Unusual Business: Movement on health care tests Obama’s ties to his base

ABC News’ Rick Klein reports:

Let's get this straight…

$250 billion doesn't cost a dime. To see President Obama talk tough with Wall Street Tuesday night, it cost more than 300,000 dimes a couple. (That's a lot of mops.)

The anti-war candidate is now thinking about escalating a war. But mostly, for now, he's thinking (while Sen. John Kerry serves as de facto secretary of state?).

And those doors behind which health care is being hashed out are really wide open — promise.

For a hungry left, the question is fast becoming: How many half loaves are going to be enough?

As we move closer (or so we're told) to a House vote on health care — it's worth remembering that the most vocal segments of the president's base are a sophisticated audience. They see past floor votes and conference committees (and can't see through closed doors that were promised to be open).

It's some politics-as-usual — closed-door meetings, gifts to key constituencies, with the president on the trail — that the president needs to get from here to there.

And on Afghanistan — growing public skepticism (just 45 percent support for the president's handling of the war, and 63 percent saying he lacks a clear plan, in the new ABC News/Washington Post poll) — with a run-off election in place. This is the time for a “quiet period” on health care? (Was he just too noisy before?)

“As Congressional leaders and White House officials huddle behind closed doors to settle their differences on health care legislation, one of the most powerful voices in the debate — President Obama's — has grown noticeably quieter,” Sheryl Gay Stolberg writes in The New York Times. “The idea, aides said, is for the president to take a breather while Democrats resolve their internal conflicts, so he can come back strong with a fresh sales pitch when the legislation moves closer to floor votes.”

Said David Axelrod: “I think his time is better spent on this particular issue in conversation with members and in talking to his own advisers and instructing them on how to proceed.”

“We've reached the top, we're headed downhill now, and we want it to stay that way,” White House deputy communications director Dan Pfeiffer tells the Los Angeles Times' Peter Nicholas.

Where's the president loudest? Raising money, in New York City Tuesday night — and streaming live for Organizing for America members:

” 'Yes we can' wasn't just a motto,” the president said, per ABC's Sunlen Miller. “That's what we're all about.”

In the House — no more delaying that day of reckoning, pitting left vs. center:

“Speaker Nancy Pelosi told Democrats Tuesday night that she wants to move forward with the more liberal version of a House health reform bill that would peg government-run coverage to Medicare — setting up a clash with moderates in her caucus who oppose the plan,” Politico's Patrick O'Connor reports. “Pelosi told her rank-and-file that she has more than 200 votes for a public option tethered to Medicare and that she wants to ‘see if we can find the remaining votes,' one member present said afterward.”

“The caucus will meet again Wednesday evening to retake the Democratic temperature. If the 218 votes are there, the party will plow forward and go to conference committee negotiations with a strong hand,” Ryan Grim reports at Huffington Post.

Life in the Senate for the public option — but not in a version that liberals are going to like: “Senate liberals are seeking to convince [Senate Majority Leader Harry] Reid that the public option has more support than the Finance Committee's votes suggested. And as the majority leader prepares to release a combined bill as soon as Friday, he is canvassing moderate Democrats to determine how much leeway he may have,” The Washington Post's Shailagh Murray and Lori Montgomery report.

A touch of payback, as Reid, D-Nev., gets tough: “Top Senate Democrats intend to try to strip the health insurance industry of its exemption from federal antitrust laws as part of the debate over health care, according to congressional officials, the latest evidence of a deepening struggle over President Barack Obama's top domestic priority,” the AP's David Espo writes. “If enacted, the switch would mean greater federal regulation for an industry that recently has stepped up its criticism of portions of a health care bill moving toward the Senate floor.”

Reid hears more noise back home: Americans United for Change is going up with $23,000 worth of radio ad buys in Nevada. This one bring sugar: “Luckily the guy whose has been handed the baton to run that last lap – is Nevada's Senator Harry Reid. Luckily… because Harry Reid isn't afraid to fight the insurance companies. He's already gone after their anti-trust exemption…. and he'll keep fighting until we get health care for all Americans — including a public option — this year.”

Yet … with the president still in campaign mode (he's in New Jersey Wednesday night to campaign for Gov. Jon Corzine, D-N.J.) — this is hardly a vote of confidence from a candidate he'll be alongside next week:

“I don't think the public option is necessary in any plan and I think Virginia — certainly, I would certainly consider, opting out if that were available to Virginia,” Creigh Deeds, D-Va., said at Tuesday's gubernatorial debate, per ABC's Teddy Davis.

