Policy

Ted Kennedy is the one to blame for Obamacare?

Politico has an interesting timeline of President Obama’s evolution from not really interested in healthcare […]

Politico has an interesting timeline of President Obama’s evolution from not really interested in healthcare (as a candidate) to completely focused on this central accomplishment (as a second-term president). Authors Carrie Budoff Brown and Glenn Thrush traced the initial idea to focus on healthcare to “the pressure to say something, anything, at the progressive health conference a year before the first presidential primary votes were cast.”

Th article traces Obama’s progress (or regression, depending on your point of view) over the next several years from that early point in the campaign to September of 2009 when the healthcare bill looked like it was going to die in Congress. Senator Ted Kennedy shows up in two crucial moments in this story. The way Brown and Thrush tell it, Kennedy won Obama over to the idea of healthcare reform and then even reached from beyond the grave to save the bill.

Kennedy’s first action was in January 2008 when Obama was looking for an endorsement. Kennedy said he would back Obama:

on the condition that Obama kept his promise to make health care his top domestic priority beyond propping up the collapsing economy.

It was a bit of a bluff, former Kennedy aides tell POLITICO: The aging Massachusetts senator, who would soon be felled by a brain tumor, probably would have backed Obama anyway.

But Obama repeated his pledge and Kennedy, hardheaded to the last, immediately steered two of his policy advisers to the task of planning, so Obama couldn’t back off for lack of a viable legislative strategy. To this day, some of Obama’s current and former aides cite the Kennedy commitment as a key reason why he refused to give up even when most of his inner circle counseled him to do just that.

Fast forward 19 months to President Obama, seriously ill Sen. Kennedy, and a healthcare bill that was floundering in Congress. According to the article, the President used a letter from the Senator to revive the bill and rally the troops to get something passed:

They had begun viewing their health reform fight as an existential moment in his presidency, and stealthily planned a highly unusual prime-time address on health care to a joint session of Congress in September.

The idea was to re-energize shell-shocked Democrats and regain the initiative. To do so, he summoned the man who had been a catalyst for his own conversion on health care two years earlier: Ted Kennedy.

Obama quietly prepared two versions of his speech: a widely circulated draft that ended with an anodyne closing statement — and another, secret copy that included an excerpt of the letter that Kennedy sent Obama shortly before his death in August 2009.

West Wing aides figured the first draft would be leaked, giving the second even greater emotional impact — a showman’s move the late Massachusetts senator would have appreciated.

“[W]hat we face is above all a moral issue; that at stake are not just the details of policy, but fundamental principles of social justice and the character of our country,” wrote Kennedy.

The speech injected just enough life back into the issue. The House passed a bill in early November, and the Senate followed on Christmas Eve morning. The only thing left to do was reconcile the two different bills and send it back through for final passage — no small feat, but within reach.

Of course it’s naive to think that Obama is a 3D chess player and had healthcare reform mapped out for years, or to underestimate Kennedy’s influence. But the serendipity and chance in this account surprised me. It’s hard to think of Obama as anything but completely dedicated to healthcare reform after his relentless campaigning for it over the last five years — and the fact that his mom died of breast cancer and didn’t have health insurance. Maybe his late embrace of the term “Obamacare” is the most accurate reflection of his early ambivalence toward the issue.

[Image from flickr user Will White DC]

Veronica Combs

Veronica is an independent journalist and communications strategist. For more than 10 years, she has covered health and healthcare with a focus on innovation and patient engagement. Most recently she managed strategic partnerships and communications for AIR Louisville, a digital health project focused on asthma. The team recruited 7 employer partners, enrolled 1,100 participants and collected more than 250,000 data points about rescue inhaler use. Veronica has worked for startups for almost 20 years doing everything from launching blogs, newsletters and patient communities to recruiting speakers, moderating panel conversations and developing new products. You can reach her on Twitter @vmcombs.

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