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Health Care Debate Takes Center Stage

NOAH ADAMS, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Noah Adams.

ROBERT SIEGEL, host:

And I'm Robert Siegel.

With most of the country getting ready for a long Labor Day weekend, Washington is in a state of high anticipation about what the president will say in next Wednesday night's health care address to a joint session of Congress. Since the announcement, Republicans who oppose the president's efforts are making it very clear that his speech will not turn them around. An address like this is very rare, and it's an indication of the high stakes of the health care debate. The success of the Obama presidency and his party's fortunes in next year's midterm elections may ride on the outcome of the health care fight.

Well, joining me now to talk about this is NPR's national political correspondent Mara Liasson. And Mara, the president's speech will come almost sixteen years to the day after President Bill Clinton gave a similar address to Congress; a year later, Clinton's health care effort was dead. Is it fair to draw parallels between these two Democratic presidents in their attempts to pass universal health coverage?

MARA LIASSON: Well, it's fair, although the parallels only go so far. There's no doubt that the lessons of the failed Clinton effort hang heavily over this White House and they've gone to great lengths to learn the lessons - some people say they over-learned them. They decided early on they wouldn't send up what they call the stone tablets of Hillary - send a bill up to Congress. They were going to let Congress write the bill. The president was going to be above the fray and talk about his broad principles. I think now they're adjusting.

There's got to be a happy medium between being incredibly deferential to Congress and sending up stone tablets and now with this speech, he's trying to get more involved. There are a lot of other big differences. First of all, President Obama is much farther along in his effort to pass this - it's gone through a number of committees - than Bill Clinton ever got. There's also a big difference in that Democrats in 1994 didn't understand that not passing health care would really hurt them politically. This year I think they all understand that not passing something is the worst outcome for them.

SIEGEL: One of the biggest questions about next week's speech is how President Obama will resolve one of the most polarizing fights in this debate, which is whether or not he wants or prefers or insists on a public option, a government-run insurance plan to compete with private insurers. Do you expect him to answer that question on Wednesday?

LIASSON: I don't know. He will definitely talk about it, but I don't know how specific he will be. The White House talking points have been he prefers a public option. He won't say he would veto a bill without it. He won't say it's a deal breaker. He won't say how hard he's going to fight for it. That makes liberal Democrats in Congress very nervous. Every time the president comes out with a statement that seems less than foursquare behind the public option, saying it's just one part of this, there's tremendous pressure on him to restate his preference and reassure them that he's not bailing out.

He is trying to balance the interests of his liberal wing, who wants this public option very much, and his moderates in the Senate, who he has to have to pass this bill, who will not vote for a public option. And this has become a real flashpoint. As a political matter, certainly in the House of Representatives and probably in the Senate there is no liberal Democrat who will lose their seat if there is not a public option in the bill, but there are moderates and conservative Democrats who might.

SIEGEL: Now what about the idea of a public option, a sort of a public option in waiting, in the wings. Something that would be triggered if the system without a public option didn't meet these standards that Congress seeks.

LIASSON: That is a big option right now. It's something that the White House is talking a lot about with Senator Olympia Snowe. She is the main proponent of this idea. She is in the catbird seat in the Senate right now because she is the only Republican who seems to be negotiating in good faith on this. She wields disproportionate power over the debate, not unlike the kind of power she wielded over the stimulus bill because she is one of the very few Republicans. The Democrats need 60 votes in the Senate to overcome a filibuster. And with 59 votes after the death of Ted Kennedy, they're going to need a Republican or maybe more than one. So the question is whether the president on Wednesday would say he's open to this idea of a trigger. The trigger is anathema to liberal Democrats. They think it's a way of never getting to a public option. They point to the Medicare prescription drug bill, which has a trigger in it. It's never been pulled. And that's what they're worried about. That the mechanism for the trigger would be set too strictly.

SIEGEL: Thank you, Mara.

LIASSON: Thank you, Robert.

SIEGEL: That's NPR national political correspondent Mara Liasson. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Mara Liasson is a national political correspondent for NPR. Her reports can be heard regularly on NPR's award-winning newsmagazine programs Morning Edition and All Things Considered. Liasson provides extensive coverage of politics and policy from Washington, DC — focusing on the White House and Congress — and also reports on political trends beyond the Beltway.
Prior to his retirement, Robert Siegel was the senior host of NPR's award-winning evening newsmagazine All Things Considered. With 40 years of experience working in radio news, Siegel hosted the country's most-listened-to, afternoon-drive-time news radio program and reported on stories and happenings all over the globe, and reported from a variety of locations across Europe, the Middle East, North Africa, and Asia. He signed off in his final broadcast of All Things Considered on January 5, 2018.