(Underwhelming day for Deeds, despite the star power. Politico's Jonathan Martin and Andy Barr: “It's doubtful that any of the few hundred people who turned up for Democrat Creigh Deeds at a Northern Virginia campaign office needed a reminder that their candidate is trailing badly in his race for governor. They got one anyway — courtesy of the former president and still-current political analyst Bill Clinton, who offered the small-by-late-October-standards crowd an extended discourse on why Deeds's situation is not necessarily as bad as it seems.”)

Minding the numbers: “House Democrats have cut the cost of their health care bill from more than $1 trillion over 10 years to $871 billion over a decade,” the AP's Erica Werner reports. “Getting to $871 billion requires going with a strong government plan to sell insurance in competition with private insurers — something Pelosi and liberals have pushed for.”

Tending the base: Organizing for America's Mitch Stewart writes an e-mail to supporters on Wednesday, taking a victory lap (it helps when you set your own goals and then exceed them thrice over). “I'm looking at the numbers, and with almost all of the reports now in, the tally wasn't 200,000 calls placed or pledged — it was 315,023. You did it. . . . You set a new OFA record, you caught the national media's attention, and you certainly put Congress on notice. But you know that's not what really matters.”

Fudging the math: “Medicare is hurtling toward insolvency, but [Sen. Debbie] Stabenow would essentially repeal past cost-cutting efforts,” Dana Milbank writes in his Washington Post column. “And even granting that it's a good idea not to cut Medicare payments to doctors, it's a strange interpretation of honesty to separate this $250 billion cost from the health-care bill and then claim that the other bill doesn't raise the deficit.”

“It's never been something everyone said you had to pay for,” Stabenow said Tuesday onABCNews.com's “Top Line.”

Not so fast: “What seemed like an easy solution last week in the health-care negotiations is now facing uphill battles in both chambers, which is why Democrats are relying on physicians' groups to throw the power of their lobby behind the bill,” Time's Jay Newton-Small reports. “The AMA has run $200,000 worth of ads in a dozen states in the past week and has pledged to spend upwards of $1.8 million on more. Likewise the seniors' lobbying organization AARP, which strongly supports the legislation, has run about $2 million in ads in the past two weeks, mostly on this issue.”

The big messaging picture: “With a series of private meetings and public taunts, the White House has targeted the U.S. Chamber of Commerce, the biggest-spending pro-business lobbying group in the country; Rush Limbaugh, the country's most-listened-to conservative commentator; and now, with a new volley of combative rhetoric in recent days, the insurance industry, Wall Street executives and Fox News,” Politico's Jim VandeHei and Mike Allen report.

“All of the techniques are harnessed to a larger purpose: to marginalize not only the individual person or organization but also some of the most important policy and publicity allies of the national Republican Party,” they write.

Obama's war: “Barack Obama's ratings for handling the war in Afghanistan have dropped sharply, with Americans by 2-1 saying he lacks a clear plan there. But the public itself is divided on how to proceed, torn between the difficulties of the war and the threat of Taliban or al Qaeda-backed terrorism,” ABC polling director Gary Langer writes in his analysis.

“Forty-five percent now approve of the president's handling of the situation, down by 10 points in a month, 15 points since August and 18 points from its peak last spring. His approval rating on Afghanistan has fallen farther than on any other issue in ABC News/Washington Post polls this year.”

The Post's Dan Balz and Jon Cohen: “Gen. Stanley A. McChrystal, the top U.S. commander in Afghanistan, has recommended the substantial increase in troop strength, and 47 percent of those polled favor the buildup, while 49 percent oppose it. Most on both sides hold their views ‘strongly.' ”

The pressure builds: “The longer we delay to send the necessary additional troops, the longer it will be that our troops are unnecessarily in danger,” Sen. John McCain, R-Ariz., told ABC News, in Martha Raddatz's “Good Morning America” report Wednesday.

Kerry, D-Mass., is back in Washington Wednesday — and headed to the White Housefor a debrief, at 12:40 pm ET.

Man of the many hours: “What began as a routine fact-finding trip to Afghanistan last week turned into a high-profile diplomatic foray for Senator John F. Kerry, who unexpectedly plunged into five days of talks with Afghan President Hamid Karzai to resolve a political impasse over disputed elections that threatened to drag the country deeper into crisis,” The Boston Globe's Farah Stockman reports.

“Hours after he landed in Kabul on Friday, the Massachusetts Democrat was called upon by the US ambassador to negotiate with Karzai, a request that triggered a marathon of detailed meetings — over tea, over dinner, and in private strolls on grounds of the presidential palace. Yesterday, Kerry stood beside Karzai as the Afghan president announced that he had agreed to a runoff election Nov. 7.”

