Loopholes in Obama’s low-cost health coverage plan

President Barack Obama and Nancy Pelosi (AP)

It’s an eagerly awaited early benefit of President Barack Obama’s health care overhaul: affordable coverage for Americans with medical problems who can’t get a private insurer to even take a look.

Starting in July, a special high-risk pool will offer coverage to uninsured people with pre-existing health conditions at a cost similar to what everyone else pays. It’s the first test of whether the administration can deliver on Obama’s vision within the budget Congress set.

But some vulnerable patients are probably going to feel a little cheated. Consider this coverage wrinkle:

Suppose your cancer is in remission. You had to quit your job while you were having chemotherapy, and your employer coverage ran out. You can’t find a private insurer who’ll take you, but you’re lucky to live in a state that has its own high-risk pool. Still, you have to struggle to pay the premiums, well above standard insurance because sicker people are in the group. Yet as the federal program is designed, you wouldn’t be able to switch over and take advantage of significant savings.

The reason: You have to be uninsured to qualify for the new plan.

“It’s awkward,” said John Rother, senior strategist for AARP, which supported the overhaul. “None of us would want to see the program lock people in to the more expensive existing coverage, but to switch over all those people would have definitely boosted the cost, and Congress was looking for ways to minimize it.”

That means some 200,000 patients now enrolled in more than 30 state high-risk insurance pools will be stuck paying higher premiums. Many are on tight budgets, drawing down their savings and borrowing from family members.

Premiums in the new federal pool are expected to be 10 percent to 50 percent lower than current state rates, said Richard Popper, who directs Maryland’s program. Co-payments and deductibles are also expected to be considerably lower. But the only way current beneficiaries could get the federal coverage would be to drop out of their state pool and go uninsured for six months.

“That would be a very risky thing to do,” said Stephen Finan, policy director for the American Cancer Society Cancer Action Network. “Can you afford to go without coverage for six months in the hopes of getting a better price? It’s a big gamble.”

Health and Human Services Secretary Kathleen Sebelius calls the federal risk pool a first step toward ending insurance discrimination against people with health problems. But HHS officials say Congress wrote the rules and there’s nothing they can do to open up the program to people now in state pools. The federal pool is designed for the uninsured.

The program will be temporary, a bridge to 2014, when denial of coverage for medical reasons will be against the law, and new insurance markets will offer taxpayer subsidized coverage for millions. Number crunchers at Medicare estimate that 375,000 people will sign up this year.

Sebelius says she expects the plan will operate alongside state risk pools where such programs exist — making premium comparisons inevitable. She’s also planning a national program to serve people in states that have no risk pools, or opt not to participate.

Georgia insurance commissioner John Oxendine announced this week that his state would not. Oxendine, a Republican running for governor, questioned the constitutionality of the federal overhaul law, and said he thinks joining the new risk pool could end up costing state taxpayers money.

On the other side of the debate, consumer groups supporting the health care law are worried that the federal risk pool may still be unaffordable for some. In a letter to Sebelius, 13 consumer, labor, and patient advocacy groups urged additional subsidies to help low-income people. But the $5 billion that Obama and Congress set aside may not be enough to support even a basic program for long.

A recent report by Medicare economists warns that the program could go through $4 billion in its first year, and run out of money as early as 2011.

“These are some of the sickest people in the country, and therefore their costs would be dramatically higher — yet the law requires that they be subsidized to standard rates,” said Robert Laszewski, a health care industry consultant. “I think they’ve given (Sebelius) an impossible task.”

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Health care opposition up, Obama down in poll

President Barack Obama: Health care bill means trouble (AFP)

Opposition to President Barack Obama‘s health care law jumped after he signed it — a clear indication his victory could become a liability for Democrats in this fall’s elections.

A new Associated Press-GfK poll finds Americans oppose the health care remake 50 percent to 39 percent. Before a divided Congress finally passed the bill and Obama signed it at a jubilant White House ceremony last month, public opinion was about evenly split. Another 10 percent of Americans say they are neutral.

Disapproval for Obama’s handling of health care also increased from 46 percent in early March before he signed the bill, to 52 percent currently — a level not seen since last summer’s angry town hall meetings.

Nonetheless, the bleak numbers may not represent a final judgment for the president and his Democratic allies in Congress.

Only 28 percent of those polled said they understand the overhaul extremely or very well. And a big chunk of those who don’t understand it remain neutral. Democrats hope to change public opinion by calling attention to benefits available this year for seniors, families with children transitioning to work and people shut out of coverage because of a medical problem.

