Love to Hate: Democrats drive skepticism of health care reform

ABC News’ Rick Klein reports:

Why ask a Republican when you can ask a Democrat?

Start with, say, Sen. Ben Nelson, D-Neb., who listened to former President Bill Clinton say inaction is the “worst thing we can do” and then said he wouldn’t mind inaction one bit if the alternative is the House-passed health care bill:

“It’s got a totally government run plan, the costs are extraordinary associated with it, it increases taxes in a way that will not pass in the Senate, and I could go on and on and on,” Nelson told ABC’s Jonathan Karl, in his latest “Subway Series” interview. (“I won’t vote to move it,” Nelson said.)

Move to Rep. Linda Sanchez, D-Calif., who voted for that same bill but doesn’t sound like she’d make the same vote on final passage:

“Has Congress become like an episode of Mad Men? The Stupak Amendment slams women back to a time of stenographs and unsafe abortions,” Sanchez writes in a Politico op-ed.

Add Diana DeGette, D-Colo., who’s among those threatening to help sink the health care bill if it still has the abortion provision worked in at the insistence of the US Conference of Catholic Bishops:

“Every group should be listened to, but I don’t think one group should be given veto authority over what we do,” DeGette tells the AP’s Julie Hirschfeld Davis.

Then choose a liberal activist or three, who are making noises about primary challenges against Democrats who vote against health care:

“It was kind of like a slap in the face from someone you’d expect to be a friend,” Tony Fransetta, president of the Florida chapter of the Alliance for Retired Americans, said of Rep. Suzanne Kosmas, D-Fla, per Politico’s Alex Isenstadt.

Health care was supposed to energize the base — and by that measure, maybe it succeeded beyond anyone’s expectations.

Reform efforts are back in one of those limbo states, now that the House has voted and the Senate awaits word on what an actual bill would actually cost.

These have been dangerous times for reform efforts in the past, since they opened the news cycle up for introspection and recriminations. This one’s no different — and addition still looks like subtraction for the vote counters.

“Yes and yes,” Senate Majority Leader Harry Reid, D-Nev., said when asked whether the bill would be on the floor next week and be finished by Christmas. (Except the answer really might be “no and no.”)

Has hope changed sides? Yes — that’s a GOP lead on the generic ballot:

“Republicans have moved ahead of Democrats by 48% to 44% among registered voters in the latest update on Gallup’s generic congressional ballot for the 2010 House elections, after trailing by six points in July and two points last month,” Jeffrey M. Jones reports in his Gallup Poll write-up. “In the latest poll, independent registered voters favor the Republican candidate by 52% to 30%.”

Cue the Big Dog: “The worst thing we can do is nothing,” Bill Clinton said he told Senate Democrats Tuesday. (Think of the implications of taking that sentence literally.)

From one who knows — and who knows what it’s like to be a red-state Democrat: “It’s not important to be perfect here. It’s important to act, to move, to start the ball rolling,” the former president told reporters after his meeting with the Democratic caucus, per The Washington Post’s Shailagh Murray. “There will be amendments to this effort, whatever they pass, next year and the year after and the year after, and there should be. It’s a big, complicated, organic thing.”

On why the anger’s out there, Clinton’s argument, according to Sen. Sheldon Whitehouse, D-R.I.: “The reason the teabaggers are so inflamed is because we are close on health care,” Whitehouse said, per ABC’s Z. Byron Wolf.

“The appearance by Mr. Clinton, whose own attempt at a health bill failed 15 years ago, reflected the urgency Democrats feel to maintain the momentum behind the bill following its narrow House passage Saturday and signs of a tempestuous debate ahead in the Senate,” The Wall Street Journal’s Naftali Bendavid and Janet Adamy report.

(And Time’s Karen Tumulty solves a mystery: “A source close to Bill Clinton confirms that the cellphone call he received while talking to reporters in the Capitol was indeed from the Secretary of State. However, he informs us that the intriguing ringtone we heard this afternoon was a generic jazz one, which the former President picked because, well, he just likes jazz.)

Bring in the funk: “The latest Associated Press-GfK poll shows that Americans grew slightly more dispirited on a range of matters over the past month, continuing slippage that has occurred since Obama took office as the year began,” per the AP’s Liz Sidoti.

