Obama Presidency Hinges on Health Reform

resident Obama had nothing but momentum going into the White House.

He arrived in office on a “Yes, we can!” wave and decided to use his considerable political capital to make health care reform his first major initiative as president. But if he fails, “No, we didn’t” will hurt his chances to do much else for the rest of his term.

Failure is not an option—and Obama knows it.

That’s why he staked out broad policy goals for reform rather than specific details, and avoided handing Congress a set-in-stone plan, as President Clinton did, that would have been dead on arrival on Capitol Hill.

It’s the same reason the Obama administration made deals up front with doctors, hospital and big drug companies—earning their support of the president’s objectives for health care reform in exchange for limits on fees and budget cuts that would hurt those groups. And it’s why Obama indicated publicly he was open to considering other routes than a public option to increase access to health care coverage and offer more affordable alternatives to private insurance.

Will it work? In the current political climate, I wouldn’t put money on either outcome.

Some would argue war and foreign policy issues will define Obama’s presidency, but those were existing challenges he inherited and it’s likely whoever follows him in the Oval Office will have to deal with them, too. Obama chose to take up health care and he pledged to win. If he loses, no matter what the reason, much of the momentum he carried into Inauguration Day will disappear.

The battle over health care—and its outcome—will be a measure of his ability to persuade, to win people over to his side and to prevail in an atmosphere where changing the status quo is about the hardest thing you can do.

If reform fails, Obama will face roadblocks to forging consensus on other big issues such as climate change and education reform. Major interest groups might be less willing to compromise and members of Congress who face tough midterm elections next year will be reluctant to align themselves with the president on other divisive issues.

And here’s the toughest part: even if he succeeds, public opinion of his job performance could still suffer if people don’t like how it turns out in terms of access, cost or quality. And in 2012, they may decide to vote for change again.

Jenny Price is a Madison native who covered the state Capitol for the Associated Press and has written about Wisconsin politics for a decade. E-mail her at jenny.price@gmail.com.