“There are some things I like, because I think that there are some people who need health care,” said Jim Fall, 73, a retired computer consultant from Wrightwood, Calif.

But “I don’t like the idea of the government dictating what health care should be like,” added Fall. “Nor do I like them taking money out of Medicare. They are going to create more waste and they are going to take away benefits.”

Seniors — reliable voters in midterm congressional races — were more likely to oppose the law. Forty-nine percent strongly opposed it, compared with 37 percent of those 64 and younger. Seniors’ worries that Medicare cuts to insurers, hospitals and other providers will undermine their care represent a formidable challenge for Democratic congressional candidates this fall.

Analysts said the level of public wariness on such a major piece of social legislation is unusual.

“The surprise of this poll is that you would expect people to be more supportive of the bill now that it’s the law of the land — and that’s not the case,” said Robert Blendon, a Harvard public health professor who follows opinion trends on health care. “The election for the House is going to be competitive, and health care is clearly going to be an issue.”

The nearly $1 trillion, 10-year health care remake would provide coverage to nearly all Americans while also attempting to improve quality and slow the ruinous pace of rising medical costs.

Nonpartisan congressional budget analysts say the law is fully paid for. Its mix of Medicare cuts and tax increases, falling mainly on upper-income earners, would actually reduce the federal deficit. And people covered by large employers may even see a dip in their premiums.

The public doesn’t seem to be buying it.

Fifty-seven percent said they expect to pay more for their own health care, contrasted with 7 percent who expect to pay less. And 47 percent said they expect their own medical care to get worse, compared with 14 percent looking forward to an improvement.

“Based on the little information we know, somebody’s going to have to pay for it, so it makes sense that taxes would go up,” said Lang Fu, 48, an oil and gas engineer from Houston.

Politically, Americans are polarized. Democrats support the overhaul by 68 percent to 18 percent, while Republicans oppose it 85 percent to 9 percent. Independents are roughly even, with 44 percent opposed and 40 percent in favor — within the poll’s margin of error. That suggests there’s some space for Obama and the law’s supporters to make an appeal in its favor.

Donna Christian of Kingsport, Tenn., is a political independent who says she’s leaning in favor of the law. A bad heart forced Christian, 45, to leave her job as a supervisor at a wireless phone company a few years ago. She and her 10-year-old daughter make do on a limited income, and have coverage through Medicaid.

“I think Americans are going to be better off in the long run even if they don’t see that now,” Christian said. “More will have coverage, and they’ll be able to go to the hospital when they need to.”

Ron Pollack, head of Families USA, a liberal advocacy group that supports the overhaul, said it will be “a real task” to turn public opinion around, but he’s confident it will happen.

“When you dig deeper, individual provisions of the law have enormous support,” he said. Pollack believes current polls reflect public disgust with a “very lengthy and messy process.”

But Rep. Dave Camp, R-Mich., says Democrats have already lost their chance to persuade the public.

“They have had 16 months to explain this bill,” Camp said. “Good luck trying to explain it in the next six.”

The AP-GfK Poll was conducted April 7-12, 2010, by GfK Roper Public Affairs and Media. It involved interviews with 1,001 adults nationwide on landline and cellular telephones. It had a margin of sampling error of plus or minus 4.3 percentage points.

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Associated Press Polling Director Trevor Tompson, AP News Survey Specialist Dennis Junius and AP writers Alan Fram and Ann Sanner contributed to this report.

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On the Net:

AP-GfK Poll: http://www.ap-gfkpoll.com

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Mistakes will force health care bill back to the House

Sen . Chris Dodd (AP)

Senate Republicans learned early Thursday that they will be able to kill language in a measure altering President Barack Obama‘s newly enacted health care overhaul, meaning the bill will have to return to the House for final congressional approval.

It appeared initially that deleting the provisions, dealing with Pell grants for low-income students, should not cause major problems for Democrats hoping to rush the bill to Obama and avoid prolonging what has been a politically painful ordeal for the party. Democrats described the situation as a minor glitch, but did not rule out that Republicans might be able to remove additional sections of the bill.

The president, who signed the landmark legislation into law on Tuesday, was flying to Iowa later in the day for the first of many appearances he will make around the country before the fall congressional elections to sell his health care revamp.

Obama was appearing in Iowa City, where as a presidential candidate in 2007 he touted his ideas for health coverage for all. His trip comes with polls showing people are divided over the new health law, and Democratic lawmakers from competitive districts hoping he can convince more voters by November that it was the right move.

