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.

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.

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.

Health Reform “Gag Order” Tiff Escalates

ABC’s Z. Byron Wolf reports:

The ongoing spat between Sens. Mitch McConnell, R-KY, and Max Baucus, D-Mont, on how insurers can contact Medicare enrollees about health reform legislation continued Thursday.

It's a convoluted story; for background, click HERE.

First, Republicans in the Senate sent a letter to the HHS pledging to block all HHS-covered Administration nominees – the biggest of these would be the Surgeon General – until HHS rescinds the CMS order to Medicare Advantage providers not to lobby enrollees on health reform legislation in Congress.

“Until your department rescinds its gag order and allows seniors to receive information about matters before Congress, we will not consent to time agreements on the confirmation of any nominees to your department or associated agencies,” Republican leaders wrote in the letter to HHS Secretary Kathleen Sebelius on Thursday.

Then, late Thursday night came a tacit but clear response from Sen. Max Baucus, who requested the HHS investigation of Humana that started the tiff in the first place.

Rather than entreat HHS to rescind the “gag order” on insurer lobbying of Medicare Advantage enrollees, Baucus has dug in and scheduled a confirmation hearing for two HHS nominees, basically calling the bluff of Republicans.

The argument is over what Republicans are calling a “gag order” on Humana and other insurers against communicating with their Medicare enrollees about the health care reform legislation before Congress.

McConnell, whose state is home to Humana, had railed against the order in speeches on the Senate floor and Republicans have used the episode to criticize Democrats for clamping down on the first amendment.

Baucus had requested an HHS investigation into Humana for “misleading” Medicare Advantage enrollees with letters that on first glance appeared to be about current benefits offered by the insurer but were in fact an entreaty for the senior to lobby their Congressman.

“Top Line” — Health Care Reform Without Adding to Deficit: Obama’s Impossible Dream?

ABC News’ Rick Klein reports: President Obama today reiterated his pledge that health care reform will “not add a dime to the deficit, now or in the future” — a critical component of his sales pitch to a public that’s growing increasingly concerned about government spending.

But is that a promise he can keep?

On ABCNews.com’s “Top Line” today, Douglas Holtz-Eakin, a former director of the Congressional Budget Office, said he doesn’t think so — not with health care spending growing far faster than the rate of new revenues.

“I think the fundamental problem is that if you cover everybody, you put everyone in a system that is growing too rapidly in costs, and is added onto an entitlement problem where we already don’t have the revenues to pay for it,” Holtz-Eakin told us. “And so you build a big problem up front and there’s no way to unwind that quickly. A way to get there is to be more patient and sequential. Cover targeted groups like working uninsured and as you get savings, channel them back in and cover more people.”

“But the political patience isn’t there for that. The promise has been made to cover everyone, and I don’t think it’ll ever add up,” he said.

Democrats’ last best chance at producing a product that doesn’t add to the deficit is likely to come this week, as the Senate Finance Committee finishes its long-delayed draft of a health care bill. The CBO is expected to release its cost estimates of that bill this week as well.

“They may be frustrated but this shouldn’t be a matter of surprise,” Holtz-Eakin said. “[CBO] put out in January their view of options that would change health care spending. They’ve worked with the staffs on all the drafts of the bills. They’ve talked about things that work [and] don’t work, nd so when they finally get down to putting out these final reports, everyone should know what’s coming. And what they’ll look at when they get a bill from the Senate Finance Committee is number one: How much does it cost? They’re not going to know for sure.”

Holtz-Eakin, who was a top adviser to Sen. John McCain’s presidential campaign, also joked about what it’s like to see the president own ideas McCain once espoused, such as subjecting health insurance coverage to taxation, and the creation of “high-risk pools” for those with preexisting health conditions.

“Democrats have been phenomenal advocates of most of the McCain plan,” he said. “They will in fact propose the entire McCain plan, and we’ll see how it happens. But substantively this isn’t the same proposal. . . . [T]hey’re going to make the effort to put out a bipartisan proposal in this way, but when the rubber hits the road it’s not there.”

Watch the full interview with Doug Holtz-Eakin HERE.