“They were more pessimistic about the direction of the country. They disapproved of Obama’s handling of the economy a bit more than before. And, perhaps most striking for this novice commander in chief, more people have lost confidence in Obama on Iraq and Afghanistan over the last month. Overall, there’s a public malaise about the state of the nation.”

Harry Reid’s other headache: “Republicans in New Jersey and Virginia didn’t just benefit from a decrease in the so-called Obama ‘surge’ voter turnout. They also did better among groups that went for Obama in 2008,” Amy Walter writes for National Journal. “What happens if similar patterns emerge in ’10, namely a decrease in the percentage of Democratic-leaning voters as well as a narrowing of the margin of victory among groups that were key to Obama’s victory?”

Ready for another round of this? “Republicans are looking to resurrect the angry town halls of August in the last few weeks of November,” Manu Raju writes for Politico. “Senate Republican Conference Chairman Lamar Alexander said Republicans are ‘quietly’ planning some 50 in-person and telephone town hall gatherings over the next three weeks to drum up opposition to Democratic health care bills.”

Your White House day: The president and first lady, joined by the Bidens, host a Veterans Day breakfast in the White House East Room. Then it’s on to Arlington National Cemetery for a wreath-laying ceremony at the Tomb of the Unknowns at 11 am ET, with remarks at 11:25 am.

At 2:30 pm ET, the president meets (for the eighth time on the subject) with his national security team on Afghanistan and Pakistan, in the Situation Room.

ABC’s Sunlen Miller has details, White House photos, and attendee lists from all eight meetings.

Look for an Afghanistan decision to be announced the week before or the week after Thanksgiving, ABC’s George Stephanopoulos reported on “Good Morning America” Wednesday.

Four options on the table — with a low end of 10-20,000 troops, to a high end in line with the McChrystal recommendation.

Today’s they’re talking exit ramps: “The president wants to press his advisers today for a clearer understanding of the American bridge out of Afghanistan,” Stephanopoulos reported. “He’s still not satisfied by what he’s heard about how this message ends.”

The Wall Street Journal’s Peter Spiegel and Yochi Dreazen: “President Barack Obama on Wednesday will consider a new compromise plan for adding troops to Afghanistan that would deploy 30,000 to 35,000 new forces, including as many as 10,000 military trainers, over the next year or more. The new scenario combines reinforcements for fighting Taliban insurgents with trainers aimed at rapidly increasing the size and capabilities of Afghan troops to take on more operations themselves. It wouldn’t aim to eliminate the Taliban, but weaken it until Afghan forces can secure major population centers themselves.”

Can the president count on Democrats in Congress to back him up? “I think that there is a great deal of reluctance to committing any more combat troops in Afghanistan,” Sen. Ben Cardin, D-Md., said on ABCNews.com’s “Top Line” Tuesday. “I think most members of the Democratic caucus believe it’s up to the Afghans to take responsibility for the internal security within their own country — that we should be focusing on the war against terror, against the terrorists organizations, most of which are now in the Pakistan area, not Afghanistan.”

Fort Hood fallout: “Two high-profile anti-terrorism task forces did not inform the Defense Department about contacts between a radical Islamic cleric and the Army psychiatrist accused of killing 13 people in last week’s rampage at Ft. Hood, a senior Defense official said Tuesday,” the Los Angeles Times’ Julian E. Barnes and Josh Meyer report. “The possible communication lapse recalls the kind of breakdowns of intelligence-sharing that plagued U.S. agencies leading up to the Sept. 11 attacks. However, it is striking because the interagency task forces were created in large part to make sure information is more easily and routinely shared.”

“As the nation mourned the 13 people shot dead last week at Fort Hood, Tex., finger-pointing in Washington intensified Tuesday about whether officials at several agencies had failed to coordinate as they tracked the suspect’s activities or to react to possible warning signs in the months before the attack,” Carrie Johnson and Spencer S. Hsu report in The Washington Post.

A New York Daily News headline the White House has got to like: “Obama to feds, Army: What did you know about Fort Hood killer and when did you know it?

Also making it a really interesting day at the Pentagon: “Top executives at Blackwater Worldwide authorized secret payments of about $1 million to Iraqi officials that were intended to silence their criticism and buy their support after a September 2007 episode in which Blackwater security guards fatally shot 17 Iraqi civilians in Baghdad, according to former company officials,” Mark Mazzetti and James Risen report for The New York Times.