As an exhausted Senate labored past 2 a.m. on a stack of GOP amendments, Jim Manley, spokesman for Senate Majority Leader Harry Reid, told reporters that Republicans consulting with the chamber’s parliamentarian had found “two minor provisions” that violate Congress’ budget rules.

Republicans have been hunting for such violations in hopes of bringing down the legislation. Democrats had also been consulting with the parliamentarian, Alan Frumin, and hoped they had written a measure that would not be vulnerable to such problems.

The two provisions are expected to be formally removed from the bill on Thursday. Manley said he expected the Senate to approve the measure without them and send it to the House. He said Senate leaders, after conversations with top House Democrats, expect the House to approve the revised measure.

The Senate scheduled passage of the health bill for Thursday afternoon. Both chambers are hoping to begin a spring recess by this weekend.

Besides reshaping parts of the landmark health overhaul, the legislation transforms the federal student loan program — in which private banks distribute the money — into one in which the government issues the loans directly. That produces some federal savings, which the bill uses in part to increase Pell grants to needy students.

Democratic aides said the problematic provisions deal with protecting students from future cuts in their grants if Congress does not provide enough money for them. They violate budget rules because they do not produce savings, one aide said.

The development came as the Senate completed nine hours of uninterrupted voting on 29 GOP amendments to the legislation. Majority Democrats defeated every amendment.

The legislation would change the new health care law by making drug benefits for Medicare recipients more generous by gradually closing a gap in coverage, increasing tax subsidies to help low-income people afford health care, and boosting federal Medicaid payments to states.

It kills part of the new statute uniquely giving Nebraska extra Medicaid funds — designed to lure support from that state’s Sen. Ben Nelson — that had become a glaring embarrassment to Democrats. It also eases a new tax on expensive health coverage bitterly opposed by unions and many House Democrats, while delaying and increasing a new levy on drug makers.

As they began pushing the bill to passage on Wednesday afternoon, Democrats ran into a mountain of GOP amendments. Outnumbered and all but assured of defeat, Republicans forced votes on amendments aimed at reshaping the measure — or at least forcing Democrats to take votes that could be used against them in TV ads in the fall campaigns.

“There’s no attempt to improve the bill. There’s an attempt to destroy this bill,” said an exasperated Reid, D-Nev.

“The majority leader may not think we’re serious about changing the bill, but we’d like to change the bill, and with a little help from our friends on the other side we could improve the bill significantly,” answered Senate Minority Leader Mitch McConnell, R-Ky.

Senators voted on 29 consecutive GOP amendments between 5:30 p.m. Wednesday and 2:30 a.m. Thursday, when they recessed.

By 57-42, Democrats rejected an amendment by Sen. Tom Coburn, R-Okla., barring federal purchases of Viagra and other erectile dysfunction drugs for sex offenders. Coburn said it would save millions, while Sen. Max Baucus, D-Mont., called it “a crass political stunt.”

Democrats also deflected GOP amendments rolling back the health law’s Medicare cuts; killing extra Medicaid funds for Tennessee and other state-specific spending; barring tax increases for families earning under $250,000; and requiring the president and other administration officials to purchase health care from exchanges the statute creates.

The landmark legislation that Obama signed Tuesday would provide health care to 32 million uninsured people, and make coverage more affordable to millions of others by expanding the reach of Medicaid and creating new subsidies. Insurance companies would be forbidden to refuse coverage to people with pre-existing illnesses, individuals could buy policies on newly created exchanges and parents could keep children on their family plans until their 26th birthdays.

The $938 billion, 10-year price tag would be financed largely by culling savings from Medicare and imposing new taxes on higher income people and the insurance, pharmaceutical and medical device industries.

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Associated Press writer Darlene Superville contributed to this report.

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Will America buy the flawed premise of health care ‘reform?’

(AFP)

The initial blush of President Barack Obama‘s health care triumph immediately gives way to a sober political reality — he must sell the landmark legislation to an angry and unpredictable electorate, still reeling from the recession.

Voters may not buy it.

And that could mean a disastrous midterm election year for Obama and his fellow Democrats.

“We proved that this government — a government of the people and by the people — still works for the people,” the president said late Sunday, beginning his sales pitch from the White House one hour after Congress passed the sweeping measure.

“This isn’t radical reform but it is major reform,” he added. “This is what change looks like.”