We also chatted with Politico columnist Roger Simon about the health care push and the latest trouble signs for the president in the new ABC News/Washington Post poll.

Click HERE to see the discussion with Roger Simon.

“Top Line” — Health Care Reform Without Adding to Deficit: Obama’s Impossible Dream?

ABC News’ Rick Klein reports: President Obama today reiterated his pledge that health care reform will “not add a dime to the deficit, now or in the future” — a critical component of his sales pitch to a public that’s growing increasingly concerned about government spending.

But is that a promise he can keep?

On ABCNews.com’s “Top Line” today, Douglas Holtz-Eakin, a former director of the Congressional Budget Office, said he doesn’t think so — not with health care spending growing far faster than the rate of new revenues.

“I think the fundamental problem is that if you cover everybody, you put everyone in a system that is growing too rapidly in costs, and is added onto an entitlement problem where we already don’t have the revenues to pay for it,” Holtz-Eakin told us. “And so you build a big problem up front and there’s no way to unwind that quickly. A way to get there is to be more patient and sequential. Cover targeted groups like working uninsured and as you get savings, channel them back in and cover more people.”

“But the political patience isn’t there for that. The promise has been made to cover everyone, and I don’t think it’ll ever add up,” he said.

Democrats’ last best chance at producing a product that doesn’t add to the deficit is likely to come this week, as the Senate Finance Committee finishes its long-delayed draft of a health care bill. The CBO is expected to release its cost estimates of that bill this week as well.

“They may be frustrated but this shouldn’t be a matter of surprise,” Holtz-Eakin said. “[CBO] put out in January their view of options that would change health care spending. They’ve worked with the staffs on all the drafts of the bills. They’ve talked about things that work [and] don’t work, nd so when they finally get down to putting out these final reports, everyone should know what’s coming. And what they’ll look at when they get a bill from the Senate Finance Committee is number one: How much does it cost? They’re not going to know for sure.”

Holtz-Eakin, who was a top adviser to Sen. John McCain’s presidential campaign, also joked about what it’s like to see the president own ideas McCain once espoused, such as subjecting health insurance coverage to taxation, and the creation of “high-risk pools” for those with preexisting health conditions.

“Democrats have been phenomenal advocates of most of the McCain plan,” he said. “They will in fact propose the entire McCain plan, and we’ll see how it happens. But substantively this isn’t the same proposal. . . . [T]hey’re going to make the effort to put out a bipartisan proposal in this way, but when the rubber hits the road it’s not there.”

Watch the full interview with Doug Holtz-Eakin HERE.

We also chatted with Politico columnist Roger Simon about the health care push and the latest trouble signs for the president in the new ABC News/Washington Post poll.

Click HERE to see the discussion with Roger Simon.

ABC News' Kristina Wong reports: This Sunday, White House advisers and lawmakers previewed a big week ahead for President Obama, who will attempt to take the lead on health care reform, and regain momentum after a summer marked by heated, partisan and confusing debate.

White House Press Secretary Robert Gibbs and senior White House adviser David Axelrod sounded confident ahead of Obama?s big speech to Congress this Wednesday evening, to be televised live to the nation. In the speech, they said, Americans would hear exactly Obama stands on health care reform.

?They'll leave that speech knowing exactly where the president stands, exactly what he thinks we have to do to get health care reform done this year,? Gibbs said on ABC News? ?This Week.?

The president has an opportunity on Wednesday to speak to the nation and the Congress on this,? said Axelrod on NBC?s ?Meet the Press.? ?We've been through a long debate now.All the ideas are on the table.It's time to bring the strands together and get the job done for the American people here.?

Liberals, Conservatives Unwilling to Back Down Over Public Option

So far, consensus has been difficult to achieve, with lawmakers divided on multiple party and intraparty fault lines over the best way to lower private insurance costs, and how to pay for health care reform in light of an economic recession and a skyrocketing budget deficit.

The president is stuck in the middle, between Senate Republicans that could block much of what the President wants, and liberal supporters who want it all. Republicans reject the president?s idea to create a the public option ? a government-run insurance exchange intended to compete with and lower the costs of private insurance. House democrats overwhelmingly favor the idea. Progressive democrats say they will not pass a bill without it.

