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President Obama, along with senior advisers David Axelrod and Nancy Ann DeParle, held a conference call with bloggers this afternoon to discuss healthcare reform and the need for grassroots and netroots pressure on Congress to keep the urgency of the issue alive.

President Obama strongly reiterated his basic principles for a reform bill:

  • Cover all Americans
  • Drive down costs over the long term for both the private and public sector
  • Improve quality
  • Strengthen prevention and wellness
  • Enact real insurance reforms that end exclusions for preexisting conditions, etc.
  • Relief to small businesses
  • Create a robust public option

But the main message of the call was the urgency of getting this done sooner rather than later. In answer to John Amato's first question about the latest push for delays from Democrats and Republicans alike, President Obama answered that "we've been debating this for 50 years, that now's the time to make the tough decisions" with the options now on the table. In a followup question after President Obama left the call, Axelrod reiterated that message. This issue has been "talked to death for decades," and we've been "circling around the same issues"--what matters now is getting it done. He added that if you needed a demonstration of the urgency of getting it done, it's that those who want to stop it are counting on delays that will give them enough time to kill it. He also suggested that those pushing for delays, be they arguing in good faith or not, listen to their constituents who call and e-mail every day with their insurance horror stories.

In a follow up question from Jonathon Singer on the timeline, the President was asked whether there was a point at which he might say that 60 votes in the Senate isn't going to happen, and to push for reconciliation. He responded that the reconciliation option was structured under the assumption that the major work on the legislation would be done by October, with reconcilation held out as sort of a last resort possibility. He said that if that's not the case, then they'll "look at all the options, including reconciliation," and that the "only thing that is unacceptable is inaction."

The conversation turned to the public option, with the President reiterating that a robust public option participating in the insurance exchange would be the best competition for people like the self-employed and small business owners and employees. With the topic the public option, and the fact that the Senate Finance committee is still considering the coop model as an alternative, I asked whether there was a coop model that would be an acceptable substitute to his vision of a robust public plan. He gave the well-informed, wonky answer I'd been hoping for. His advisers have been looking at the details the coop approach, and have yet to find a model that answers the problems that co-ops have in getting off the ground and growing quickly enough to compete at the level that will be necessary in a public option. His team is looking for the evidence that exists to show that a co-op could provide that competition, and if they can find it, it might be an option. He then reiterated his commitment to having  a robust public option.

That segued into his concluding remarks, in which he said that he was "not interested in making the best the enemy of the good" in the bills the individual committees were reporting out, that the House and Senate conference will be where the tough and serious negotiations play out, and where much of the heavy lifting will occur. (That said, this blogger thinks that we still need to keep the pressure on to try to have the bills that get to the floor of each chamber the best that they can be, making sure that the key elements, like a robust public option, are at least one of the bills that goes to conference.)

Axelrod continued to reinforce the urgency of this effort, and of the necessity for the netroots to keep talking about the "enormous human price of inaction." Answering a question from Joe Sudbay about whether good policy will be a driver over bipartisanship, particularly in light of DeMint and Kristol and "Waterloo," Axelrod said that the White House expects the bill to meet certain standards and that while it would probably be easier to get a good bill through the regular process with some Republican support, they are "driven by outcome, not process." He did, however, say that there are some Republicans working in good faith, that not all of them are following Kristol and some even want fundamental reform for the American people.

He was also asked if the President would veto a bill without a strong public option, and answered that the President "expects that the bill he signs will include a robust public choice," and that they have not "weiled the threat of the veto pen as of yet," but have made it very clear to all of the negotiators that is has to be included.

While not directly stated as such, the call was part of the White House take charge strategy, which includes OFA's 50 state healthcare reform push. His charge to the netroots, via Axelrod in answer to a question from Cheryl Comtee about what we can do, "spread the word."

Update: Read dday's write-up of the call. You can hear the audio at C&L.

Originally posted to Daily Kos on Mon Jul 20, 2009 at 04:30 PM PDT.

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