President Obama just made a statement, proclaiming himself “cautiously optimistic” that the Senate will pass their health care bill. While maintaining that there are still disagreements to be worked out, he said that the bill meets “all of my criteria” that he laid out in a joint session to Congress in September – that it would bend the cost curve, would be deficit neutral, and would provide coverage to 30 million Americans.

Obama, showing some fire but reserving it for rebutting critics claiming that the bill doesn’t control costs or cut the deficit, said that his session with the entire Senate Democratic caucus was “very productive.” Obama did not engage in a roll call of whether the Senate leadership had the votes to pass a revised bill, but he said that there was a “broad consensus” around key issues – insurance regulations, reducing costs of health care (“this is the largest deficit reduction plan in over a decade”), and expansion of coverage to make it affordable to over 30 million Americans who do not have health insurance.

Obama referenced Atul Gawande’s recent New Yorker article in saying that every idea that exists to “bend the cost curve” in health care are already in the bill (if the Dorgan amendment passes to lower the cost of prescription drugs for individuals and the government, with no help from Obama, he may even be right!). He cited the initial CBO scores in saying that the bill would reduce the federal budget deficit, and he asserted that costs would lower for families and businesses as well as the government. “All the scare tactics out there are simply inaccurate.”

Obama said that these added up to big changes, “the most significant reform since the passage of Medicare.” He even added some of that moral tone by saying that it would save lives. In a key moment, Obama said that “We cannot allow differences from individual issues to keep us from resolving the longstanding problems confronting the American people.” The consequences of inaction are too great for the health care system, he said, and so failure is not an option. And, he concluded, “any fair reading of this bill will agree that every piece I laid out in the joint session of Congress has been met.”

What was surprising was not Obama’s insistence on a bill, any bill, that could be called health care reform, but his hesitancy to affirm that the deal apparently reached yesterday to resolve the public option would pave the way for cloture and a final passage in the Senate. He said twice that there were “disagreements that have to be ironed out,” which would be completed in the next several days. Obviously, we don’t know what was said in the room, but clearly there is not yet a full consensus.

David Dayen

David Dayen

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