?We support what the president has said all along he'd like to see, and that is a robust public option. He campaigned on it. He continues to talk about his support for it. And we're going to stand behind him. Nancy Pelosi has said that nothing is going to pass that floor without a public option,? said Rep. Maxine Waters, D-Calif., on ABC.

Howard Dean,former Democratic National Party chair said compromise on the public option is unacceptable.

?If, for whatever reason, he chooses to go in a different direction [than the public option], then I'd scale back the bill. I wouldn't spend 5 cents on it,? Dean said on Fox. ?I'm very hopeful that he will stick to his guns and that we'll have the reform we were promised in the campaign.?

Despite the White House toning down insistence on the public option in recent weeks, Gibbs said the president would continue to support a public option in his speech Wednesday.

?He will talk about the public option and why he believes and continues to believe that it is a valuable component of providing choice and competition, it helps individuals and small businesses, at the same time provides a check on insurance companies so they don't dominate the market,? Gibbs said.

Critics Says Public Option Alternatives Won?t Work

Lawmakers have floated compromise alternatives to the public-option, such as an insurance co-op ? a group of private insurers that would be set up by the government, but controlled by its members. But Gov. Tim Pawlenty, republican governor from Minnesota and oft-speculated 2012 presidential candidate, said a co-op was not a viable solution.

?To say that that is the solution, I think, defies what we know about the experience with co-ops already.It hasn't substantially altered the trajectory of health care costs,? Pawlenty said on CNN?s ?State of the Union.?

Another alternative to the public option, recommended by a bipartisan group of former lawmakers including former republican Sen. Bob Dole, is the idea of a public-option trigger that would give private insurers time to reform the industry and lower costs, but trigger the public-option if they failed to do so by a deadline.

Sen. Ben Nelson, R-Neb., said he supported the idea.

?If there's going to be a public option, it has to be subject to a trigger, Nelson said on CNN. ?In other words, if somehow the private market doesn't respond the way that it's supposed to, then it would trigger a public option or a government-run option, but only as a fail-safe backstop to the process.?

However, Dean rejected the notion of postponing the public-option.

?The problem is it won't work. It doesn't add anything. If you're going to do that, just do the insurance reform,” Dean said on FOX. “Don't pretend you're doing reform.?

And Pawlenty rejected the idea of any type of public-option, now or in the future.

?The trigger option simply kicks the can down the road,? Pawlenty said. ?All it does is delays the inevitable, and for a lot of reasons, it's a bad idea. I think, if the Democrats embrace the public option, even in the form of the trigger, they're going to shoot themselves in the foot.”

Republicans Warn Against Using the Reconciliation Process

Despite these battles awaiting Congress when it returns from recess Monday, the president is determined toachieve health care reform this year,fueling speculation that with a large Democratic majority in the House, and a Democratic majority in the Senate, democrat lawmakers would resort to the budget reconciliation process, by which a bill could pass the House and Senate on an up-or-down vote, avoid a Senate filibuster, and require only a simple majority of 51 senators in order to pass.

Former democratic senate majority leader Tom Daschle said Congress should not rule out invoking the reconciliation process.

?If we can't do it any other way, we shouldn't be bound by this process. I think both parties have used it. We used it to pass a single most important health bill ever in the last 20 years, the Children's Health Insurance Plan. We used reconciliation to do that,? Daschle said on ABC.

?The Republicans tried to use it to pass the Alaskan National Wildlife Refuge,? Daschle continued. ?And they've used it for every tax cut so far. There's no question both Republicans and Democrats have used it in the past.?

But Sen. Alexander warned democrats of the consequences.

?One, it would create a bad health care bill because under the provisions in the rules, the parliamentarian would write the bill, so all the senators would be voting on are tax increases or Medicare cuts, and you wouldn't get to put in the bill things like pre-existing conditions or buying insurance across party lines.So it would be a bad bill,? said Alexander.

