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If this is accurate, then President Obama not only had to battle Republicans and conservative Democrats to pass health care reform, he had to battle his own chief of staff.

Rahm Emanuel spent nearly a week in the summer of 2009 aggressively trying to talk Obama out of moving foward with an ambitious version of health care reform, and by his own admission "begged" him not to do it, a book out next week reports.

The book, Jonathan Alter's The Promise, goes much further than previous accounts in documenting just how opposed Rahm was to proceeding with ambitious reform -- something that was widely suspected at the time but never proven in detail. Excerpts of the book were made available in advance of its release next Tuesday.

Heading into August, the Obama administration was still in good shape on health care reform. Americans trusted President Obama over Republicans in Congress by nearly 30 points, 55%-26%. Republicans had just unveiled a health care proposal that represented a dream come true for insurance companies.

Then came the town halls, and Republicans for the first time on health care went on the attack. Instead of keeping the initiative and firing back, using the newly introduced Republican plan (which would have deregulated insurance across the nation) to illustrate a narrative featuring Republicans and health insurers as the villains, the White House was virtually silent, except to focus on concerns that the town halls might turn violent.

By the middle of August, President Obama was backtracking on the public option, and while he made it clear he was pressing forward with a plan, the initiative had been lost -- along with the enthusiasm of a large chunk of the Democratic base.

Based on the relative quiet of the White House in early August, it seems likely that it is during that period that Rahm would been pushing against health care reform. So if Alter's account is accurate, right as the Republican attack machine was hitting its stride, the White House was stuck in neutral, with Rahm urging the President to throw things into reverse.

What's especially frustrating is that ultimately, President Obama did ultimately try to build a narrative in which Republicans were doing the bidding of insurance companies, but he did so very late in the game. Imagine how things might have been different if instead of battling Rahm, he'd been able to seize the opportunity Republicans gave him at the end of July.

Originally posted to Daily Kos on Fri May 14, 2010 at 02:34 PM PDT.

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