Huffington Magazine Issue 12-13 | Page 45

HUFFINGTON 09.09.12 that in ‘94, Clinton didn’t spend a lot of time dealing with all the stakeholders, and they all came out against it. Because they didn’t feel brought into the process,” explained a top administration official shortly after health care passed, who spoke on condition of anonymity because he wasn’t authorized to discuss the deliberations. “So we brought them all in.” At first, openness meant hosting public forums where groups ranging from the unions to private insurance companies could voice their visions for reform, from the need for preventative services to the pitfalls of fee-for-service care. Behind the scenes, however, the White House went out of its way to ensure that any group or lawmaker with relevance to the bill wasn’t alienated by the negotiations. According to Democratic officials close to the situation, the administration decided not to enlist its massive email list to fight for the public option — a government agency to provide insurance coverage — because they worried that the measure would inevitably be traded away, disappointing those who fought for it. “He was husbanding them for the political battles to come instead of releasing them to go nuts,” said a former top Senate leadership THE DEMOCRATIC CONVENTION transactional politics. The decision to tackle health care reform itself was born from an un-inspirational premise. While Obama had talked frequently during the campaign about the moral obligation to expand access to the uninsured, it was basic accounting that convinced him to move forward in the spring of 2009. Rising health care costs are one of the biggest drivers of the national debt, and curbing the rate of growth was not just a policy objectiv e, but a governing necessity. “He was persuaded to do health care, I believe, by Peter Orszag [the budget director], not Ted Kennedy [health care reform’s righteous champion],” explained one top ally in the fall of 2010, who requested anonymity in order to speak frankly. Having reached this conclusion, Obama and his advisers made a set of strategic decisions that would define the subsequent health care reform process. The first was that everything had to be paid for. There was little appetite for more deficit spending after the Troubled Asset Relief Program, the stimulus and the auto bailout. The second was to grant Congress a huge say over the legislative process. “There was a view — and I don’t know how accurate the view is —