?Second, it would be thumbing your nose at the American people who have been trying to say to Washington for the last several months, ?Slow down.I mean, too many Washington takeovers, too much debt. You're meddling with my health care,?? Alexander sad. ?So thumbing their nose at the American people by ramming through a partisan bill would be the same thing as going to war without asking Congress' permission.You might technically be able to do it, but you'd pay a terrible price in the next election.”

Failed Health Care Reform Could Hurt Democrats

Some analysts are predicting democrats could lose up to 25 seats in the House if health care reform fails.

?Democrats are on a dangerous slide. And when we see this kind of sea change in public option take place, it should be a flashing warning sign,? David Wasserman, House editor of the Cook Political Report, said in an interview with ABC.

Indeed, since the beginning of the president?s push for health care reform, his popularity has dipped according to the daily Gallup polls, from a high of 68 percent early this year, to 50 percent last week.

Stuart Rothenberg, editor of the Rothenberg Political report, said health care reform was now critical for the president?s credibility.

?If he is perceived to fail on health care, it is going to raise significant questions about leadership, his leadership and really when you get down to it, that?s what the presidency is about,? Rothenberg said in an interview with ABC.

Still, democrats remain hopeful the president can recapture a largely-runaway debate over health care reform, and improve his standings by taking a strong lead over health care reform.

?I think he's got to stand up and lead and be strong,? said Dean. ?What people value more in a president than anything else is strength, and that's what we've got to see on this week.?

ABC News? David Kerley contributed to this report.

Obama Ally: Dem Majority Is History If Health Reform Fails

ABC News' Teddy Davis reports:

A top Obama ally predicted Wednesday in an interview with ABC News that Democrats will lose their congressional majority in next year's midterm elections if they fail to put a health-care reform bill on President Obama's desk.

“I think we're talking losing control of Congress,” said Andy Stern, the president of the Service Employees International Union. “[The failure of health-care reform] would totally empower Republicans to kill all change.”

“It's hard to imagine the Democrats convincing the public that Republicans are to blame for health-care reform going down when the Democrats have such large majorities,” he added. “After last year's promise of change, voters will start feeling buyer's remorse.”

Stern, who was invited to sit with the Obama family during the president's inaugural parade, is watched closely on health-care reform not only because of the labor muscle he wields as the head of the 2-million member SEIU but also because of the effort he has made to work with business groups: in 2007, he started “Divided We Fail,” a coalition which joined SEIU and AARP with the Business Roundtable and National Federation of Independent Business to promote the general principle of universal health care coverage.

Stern did not tie his 2010 prediction to the inclusion of a public option in the final bill. He did, however, warn that dropping a public option could “unravel” support for the more modest package of insurance reforms that President Obama began emphasizing last week.

“If there is going to be a mandate without real cost control and without an adequate subsidy, it's hard for us to go to our members and say, 'you have to buy insurance even though we know you can't afford it',” said Stern.

Since lawmakers have already decided not to pursue strict regulations on insurance premium increases, Stern said that a public option is the only real cost control mechanism on the table. Without the cost control provided by a public plan, Stern says it would be difficult for SEIU to support an individual mandate which would require all adults to purchase health insurance.

If support for an individual mandate collapses, it will become difficult for the Democrats to help those with pre-existing conditions who are currently denied coverage in the individual market. The insurance industry has made clear throughout the process that it will fight guaranteed issue and community rating tooth and nail if it does not get a new federal requirement that all adults purchase insurance. The insurance industry says that an individual mandate must go hand-in-hand with guaranteed issue and community rating because customers will otherwise avoid buying insurance until they are sick.

In addition to viewing a public option as vital to cost control, Stern is also concerned about the reach of the subsidies that are being proposed and suggested that they will be inadequate if members of the Senate Finance Committee were to limit them to 300 percent of poverty.

As for the idea of creating a co-op instead of a government insurance option, Stern said it was a non-starter.

“There is no way that a co-op can compete with Aetna or United American,” said Stern.

He signaled that a more acceptable compromise might be to create a public option whose creation is only triggered if certain circumstances are met.

“It's obviously better than no public option,” said Stern.

While Stern left the impression that a public option with a trigger was a more acceptable compromise than a co-op, he stopped short of actually endorsing the trigger approach.

