David Plouffe, the president’s top adviser and his 2008 campaign manager, summoned 16 top Democratic strategists (many of whom appear on network and cable TV) to the White House on June 15 for a bull session on the 2012 race. They gathered in Room 234 of the Eisenhower Executive Office Building, commonly referred to as the War Room because 18 secretaries of war used it as their office. According to three participants, Plouffe promised that, no matter how the Supreme Court ruled on his health care law, President Obama would not dwell on it. In focus groups, swing voters expressed numbing fatigue with the health care debate, Plouffe said. Most came back to the same gut-level question: Will I have to change my health plan? If not, they didn’t care about the law. They care about jobs and the economy. And so, Plouffe promised, would Obama.
On Thursday, the Court upheld the law, albeit with some substantial revisions. And, as promised, Obama appeared on TV two hours later. He conceded that his signature achievement was not especially popular—“I didn’t do this because it was good politics,” he said—and right away sought to assure voters that the Court has closed the book. “If you’re one of the more than 250 million Americans who already have health insurance, you will keep your health insurance.” His message seemed aimed especially at those fatigued voters. Obama promised not to “refight the political battles of two years ago.… Now’s the time to keep our focus on the most urgent challenge of our time: putting people back to work.”
One participant in the Plouffe meeting who asked not to be identified has a name for this strategy. “The White House was giving health care the Heisman,” the strategist says, referring to the iconic statue given to college football’s best player, depicting a ball carrier fending off a defender with an extended stiff arm while he runs forward. Thursday made the Heisman metaphor even more fitting: Obama’s focus has long been on the quiet implementation of the health care law. He’s downplayed it rhetorically almost since he signed it—knowing the political cost of pursuing it while recessionary fires continued to burn.
The 2008 campaign rested on a not-quite-tangible sense of history in the making, but the health care slog drained the blood and passion away from Obama and rendered him at times diffident, transactional, and aloof. In the aftermath of that legislative tussle, exhaustion and entropy overtook the White House. The administration stumbled through the debt conflict with House and Senate Republicans, and the president sank to his lowest-ever approval rating. Health care became the forgotten accomplishment, and it was starting to look like an albatross. “I was always surprised he wasn’t able to market it better,” says Chris Jennings, a health care specialist with the Clinton White House and an adviser to the 2008 Democratic National Convention Platform Committee. “I thought they would do more.”
Now, even as Obama focuses on his economic message, he has a chance to reignite the passion and to reanimate a crucial but dormant 2008 theme. Top campaign adviser David Axelrod has repeatedly said in reelection strategy sessions that health care is the path for Obama to recapture some of his lost “change” dynamism. Axelrod indicated that, if the Court nullified some of the law, Obama would say he fought for change and was thwarted by stick-in-the-mud justices; now that those justices have upheld the law, Obama will argue even more aggressively that he fought for and produced epic change that eluded Democratic presidents, such as Harry Truman, Lyndon Johnson, and Bill Clinton.
The individual insurance mandate may not poll especially well, but change—and fighting for it on behalf of the middle class—does. That’s where Obama will take health care. “This a fundamental and huge and long overdue accomplishment,” Jennings says. “He has to ratify it by being reelected.” Former Vermont Gov. Howard Dean echoed the point. He revamped his state’s health care 20 years ago without using an individual mandate and clashed with Obama’s legislative approach, but he bowed to its undisputed social and economic reach. “Obama has changed the face of health care,” Dean says. “Insurers and hospitals will continue to adapt to this law, and you will see more vertical integration of services and more downward pressure on costs. It was worth undertaking.”
House Republicans announced a July 11 vote to repeal Obama’s law, with the debate focused on what they are now casting as a middle-class tax hike. The Court’s majority declared that people who failed to buy health insurance, in defiance of the “mandate,” could not be penalized under the commerce clause; instead, the punishment is really a tax, which Congress has every right to levy. Obama and congressional Democrats specifically named the fee a “penalty” to avoid a fight over taxes. Tim Phillips, president of Americans for Prosperity, a grassroots GOP-leaning group that campaigned nationwide against Obama’s stimulus and health care bills, says that the tax issue, merged with ongoing economic anxiety, gives the health care debate a new political lease on life. “It’s a twofer,” says Phillips, who vowed a $9 million post-ruling ad campaign. “You talk about big government and the law being a drag on the economy. I can’t think of any better way to spend July.”
Back in Room 234, Plouffe foresaw this possibility: A Court decision might not hand the president a decisive and final advantage. Obama is in a fight for his political life, the poll numbers are down, and the waters are choppy, Plouffe acknowledged. “We’re in the barrel now,” he said, describing how the president is riding toward the waterfall. But at least, once again, he’s flowing downstream.
This article appears in the June 30, 2012, edition of National Journal Magazine.