At the White House, Anita Dunn is moving on, and Dan Pfeiffer is moving up.

The Atlantic’s Marc Ambinder, on the next White House communications director: “Over the summer, the White House’s Pfeifferian coolness on health care — even as the political world was going into a tizzy — came in for much external criticism. … Pfeiffer, colleagues say, was among those who regularly counseled his colleagues — and Democratic allies — not to panic. He and Dunn pushed to shift the president’s focus from cost containment to the concerns of middle class voters who worried that they might lose their insurance or their choice of doctors under the new plan.”

More fallout from the abortion provision:

“Once again, a group of mostly white men have decided to put additional burdens and increased difficulties of women — particularly low-income women,” Karen Finney writes at Huffington Post.

“The president has handed us a bill that reverses Roe v. Wade,” Terry O’Neill, the president of the National Organization for Women, tells ABC’s Jake Tapper.

(O’Neill will appear on ABCNews.com’s “Top Line” today, live at noon ET, right after a meeting at the White House.)

Stupak blowback: The Progressive Change Campaign Committee is launching online ads Wednesday (staring with 1 million-plus impressions) blasting Rep. Bart Stupak, D-Mich., for his leadership on the abortion provision in the House bill.

From the others side — more from Sen. Nelson’s interview with Jon Karl: “Federal taxpayer money ought not to be used to fund abortions. … So whether it is subsidies on premiums or whether it is tax credits or whatever it is … it should not be used to fund abortions.”

In the Massachusetts Senate race — closing an opening? “US Representative Michael E. Capuano, in a significant departure from his forceful rhetoric a day earlier, said yesterday that he would vote against a final health care bill if it includes a provision restricting federal funding for abortion,” The Boston Globe’s Matt Viser reports.

“If the bill comes back the same way as it left the House, I would vote against it,” Capuano said in an interview. “I am a prochoice person, and I do believe this is [necessary] to provide health care for everyone.”

Next up on financial regulator reform: Senate Democratic Policy Committee has a Thursday meeting set up for staff — to review polling on the subject. From the e-mail out to Democratic Hill staffers:”Please join us for a review of recent public opinion polling and recommendations on proposed regulatory reform, featuring discussion of recent polls conducted by: Lake Research Partners for Americans for Financial Reform; Benenson Strategy Group for the Service Employees International Union.”

From the annals of stimulus spin: “While Massachusetts recipients of federal stimulus money collectively report 12,374 jobs saved or created, a Globe review shows that number is wildly exaggerated. Organizations that received stimulus money miscounted jobs, filed erroneous figures, or claimed jobs for work that has not yet started,” Jenn Abelson and Todd Wallack report in The Boston Globe.

“The federal stimulus report for Massachusetts has so many errors, missing data, or estimates instead of actual job counts that it may be impossible to accurately tally how many people have been employed by the massive infusion of federal money.”

The Kicker:

“Are you from this planet?” — A Transportation Security Administration screener, caught on an iPhone recording questioning an aide to Rep. Ron Paul, R-Texas, in an incident that prompted a change in TSA screening policies.

“I don’t care what you write.” — Gary Jackson, former Blackwater president, to The New York Times.

For up-to-the-minute political updates check out The Note’s blog . . . all day every day:
http://blogs.abcnews.com/thenote/

Intern for the ABC News Political Unit:

The ABC News Political Unit is now seeking full-time spring 2010 interns in Washington, D.C.

The paid internship begins Monday, Jan. 4, 2010, and runs through Friday, June 4, 2010.

Political Unit interns attend political events and contribute to stories for the politics page of ABCNews.com. They also help ABC News by conducting research, maintaining our calendar of upcoming political events, and posting stories to ABCNews.com.

In order to apply, you MUST be either a graduate student or an undergraduate student who has completed his or her first year of college. The internship is NOT open to recent graduates.

You also must be able to work eight hours per day, Monday through Friday. Interns will be paid $8.50/hour.

If you write well, follow politics closely, and have some familiarity with web publishing, send a cover letter and resume to Teddy Davis, ABC News’ Deputy Political Director, at teddy.davis@abc.com, by Sunday, Nov. 22, 2009, with the subject line: “INTERN” in all caps.

Please indicate in both your cover letter and the body of your email your student status and the specific dates and hours of your availability.