While warning of grave consequences if the Democrats fail on health-care reform, Stern said that he is optimistic that Senate Democrats will find a way forward, possibly with the help of Maine Sen. Olympia Snowe (R).

To help Democrats get the votes that they need, Stern is prepared to use SEIU resources to pressure recalcitrant Democrats in Congress if progress is not made by Sept. 15, the deadline which Senate Finance Committee negotiators have set for themselves.

For now, however, he is holding his fire against fellow Democrats since the president has signaled through his staff that he does not want Democrats shooting at one another.

“We call it: 'helping the president be successful,'” said Stern with a smile when asked if he was willing to pressure fellow Democrats. “I don't think it will be necessary. I think Democrats find a way forward in the Senate when they stop believing that they're going to get [Iowa Sen. Chuck] Grassley and [Wyoming Sen. Mike] Enzi.”

Visit ABC News' special section on health care.

“Top Line” — No Reward for Obama’s “Legislative Panic”: CEO of FreedomWorks says Congress should Start Over on Healthcare Reform.

ABC News’ Kim Berryman reports: President Obama’s hopes for a health care bill before the August recess are long gone and with the help of skeptics and concerned constituents, the administration’s sprint towards a bill this fall is now slowing to an uphill jog. This afternoon Matt Kibbe, president and CEO of FreedomWorks, a group “leading the fight for lower taxes, less government, and more freedom” said that hope for passing reform in 2009, is lost.

The White House used “an all or nothing strategy and I think they’re going to step out of this with nothing…I think enough Americans have raised opposition that the moderate democrats and the moderate republicans that they need to pass this reform are going to back away from this process and we’re going to start over and hopefully we do it right the second time” Kibbe predicted on ABC News’ “Top Line.”

As the Obama administration and Congressional Democrats push their political chips towards the center of the table on health care reform, it seems hard to imagine anyone settling for a do-over at this point in the game.

However, Kibbe insists that “passing a big reboot of the health care system is not something that the American public is eager to see right now.”

Instead of passing overall reform in a process of what he calls “legislative panic,” Kibbe suggests an incremental approach with bipartisan support and applauded the health insurance reforms put forth by Senator Jim Demint of South Carolina.

In the months of lobbying, committee meetings and White House phone calls, “the one group that [President Obama] cut out of the conversation was the public. They have an interest in this debate and they watched how the President passed the stimulus package and … the bank bailout last fall. They’re tired of these secretive, rushed legislative efforts,” Kibbe said.

The Obama administration has often voiced its desire to be more open with the public than the administrations that preceded it. Yet, with health care, the topic of transparency is a sore one. Just this summer, the Los AngelesTimes reported the White house’s reluctance to disclose a list of visitors coming by the famous mansion to discuss reform.

Obama himself is answering questions at town hall meetings in rapid succession this week. These meetings follow months of media coverage allowing him to explain the specific changes he had in mind. In ABC’s own Prescription for America special this June the president tried to make his plans clear to the American people. Despite these attempts, misunderstandings and disagreements among Americans have distracted the White House and congressional leaders from their selling points.

Just this week, Sen. ChuckGrassley, R-Iowa,a proponent of a bipartisan bill, addressed untruths about death panelsduring a town hall meeting.Meanwhile, the White House has launched a Reality Check website among other tools to address the more common concerns people have about health care.

“If you get an e-mail from somebody that says, for example, ‘Obamacare is creating a death panel,’ forward us the e-mail and we will answer the question that’s raised” President Obama said in a town hall meeting on Tuesday.

The hurdle health care will have to clear is the dread that many Americans like Kibbe associate with “the idea of government forcing anybody to buy insurance, particularly when they mandate what insurance that is.”

To see more of what Matt Kibbe told Top Line, click HERE.

Lizzie O’Leary, co-author of today’s eye-opening report from Bloomberg News,also stopped by the studio today to discuss her findings. The exclusive report by O’Leary and Jonathan D. Salant show that there are no fewer than six health care lobbyists for every member of the House and Senate.

To hear more about O’Leary’s report click HERE.