Obama and the Perfect Political Storm

It's hard to sell change voters don't think they need

By KARL ROVE

August was the worst month of Barack Obama's presidency. And he seems to know it-he is now planning to deliver a speech to a joint session of Congress 232 days into his administration in a desperate attempt to save his biggest domestic priority, overhauling health care.

He has already had the budget-busting $787 billion stimulus package, a budget that doubles the national debt in five years, an earmark-laden appropriations bill that boosted domestic spending nearly 8%, and a cap-and-trade energy tax that limped through the House with dozens of Democratic defections (and which has stalled in the Senate). These achievements are unpopular, so they are boomeranging on him.

Mr. Obama's problems are legion. To start with, the president is focusing on health care when the economy and jobs are nearly everyone's top issue. Voters increasingly believe Mr. Obama took his eye off the ball.

In addition, Mr. Obama is trying to overhaul health care without being able to tap into widespread public unhappiness. Nearly nine out of 10 Americans say they have coverage-and large majorities of them are happy with it. Of the 46 million uninsured, 9.7 million are not U.S. citizens; 17.6 million have annual incomes of more than $50,000; and 14 million already qualify for Medicaid or other programs. That leaves less than five million people truly uncovered out of a population of 307 million. Americans don't believe this problem-serious but correctable-justifies the radical shift Mr. Obama offers.

Moreover, he's tried to sell it with promises Americans aren't buying. He says ObamaCare will save money, but Americans believe it comes with a huge price tag because the Congressional Budget Office has said it will.

Workers are also rightly concerned they won't be able to keep their current coverage. Many businesses will drop their health plans and instead pay a fine equal to 8% of their payroll costs, which is less than what they pay for employee coverage.

Families believe they will be pushed into a government plan as the "public option" drives private insurers out of the market.

Health-care providers fear they'll be forced to follow one-size-fits-all guidelines drafted by bureaucrats, instead of making judgments for specific patients.

And seniors are afraid of Mr. Obama's plan to cut $500 billion from Medicare over the next decade, including $177 billion for Medicare Advantage. It's simply not possible to cut that much from Medicare without also cutting services seniors need.

Each of these concerns is energizing opposition among many previously uninvolved voters and political independents. Members of Congress, especially those in closely contested districts, saw this firsthand when they returned home in August.

The administration's problems have been compounded by tactical mistakes. Allowing House Speaker Nancy Pelosi to push for a Democrat-only bill shatters any claim Mr. Obama can make to bipartisanship, a core theme of his candidacy. Leaving the legislation's drafting to Congress has tied the president's fortunes to Mrs. Pelosi, who has a 25% approval rating nationwide, and Senate Majority Leader Harry Reid, whose approval rating is 37% in Nevada.

Sen. Jim DeMint (R., S.C.) was inartful but basically correct when he said if Mr. Obama loses on health care, "it will be his Waterloo." It would destroy confidence in the ability of Democrats to govern. Mr. Obama knows this, which is why he will stop at nothing to get a bill, any bill, on which the label "health-care reform" can be stuck.

Given the Democratic congressional margins, Mr. Obama has the votes to do it, but at huge costs to him and his party. Legislation that looks anything like the bill moving through the House will contain deeply unpopular provisions-including massive deficit spending, tax hikes and Medicare cuts-and create enormous ill will on Capitol Hill. This will be especially true if Democrats rely on parliamentary tricks to pass a bill in the Senate with 51 votes. The public's reaction in August showed that the president is creating the conditions for a revolt against his party in the 2010 elections.

On the other hand, if Mr. Obama jettisons the public option, he may spark a revolt within his party. The Democratic base is already grumbling and could block a bill if it doesn't include a public option.

Presidents always encounter rough patches. What is unusual is how soon Mr. Obama has hit his. He has used up almost all his goodwill in less than nine months, with the hardest work still ahead. At the year's start, Democrats were cocky. At summer's end, concern is giving way to despair. A perfect political storm is amassing, and heading straight for Democrats.