Bill Clinton to Rally Senators on Health Care Reform

ABC News' Z. Byron Wolf reports: Former President Bill Clinton will travel to Capitol Hill Tuesday to rally Democratic senators on health reform.

The House passedits sweeping health reform package on Saturday, but efforts have stalled in the Senate.

A cost assessment process has delayed introduction of a bill in the Senate and internal Democratic squabbles of whether to include a public option have brought into question whether Democratic leaders can cobble together the 60 votes they will need to bypass a Republican filibuster.

Clinton, whose own attempt to pass a health reform package fifteen years ago did not pass either House of Congress, was asked by White House Chief of Staff Rahm Emanuel and Senate Majority Leader Harry Reid to make the pep talk, according to an aide familiar with the discussion. Clinton is expected to speak to Democratic senators at a closed caucus meeting, urging them to see past differences to pass compromise legislation, according to Democratic staffers.

Dem Defections Pile Up on Health Care

ABC News’ Rick Klein reports: Could the health care bill be in real trouble in the House?

The Democratic defections are starting to pile up in advance of a vote scheduled for tomorrow on sweeping health reform efforts. (That schedule could slip to Sunday or beyond, if the votes aren’t there.)

According to the National Republican Congressional Committee — which, of course, has an interest in watching this vote particularly closely — 15 House Democrats and counting are saying publicly that they’ll oppose the measure when it reaches a vote.

Democrats can afford only 40 such defections to squeak the bill through. They’d prefer to win with room to spare.

The Democrats who’ve said — either in interviews or press releases — that they’re opposing the bill include: Rep. Travis Childers (Miss.); Rep. John Adler (N.J.); Rep. Walt Minnick (Idaho); Rep. Stephanie Herseth Sandlin (S.Dak.); Rep. Suzanne Kosmas (Fla.); Rep. Frank Kratovil (Md.); Rep. Larry Kissell (N.C.); Rep. Bart Gordon (Tenn.); Rep. Dan Boren (Okla.); Rep. Jim Matheson (Utah); Rep. Michael McMahon (N.Y.); Rep. John Tanner (Tenn.); Rep. Brian Baird (Wash.); Rep. Harry Teague (N.M.); and Rep. Collin Peterson (Minn.).

House Democratic aides say the list contains no surprises so far.

Some of the Democrats’ statements leave a bit of wiggle room. Plus — as ABC’s George Stephanopoulos is reporting — Democratic leaders are working behind the scenes to answer concerns among conservative Democrats about how the bill would handle funding for abortions.

But — keeping in mind that many members of Congress prefer to announce their intentions with their votes, not press releases — the defections suggest that reaching 218 remains a serious challenge for Democrats on the eve of the vote.

“If this bill is the political winner Nancy Pelosi claims it is, then why are Democrats fighting over who gets to vote against it?” NRCC spokesman Ken Spain said in a statement.

Dueling Protests Converge at Pelosi’s Office – ‘Health Care for All!’ or ‘Kill the Bill!’

ABC News' Z. Byron Wolf reports: Capping off protest day here at the Capitol are the competing protests that have converged on House Speaker Nancy Pelosi's district office on Capitol Hill, leading to several more arrests and littering the hallway with torn copies of House Democrats healthcare bill.

An protest of about 100 people supporting universal care – including some familiar faces from Lieberman's office earlier today – was already ongoing at Pelosi's office when a new group of about 100 people who oppose the bill showed up.

Specifically, the new group of protesters is concerned that the health reform bill will put tax dollars toward abortions.

Among the protesters against a health reform bill was Randall Terry, founder of the anti-abortion rights group Operation Rescue.

Terry said one of the protesters who was arrested is Father Norman Weslin, a priest from Indiana. Weslin laid down in front of Pelosi's door until a group of police officers picked him up and carried him away.

Up to four protesters (it wasn't clear from which group) were arrested when they started ripping up pages from the bill in the hallway.

Chants of “Healthcare for all!” have been drowned out by chants of “Kill the bill!”

Police are trying to clear the hallway.

This is the office for Pelosi in her capacity as Congresswoman for the 8th District of California. It is not where she works – that office is in the Capitol building.

Lieberman Courted by Both Parties on Health Reform

ABC’s Z. Byron Wolf reports:

Sen. Joe Lieberman is technically Independent, but today he dominated press conferences by the leaders of both parties in the Senate.

