What a Health Care Loss Would Mean for Obama

In 2000, Barack Obama tried to unseat incumbent Illinois Congressman Bobby Rush in a Democratic primary. The thumping Obama received — Rush got 61% of the vote to the upstart's 30% — was a grave political disappointment for the young state senator. Some of his friends even feared that Obama had undermined his golden image and permanently altered what had been the unbroken upward trajectory of his professional ascent.

Obama, however, was undeterred by the defeat, and just four years later won the U.S. Senate seat that positioned him for the White House. The congressional race, as it happened, was merely an aberration in a series of professional and political triumphs unmarred by any genuine or lasting setbacks. Even when he ceded a few key primary contests to Hillary Clinton in 2008, Obama was able to swiftly regain the upper hand. To this day, then, the Rush contest stands out as an anomaly in Obama's political life, when a loss seemed to truly threaten his future.

And now health reform stands as another crucial juncture. If the President fails to win the upcoming series of congressional votes that are designed to get health care legislation to his desk, it will be a calamitous failure for his presidency and for him personally, dwarfing the potholes he has hit during his first bumpy year in office. Indeed, the notion of defeat is so unthinkable for his Administration that Obama's foremost argument in rounding up support in the House and Senate is a panoptic imperative: health care is too important — politically and substantively — to fail. Should the effort collapse, regaining political traction would be nigh impossible any time soon, if ever. And a potential comeback would be in further jeopardy because Obama is so unaccustomed to losing.

The President has brought some of his current travails on himself, of course, and in some cases failed to head off the harsh squalls that have made this final stage so arduous. Most important, the President long ago lost control of the message behind his drive for health care. Now, as far as a wary and weary American public is concerned, Obama's health care endeavor means messy legislative wrangling and a frightening increase in government spending rather than necessary and overdue improvements to a system defined by inefficiency and rising costs.

The civilian griping has heightened the fraught congressional machinations. As Obama, House Speaker Nancy Pelosi and their allies seek the final cache of votes required to clear the next hurdle in the House, they have one hand tied behind them. Business-as-usual eleventh-hour incentives are off limits after the pointed backlash against a spate of clumsy sweetheart deals like the so-called Cornhusker Kickback given to Nebraska Senator Ben Nelson. That's why the reality for the Democratic Party — that they must all hang together on the health care vote or they will surely all be hung separately in the midterm elections — is at the center of the case the President is now making, both in public and (more intensely) behind the scenes.

Despite the endless second-guessing, hand-wringing, finger-pointing and doomsaying (from the left, the right, the center and, predictably, the fourth estate), the President is on the precipice of an extraordinary legislative achievement. If he is victorious, he will get his win in much the manner he anticipated before he took the Oval Office — dirty, dragged-down and drawn-out.

From the get-go, the President wished for the best but expected the worst. Obama hoped for bipartisan support but knew his expansive goals for expanded coverage would make it a challenge. He knew that the press coverage would emphasize setbacks and discord over progress. He knew it would be necessary to publicly downplay his sway over Congress's committee process while laboring behind the scenes to keep the Hill on track in timing and substance. He knew setting public deadlines for congressional action was a necessary risk. He knew that it was vital to make deals with the for-profit health care industry (such as the pharmaceutical companies) and labor unions in order to keep them on board and defanged, despite the heated negative reaction from his critics on the left and the right. He knew the intraparty disputes over divisive issues such as abortion and immigration would require a particular finesse. He knew that House liberals would ultimately be forced to swallow the more conservative inclinations of Senate Democrats (and that he could use the insistence of Senators that the legislation move more to the center to get the moderate bill he wanted without having to play the heavy with the lower chamber). And he knew that final passage would require the kind of breathtaking, down-to-the-wire vote-whipping that would demand the full power of his office to snatch victory from the jaws of defeat.

Obama has faced a strong united front in recent months from Republicans in Congress, on cable TV and talk radio and across the country who have shown discipline in rallying around a common message about the flaws in the Democrats' health care gambit. So he still has a lot of work to do this week. To avoid a failure of unimaginable consequences, the President needs to inspire equivalent unity within his own party. It won't be easy to herd Congress's collection of tense, defensive, anxious Democrats, distracted by tough re-election bids and the grim disapproval of an angry electorate. But as you watch the taut health care endgame, just remember that there is a reason we don't know much about how Barack Obama handles losing: it almost never happens.