Obama Claims to be Attacking the Status Quo: Is he?– Expand Benefits and Control Costs– Health Care Viewed by Many as a “right”– Promoting HCR seen as Moral– Cost Controls suggest Rationing– Powerful Bias Towards Expansion

Health Care Reform and its Consequences

History Is Clear Medicare Originally Covered Only Those

65+

-1972 Congress Makes Disabled Eligible (15%)

-2003 Congress Creates a Drug Benefit

-Other Services (hospice care, mammograms) are Subsequently Added,

Medicare Very Popular Today

Medicaid: Fed/State Program for the Poor

Originally Covered People on Welfare

-Now, Children Ages 6 to 18 under the Poverty Line ($22,050 Family of 4)

-Congress Sets Higher Limit (133%) for Pregnant Women and Children Under 6

-1997 (SCHIP) Expands Coverage

Ballooning Costs

1965 Health Care Spending to Individuals <1% of Federal Spending

2008 Federal Spending to Individuals 28%

Battle For Health Care Reform

Wasn’t Just About Health Care—For Conservatives it is About Killing a Progressive Agenda

Wanted This Policy Debate to be Obama’s “Waterloo”

If Defeated, They Could Block Climate Change Leg, Immigration Reform, Marriage Equality, Bank Reform, Educ

Obama and Progressives

Disappointed Progressives on Several Fronts: – Wall St. Bailouts– Weak Foreclosure Plan– Expansion of War in Afghanistan– Catering to Insurance Companies

Lessons From the Last Year

It Takes Social Movements that Exhibit, Tenacity, Intensity, and Imagination to Get Big Things Done– E.g., Abolition, Women’s Suffrage, New

Deal, Great Society– Not Won in a Single Election

Why Health Care Reform Was So Contentious

Tactical and Strategic Errors Failing to Confront Powerful Interests Massive Corporate Resistance to

Reform Tea Party Movement Successfully

Tapped into Public Populist Anger Massachusetts Special Election Rules of the Senate

Thursday, April 08, 2010 Obama Approval Index -14 Strongly Approve 28% Strongly Disapprove 42% Taxes Will Go Down 8% Gov't Spending Will Go Up 67% Obama on Economy - Ex/Good 41% Obama on Nat'l Sec - Ex/Good 43% Leadership - Ex/Good 44% Trust Obama on Economic Crisis 27%

Any Questions?