Lieberman's announced today that he'd probably vote for cloture on whether to consider a health reform bill, but oppose cloture on the bill later on the Senate floor if it still had a public option.

Senate Majority Leader Harry Reid heaped praise on Lieberman.

“I don't have anyone that I have worked harder with, have more respect for in the Senate than Joe Lieberman. As you know, he's my friend. There are a lot of senators, Democrat and Republicans, who don't like part of what's in this bill that we went over to CBO. We're going to see what the final product is. We're not there yet. Senator Lieberman will let us get on the bill, and he'll be involved in the amendment process,” Reid said, pointing to Lieberman's bipartisan work in the past.

“I have the greatest confidence in Joe Lieberman's ability as a legislator. And he will work with us when this gets on the floor, and I'm sure he'll have some interesting things to do in the way of an amendment. But Joe Lieberman is the least of Harry Reid's problems,” said Harry Reid.

Sen. Mitch McConnell, the top Republican in the Senate, had a far different assessment. He did not mention Lieberman by name, but said any vote for cloture – even one to consider health reform bill as Lieberman indicates he could support – is a vote for everything in the bill.

McConnell invoked the infamous and fateful statement by Sen. John Kerry about an appropriations bill in 2004 that he “voted for it before he voted against it.”

“I think it's appropriate to make the point at the outset that a vote on cloture on the motion to proceed to this bill will be treated as a vote on the merits of the bill. We all recall Senator Kerry's strained way in the 2004 campaign of explaining why he voted for it before he voted against, and I think it is perfectly clear that most Americans will treat the vote to get on the bill as a vote on the substance of the bill,” said McConnell. “So our view is that cloture on the motion to proceed to the bill is a bill — is a vote to endorse a half a trillion dollars in Medicare cuts, $400 billion in new taxes, and higher insurance — health insurance premiums for everyone else.”

McConnell brought it up again later.

“I think we all remember the Kerry campaign, and we all remember the difficulty of explaining to our constituents why we were for something before we were against it,” he said.

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.

For up-to-the-minute political updates check out The Note's blog . . . all day every day:

‘Cadillac Tax’ Slammed in New Health Care Ad

ABC News’ Teddy Davis Reports:

A proposed tax on high-cost health insurance plans, the so-called “Cadillac tax,” is blasted in a new television ad by a union-funded group called Health Care for America Now (HCAN).

“We all know that America needs health-care reform,” says the ad’s narrator. “But there is a right way, and a wrong way, to pay for it.”

“Some senators say they want to tax so-called ‘Cadillac health-care plans,” the narrator continues. “But those proposals will also tax the benefits of millions of middle-class workers.”

Watch it HERE.

HCAN’s ad, which is dubbed “Right Way,” urges Congress to limit new taxes to individuals who make more than $250,000 per year.

Under the Finance Committee bill which was approved earlier this week, a 40 percent tax would be imposed beginning in 2013 on the portion of employer-sponsored health plans exceeding $8,000 for individuals and $21,000 for families.

Citing a preliminary analysis by the nonpartisan Joint Committee on Taxation, HCAN warns that the tax is projected to affect up to 40% of health plans by 2019.

The tax would be levied on insurers — rather than individuals — but economists expect insurance companies to pass the cost of the new tax to consumers in the form of higher prices.

Supporters of the “Cadillac tax” see it not only as a revenue raiser but also as a way to restrain health spending.

The idea is that individuals and businesses would be incentivized to look for cheaper health plans if expensive ones were taxed.

Critics of the “Cadillac tax” worry, however, that it would hit middle-income union members who have foregone wage increases for generous health care benefits.

Critics also worry that the tax would have an inequitable impact, falling harder on employers with older workforces or that happen to be located in high-cost regions of the country.

HCAN’s new ad will air for one week on national CNN and MSNBC, broadcast and cable in DC, and during Sunday political programs in select states.

‘Top Line’ — Sen. Wyden: Lack of Choice in Health Care Bill Doesn’t Pass ‘Smell Test’

ABC News’ Rick Klein reports: Almost lost in the coverage of Sen. Olympia Snowe’s decision to vote for the Senate Finance Committee’s health care bill was Sen. Ron Wyden’s favorable vote — a slight surprise, since Wyden had been critical of what he sees as major shortcomings in the measure.

