two wars and on Bush administration tax cuts.
"The plan will not add to our deficit," the president said. "The middle class will realize greater security, not higher taxes. And if we are able to slow the growth of healthcare costs by just one-tenth of 1 percent each year, it will actually reduce the deficit by $4 trillion over the long term."
He also attacked GOP claims that the plan would set up death panels that would lead to euthanasia for senior citizens, saying it was "a lie, plain and simple," and the reform effort would provide health insurance for illegal immigrants. The latter point led to the evening's most dramatic moment.
"The reforms I'm proposing would not apply to those who are here illegally," Obama said, prompting Rep. Joe Wilson, R-S.C., to shout, "You lie," and Obama to respond, "not true."
The other hint of drama came as Obama mentioned a letter Kennedy had written to Obama, with instructions to deliver it after his death. With Kennedy's widow, Vicki, in the First Lady's box and his children in the audience, Obama noted that Kennedy was optimistic to the end that health reform -- "that great unfinished business of our society" -- would pass this year.
Obama's rhetoric was clearly aimed at trying to change public opinion, not GOP votes. Indeed, Republican reaction generally followed the script the GOP has used all year -- that the plan would result in higher taxes, lost jobs and a government takeover of the health system.
"Replacing your family's current health care with government-run care is not the answer," said Rep. Charles Boustany, R-La., a heart surgeon who delivered the GOP's official response. "In fact, it'll make health care much more expensive."
Added Senate Republican Conference Chairman Lamar Alexander of Tennessee: "We should listen to the American people and start over. Stop trying to pass thousand-page bills and start, step by step, to re-earn the trust of the American people. Focus on cost and the five or six steps we can take together to begin reforming health care."
Obama said pointedly that delaying action on health care was not an option.
"Everyone in this room knows what will happen if we do nothing," the president said. "Our deficit will grow, more families will go bankrupt, more businesses will close, more Americans will lose their coverage when they are sick and need it most, and more will die as a result."
Indeed, Obama issued a pointed call to Republicans to get on board or risk being left behind.
"I will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it," the president said. "I will not stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what's in this plan, we will call you out."
While he said good ideas could come from either side of the aisle, Obama's only bow to the opposition was praise for former Republican presidential candidate Sen. John McCain's campaign proposal to allow "low-cost coverage" for people with pre-existing conditions and an acknowledgment that some reform of medical malpractice law could help control healthcare costs. "I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine," Obama said, adding he would direct HHS Secretary Sebelius to move forward on a pilot program to test new ideas.
One specific policy Obama backed in his speech -- a proposed tax on the most expensive insurance plans -- drew immediate fire from members of his own party. "Taxing the so-called Cadillac plans by taxing the insurance companies will, in my opinion, result in the tax being spread out ... it's not going to be absorbed, it's going to be passed on. I don't know that I agree that that's the best way to do it," said Sen. Ben Nelson, D-Neb., a moderate who has expressed reservations about including a public option.
Obama's embrace of taxing the insurance companies for such plans also jeopardizes unions' support, which have generally opposed such a move.
In general, there was little to encourage Democrats in his party's left wing. His commitment to a public option did not come across as unbreakable, and he even chided "my progressive friends" for forgetting that the goal is insurance reform and universal coverage and that the public option is "only a means to that end."
The carefully chosen words to describe the public option -- and his avoidance of duplicating former President Bill Clinton's pen-waving veto threat if he didn't get his way -- underscored the tightrope Obama is walking on that particular issue with members of his own party and with some Republican moderates.
On one hand, House liberals have threatened to oppose the legislation if it does not include a public plan. On the other hand, some senators have said they would vote against the bill if it does contain such an option.
"He didn't get into much of the specificity we wanted, but at the same time he didn't throw it under the bus," said Rep. Raul Grijalva, D-Ariz., co-chairman of the Congressional Progressive Caucus.
But the mere mention of the public option drew fire from Senate Finance ranking member Charles Grassley, one of the "gang of six" members of that committee trying to negotiate a compromise, and Sen. Olympia Snowe of Maine, one Republican Democrats are hoping to sway in their bid to get the necessary 60 votes.
"The speech could have been pivotal for bipartisanship if it had been clear cut in ruling out the prospect of a new government-run plan," said Grassley.
Snowe added, "I would have preferred that the issue were taken off the table, as I have urged the president."
While Obama stopped short of a veto threat, he also did not back down from his oft-stated views. He reiterated his call for mandatory coverage, except for a few poorer Americans who receive a hardship waiver and his insistence on cracking down on insurance companies by preventing them from canceling coverage for someone who becomes ill or denying coverage because of a pre-existing condition.
Describing the current situation as at "a breaking point," he blamed the critics of reform, many of whom raised their voices at town hall meetings that lawmakers held in August. While he did not specifically state those critics were Republicans, there was no doubt that he had Republicans in mind when he lamented the "partisan spectacle that only hardens the disdain many Americans have toward their own government."
Instead of "honest debate," he said, "we have seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise. Too many have used this as an opportunity to score short-term political points."
This article appears in the September 12, 2009 edition of NJ Daily.