ABC's Jonathan Karl reports that Karzai wanted to back out at the last minute: “As the afternoon drags on, Kerry takes a walk with Karzai on the presidential compound for another more one-on-one talk. The two men visit a mosque on the presidential compound and then return to the palace. Karzai agrees, once again, to accept the updated election results and the run-off election.”

Also on the president's schedule: “President Barack Obama will announce initiatives Wednesday aimed at boosting credit to small businesses, as the White House tries to address a complicated issue many believe is dragging on the economy,” The Wall Street Journal's Damien Paletta and Deborah Solomon report. “The White House will move to increase the caps on Small Business Administration loans and to make it easier for small banks to access funds from the Troubled Asset Relief Program, an administration official said.”

Warning to Wall Street: “If there are members of the financial industry in the audience today, I will ask that you join with us in passing what are necessary reforms — don't fight them, join us on it,” the president said at a DNC fundraiser Tuesday night, per ABC's Sunlen Miller.

Back to health care — casting concerns in a slightly different way:

“Americans are increasingly worried about the cost and quality of medical care that could result from President Obama's effort to revamp health care, but a majority still trust him more than Republicans to change the system, a USA TODAY/Gallup Poll shows,” John Fritze reports for USA Today. “The poll, which comes as Senate leaders are crafting a bill for a critical floor vote, finds that people who fear their costs would increase under the measure jumped 7 percentage points since last month, to 49%. There were similar increases among those who believe that both quality of health care and insurance company red tape will get worse if legislation passes.”

Per Gallup: “By 58% to 38%, Americans would generally prefer to see Congress deal with healthcare reform 'on a gradual basis over several years' rather than 'try to pass a comprehensive reform plan this year.”

Reframing a constant refrain: Senate Minority Leader Mitch McConnell delivers his 50th Senate floor speech of the year on health care, where “he'll talk about the need for reform and argue that Democrat proposals which raise premiums, hike taxes and cut Medicare won't do the job,” per a GOP leadership aide.

“The simple fact is, every Republican in Congress supports reform,” McConnell, R-Ky., writes in a USA Today op-ed. “The dramatic shift between what Americans expected and what they got is the reason so many of them turned out at town hall meetings in August, and it's the reason that an ever increasing percentage of them oppose the health care proposals now taking shape in Congress.”

A one-two political punch: “Treasury officials have privately informed lawmakers that a vote on the debt limit must occur before Congress leaves in December. Republicans believe that the $900 billion or larger increase will feed into voters' concerns about the price tag of the health bill,” Roll Call's Keith Koffler writes. “And Republican Congressional sources talk as if they already have the Virginia gubernatorial contest locked up. They stand ready to use a GOP victory in a moderate state carried by Obama to spook moderate Democrats whose support for health care reform is not a sure bet.”

From the other side: Look for House floor speeches Wednesday morning “to call out congressional Republicans for their hypocrisy on Medicare, failing to make good on their promises to introduce an official health reform bill and for continuing to try to kill reform,” per the Democratic leadership press release.

Making Congress look really … grown-up: “Rep. Edolphus Towns (D-N.Y.) locked Republicans out of the House Oversight and Government Reform Committee room to keep them from meeting when Democrats aren't present,” The Hill's Susan Crabtree reports. “Towns' action came after repeated public ridicule from the leading Republican on the committee, Rep. Darrell Issa (R-Calif.), over Towns's failure to launch an investigation into Countrywide Mortgage's reported sweetheart deals to VIPs.”

Why? “Because they don't know how to behave,” Towns said in a statement to Politico's Jake Sherman.

Sarah Palin. Oprah. Seriously. “To coincide with the release of her ghost-assisted book, Going Rogue, Palin and her advisers are planning a careful TV and Web rollout in mid November, to be followed by paid speeches to business, civic, and college groups,” Newsweek's Howard Fineman reports. “Assembled with the advice of her Washington lawyer, Bob Barnett, and her speech agency, Washington Speakers Bureau, Palin's junket will go light on the free-ranging, traditional hard-news venues and heavy on personality: one major stop will be Oprah.”

The Kicker:

“I have not been involved in such an open and transparent process as this. I'm very, very proud that we have done it.” — Sen. Max Baucus, D-Mont., before heading back behind closed doors to meet on health care.

“You can't afford a fund-raiser involving [First Daughters] Malia and Sasha. I'm cheap.” — President Obama, at a DNC event in New York City that cost $30,400 per couple to attend.

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Tags: base, Business, Care, Health, Movement, Obama, Tests, ties, Unusual

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