While Wyden, D-Ore., ultimately joined Snowe and all the committee’s Democrats in voting yes, he — like Snowe — is serving notice that he may not support the final product.

On ABCNews.com’s “Top Line” today, Wyden renewed his call to inject more choice into the health care system by allowing individuals — not just small businesses — to buy into the new “insurance exchanges” that would be created by the bill.

Intriguingly, Wyden used the White House’s own calls for ensuring choice in the health care system in making his case.

“I’ve made it very clear that when the White House and particularly [Press Secretary] Robert Gibbs talks about choice and competition about three times an hour, and then you have a bill that we’re told leaves 90 percent of the American people outside the marketplace — outside the exchanges — after seven years, that’s not going to pass the smell test,” Wyden told us.

“At every single rally you hear politicians stand up and say the American people ought to have choices like their member of Congress, and of course that’s what holds the insurance industry accountable,” Wyden said.

“And under this bill not only are most Americans not going to have choices like members of Congress, they aren’t going to get any choice at all, even when their insurance company is abusing them.”

Wyden is a longtime proponent of a different means of pursuing universal health coverage, encapsulated in a bill — the Healthy Americans Act, co-sponsored with Sen. Robert Bennett, R-Utah — that emphasizes individual choice over the current employer-based system.

Unless the current bill achieves a similar level of choice for individuals, Wyden said he won’t support it.

“I am trying to export the key principles of the Healthy Americans Act, particularly choice and competition, holding insurance companies accountable so the consumer gets more affordable coverage, to the final bill. And without that, the final bill is not going to have my support,” Wyden said.

Wyden’s amendment to open up the insurance exchanges to individuals was set aside in a parliamentary dispute in the Finance Committee — a fact that irked Wyden.

He’s still trying to include that component in the final bill, and yesterday engaged in an unusual Senate floor discussion with Chairman Max Baucus, D-Mont., that strongly suggested that a deal is in the works.

Wyden told us today: “I think we got our foot in the door, and I’ve talked at length with Chairman Baucus about it, with Chairman [Chris] Dodd, Senator [Harry] Reid,” the Senate majority leader.

Watch the full interview with Sen. Ron Wyden HERE.

We also chatted with Christina Bellantoni of Talking Points Memo about the pressures being applied by the political left in the health care debate, in addition to President Obama’s (brief) trip to New Orleans today.

We also got her take on the “Goatee Gamble” pitting ABC Senior White House Correspondent Jake Tapper against NBC’s Chuck Todd, with the Phillies-Dodgers playoff series (maybe) carrying bearded repercussions.

“Now I have a reason to care about baseball. I think Chuck could use a new look so you know, go Phillies,” Bellantoni said.

Click HERE for the full discussion with Christina Bellantoni.

Gov. O’Malley: Health Care Reform ‘Good for States’; Will Mean Paying More to Save in Long Run

ABC News’ Rick Klein reports: With Republican governors warning that President Obama’s health care plan will foist new costs on states, a leading Democratic governor is pushing back, arguing that health care reform will help states shoulder growing health costs in the long run.

“In fact, if we do not change the status quo, there is no way that any state in the union is going to be able to afford the constantly escalating 7, 8, 9 percent annual increases,” Gov. Martin O’Malley, D-Md., said today on ABCNews.com’s “Top Line.”

“We do not mind, for example — I would not mind as governor as I looked at the status quo, which would add $3.6 billion to our expenses for health care both on the Medicaid and employer’s side, if instead we only had to pay a billion additional over the next five years. One would have to say that that’s a step in the right direction. So really a lot of this is about cost avoidance.”

“We have to pay a little bit more in order to realize the long-term savings and bring down the cost curve. And that’s what the Obama administration is doing, and I’m very much encouraged by the direction in which it’s going,” O’Malley said.

“The truth of the matter is that both the Senate versions and the House versions are actually moving to something that’s good for states,” he added.

He also said “thank God” President Obama pressed to pass the stimulus package, arguing that the current unemployment race would be much worse without it.

“None of us likes 9.8 percent unemployment, but I will betcha that it would have been more like 16 or 17 percent had President Obama not acted,” he said. “So we are far better off because of the recovery and reinvestment dollars, despite all the people saying that we could not possibly spend it or apply it the right way. We are applying it. And the other good news is these dollars are creating new jobs that are actually going to benefit the economy for many years into the future, and it absolutely had to be done otherwise we would have headed into a depression.”

