President Obama speaks Friday at a health care rally in suburban Virginia, part of a final frenzied push before the health care bill comes up for a vote in the House on Sunday.
Obama is playing both an outside game and an inside game to pass the bill. In public, there are speeches and rallies, but in private he is using his own style of delicate arm-twisting.
It's hard to exaggerate the stakes for the Obama presidency in the health care debate. If the bill fails, he will be severely weakened. He will have failed to deliver his signature initiative, and his Democratic Party will look incapable of governing.
If there was any doubt about the stakes and the importance of Obama's presence in the home stretch, look no further than his travel schedule: He postponed a trip to Asia that was supposed to begin Sunday. Between now and the House vote, Obama will do everything he can to win the vote.
Urging Lawmakers
On Thursday, the president trumpeted the latest analysis by the Congressional Budget Office that said the bill would cut $1.3 trillion from the deficit over the next two decades.
"This is but one virtue of a reform that will bring more accountability to the insurance industry and greater economic security to all Americans," Obama said. "So, I urge every member of Congress to consider this as they prepare for their important vote this weekend."
Obama wants members to consider other things as well. He has had phone calls and meetings with more than two dozen Democrats who voted no on the bill in November. While he is no President Johnson, who struck fear into the hearts of Democrats who dared to defy him, Obama listens carefully; he uses a gentle form of moral and political suasion, and he's persistent.
"I've had four separate meetings with the president," said Rep. Dennis Kucinich (D-OH), who switched his vote from no to yes after traveling with the president this week. "And he explained to me what he felt was at stake."
But Kucinich was blunt in stating that one thing at stake is the fate of the Obama presidency itself.
"We have to be very careful that the potential of President Obama's presidency not be destroyed by this debate," he said. "Even though I have many differences with him on policy, there's something much bigger at stake here for America."
More Direct Argument
Obama is also making another point to members considering voting no in hopes of surviving a tough re-election campaign. It's personal, and it goes something like this: If you run away from me on health care, the Republicans will tie you to me anyway and the Democratic base will desert you.
At the rally Friday in Virginia, Obama will repeat the argument he made when he traveled to Ohio on Monday, warning voters what would happen to their insurance if his bill doesn't pass.
"Even if you've got good health insurance, what's happening to your premiums? What's happening to your co-payments? What's happening to your deductible? They're all going up," he said. "That's money straight out of your pocket. So the bottom line is this: The status quo on health care is simply unsustainable."
This is a change from the more abstract arguments he used last year: how a health care overhaul would bend the cost curve and help the federal budget. Now, the president's public pitch is more about individual family budgets, says Drew Altman, president of the Henry Kaiser Family Foundation.
"The message now is a consumer message, it's a people message, it's a message not about percent of GNP or bending the curve — it's a message about people's own health care costs," Altman said. "In a sense, it brings this whole health care debate back full circle, because that's where this began."
Altman says, however, that public argument, while a welcome change to supporters like him, is actually not the most significant part of the debate right now.
"At this late stage, it's really the inside game that's fundamentally important; it's about a small number of votes from wavering Democrats," he said.
Obama is working it hard as his health care bill and the health of his presidency hang in the balance.
