The death of Senator Ted Kennedy (D-MA) last August – who had made healthcare reform the focus of his legislative agenda — provided much of the impetus that gave President Barack Obama the determination to pass legislation despite resistance from both the right and left. The lack of Kennedy’s legendary legislative skills at a crucial time made the quest for healthcare reform a fight every step of the way.
“I had a whole bunch of political advisers telling me, this may not be the smartest thing to do,” President Obama told a crowd in Elyria, OH, in January. “I had no illusions when I took this on that this was going to be hard. Seven presidents had tried it, seven Congresses had tried it – and all of them failed. I didn’t take this on to score political points.”
The White House team pored over the failed healthcare reform effort of former President Bill Clinton and his wife, Hillary, in 1993 and 1994. One lesson from the Clinton healthcare failure was to work to win support from healthcare companies, many of whom had put an end to the earlier attempt. As a result, President Obama brought pharmaceutical companies and hospitals into the discussion to assure a limited impact on their profits in return for financial contributions to the overhaul and a promise of support. The administration also preferred that Congress write the legislation, rather than having it dictated from the White House.
Without doubt, the president’s most effective ally was Speaker of the House Nancy Pelosi, who rode herd on her caucus and delivered a majority vote on the legislation three times. According to Pelosi, “When I spoke with him (President Obama) after the vote, he said that he was happier after the vote than he was the night he won the presidency. “And I said, well, I’m pretty happy, but I’m not happier than the night he won the presidency because if you hadn’t won the presidency, we wouldn’t be here.”