O’Malley, the vice chairman of the Democratic Governors Association, also said he would “guarantee” Democratic victories in the 2009 gubernatorial contests in Virginia and New Jersey. He said he doesn’t believe national Democrats or President Obama will be a drag on Democrats running for governor in 2009 or 2010.

“I don’t think it’s a matter of running away [from] or running to — I think it’s a matter of governing well,” O’Malley said. “People in their chief executives, especially when we’re facing unemployment and home disclosures, they want men and women that are going to make the tough decisions regardless of politics. And so governing well is really the best political advice that any of us incumbents had, and it’s the best advice that we can give to those that are challenging.”

ClickHERE tosee the full interview with Gov. Martin O’Malley.

We also chatted with veteran GOP pollster Frank Luntz about his new book, “What Americans Really Want…Really.” Watch that interview HERE.

Will Health Care Bill Raise Taxes? Finance Committee Debates

ABC News Z. Byron Wolf reports: Republicans on the Senate Finance Committee have taken delight this morning in pointing out that if Democrats can enact a health carereform bill that mandates Americans buy health insurance or pay a fine, they are, by definition, enacting a new tax that would break President Obama’s campaign pledge.

And they have taken the opportunity to read Sen. Obama’s pledge as he was running for the White House.

GOP Sen. Mike Crapo of Idaho, quoting Obama, said, “If you're a family making less than $250,000 a year, my plan will not raise your taxes — not your income taxes, not your payroll tax, not your capital gains tax.”

Sen. John Ensign of Nevada quoted a different riff on the same sentiment.

“But let me be perfectly clear,” he said, quoting candidate Obama. “If your family makes less than $250,000, you will not see your taxes increase one single dime.”

Granted, the penalty for not obtaining health insurance would be a penalty and could be avoided by purchasing insurance, but the effect of the bill– the government exacting a fee from uninsured families who make less than $250,000 — cannot be denied.

Republicans have offered several amendments today that would exempt families making less than $250,000 from the individual mandate to buy health insurance that is at the core of the reform bill.

“If we want to keep the president's promise of not raising taxes by one single dime,” said Ensign, the pledge should be a part of the reform bill.

“We need to settle down and find ways of living within the promises that have been made,” said Sen. Orrin Hatch, R-Utah.

The author of the bill, Max Baucus, D-Mont.,was frustrated at times, arguing against the amendments.

“If we're serious about this, we have to have shared responsibility,” Baucus said, raising his voice. He called the amendments not serious and designed simply to send a message by Republicans about taxes. They would have the effect, said Baucus, of gutting the provisions in the bill that keep health reform from adding to the deficit.

Baucus had lowered the penalty in half at the outset of the markup. A family of four making more than four times the poverty level– about $88,000– would have to pay a fine of $1,900 for not having insurance. The penalty is lower for families making less money.

Other amendments, also turned back, would have scaled back an excise tax Baucus would place on insurance companies that offer high-value “Cadillac” insurance plans. This is a back door to taxing the people who receive those plans, which often include no co-payment and are thought to drive up the cost of health care. And Republicans argued that insurance companies would simply pass the excise tax along to people, many of them union members, who receive the plans.

Baucus had raised the value of the plans that would be taxed at the outset of the markup and exempted many people in public service who receive them.

The amendments were repelled with largely party line votes. Sen. Blanche Lincoln, D-Ark., who faces a tough reelection fight in 2010, sided with Republicans.

This is the seventh day of the markup. Tomorrow, it will become the longest markup staffers on the committee can find.

There probably will not be a final vote on the health reform bill in the Senate Finance Committee until next week, when the CBO can come up with its best guess cost estimate. We are entering the final stretch of the amendment process, which Baucus predicted would end either late Thursday or Friday.

UPDATE: Eagle-eyed Republicans point out that Baucus’ own bill refers to the penalty for not having insurance under an individual mandate as an excise tax. Check out page 29 HERE.

White House Press Secretary RobertGibbstoday referred to the tax as more like a speeding ticket.

The IRS says an excise tax is what is paid on something like motor fuel.

But the point remains that health reform will leave people who make less than $250,000 paying a new tax to the government. It's clear that Democrats and the White House are comfortable living with that if they can enact health care reform.