Obama and the Democrats are certain to look for a much-needed political lift from the legislation, a capstone for a young presidency and a party after decades of trying to remake the nation’s health care system.

But there’s no guarantee they’ll get it.

For now at least, Obama is savoring victory; he looks strong, principled and effective for getting something huge done in a city many Americans detest.

Still, the near-term reward could easily be forgotten come November.

This campaign season already has been unforgiving for the White House and the Democratic Party, with a monumental loss in the Massachusetts Senate election and a spate of debilitating congressional retirements. And conditions seem ripe for the electorate to punish the party in power.

Voters are furious. They hate Washington. They also detest incumbents. They’re concerned most about the economy. And unemployment that’s hovering near 10 percent. They’re also split over whether Obama’s health plan is good for a nation with enormous budget deficits and climbing debt.

How those variables play out is anyone’s guess.

Even so, Obama reassured rank-and-file Democrats before they cast what he rightly called a tough vote.

“It will end up being the smart thing to do politically because I believe that good policy is good politics,” the president said Saturday at the Capitol.

Nearby, enraged tea party protesters filled the grounds and the steps of adjacent office buildings, railing against the measure and promising to fire lawmakers who backed it. Some cursed and yelled racial epithets at black lawmakers.

Protesters were back Sunday, the message the same: “Kill the Bill.”

Ahead of the vote, a Gallup poll showed more Americans believe the measure will make things worse rather than better for the country as a whole and for them personally. And most polls show most people don’t like the plan although some surveys showed Americans giving high marks to individual elements.

“It’s very unusual that you have a major policy that doesn’t have a majority of support in the public,” said George Edwards, a Texas A&M University presidential historian. “When they enjoy the benefits of the bill, they may come around. But that may take some time.”

Also unclear is how voters will treat Republicans. Some of the measure’s elements go into effect immediately, such as coverage for children on their parents’ policy until age 26 and prescription drug benefits for seniors. Republicans could be tagged obstructionists if the electorate likes these provisions and if the economy improves.

From now on, Obama and the Democrats will promote the measure’s benefits while countering Republican nay-saying and griping about process. The president also will focus primarily on voters’ most pressing concern — jobs. And that may endear him to voters more than the passage of his signature domestic issue.

Obama’s immediate concern is holding Democratic majorities in Congress. His own political re-election is a while off, but the White House is almost surely focused on it, too.

His job-performance rating is hovering near 50 percent and may not rise even after he put so much political capital on the line.

Past presidents have either seen their poll numbers stay the same or dip following passage of divisive, though history-making, measures.

That was true for Lyndon B. Johnson‘s Civil Rights Act and Great Society agenda in the 1960s, Ronald Reagan‘s economic measures in the 1980s, and George W. Bush‘s tax cuts in the early 2000s. The exception was Bill Clinton, who saw his support increase in the 1990s after signing a contentious budget measure and welfare reform legislation. But it eventually fell.

Obama’s political boost may come later.

“There’s a bump for the history books,” said Fred Greenstein, a Princeton University presidential scholar. “When historians ask if this is a kind of squandered presidency, there will be health care to point to.”

The immediate future is less certain.

Will voters give Obama credit for addressing the issue if many Americans won’t feel most changes immediately? Or will voters punish Democrats for a year of partisan wrangling that has exacerbated Americans’ anti-Washington feelings and diverted focus from the economy? Will health care even be on the minds of Americans struggling through recession?

Throughout the yearlong debate, the GOP derided the bill as “socialized medicine” and warned that it would be devastating. But Republicans may find themselves looking sheepish given that the status quo won’t change for most people for years.

Democrats now have an accomplishment around which to unite. Also, critical constituencies like senior citizens and young voters will feel change soon. And independent voters may praise Obama for showing that a Democratic majority can make Washington work.

Still, Democrats face a public fed up with Washington and disappointed by a president elected to change it. A year of bitter haggling and legislative maneuvering may feed into the argument — successfully stoked by Republicans — that Democrats have failed to fix Washington.

That’s the reason some Democrats now worry about losing control of Congress.

“The voters will have their say on the politics,” says White House press secretary Robert Gibbs. Still, he adds: “The president was and the Congress were sent here to address the problems that people face in this country, and that’s what voters want us to see.”

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Liz Sidoti has covered national politics for The Associated Press since 2003.

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Obama more popular than Congress

President Barack Obama (AP)

Americans have come to detest Congress ever more deeply as it nears the end of a nasty fight over health care. But more than half still back President Barack Obama, a bright spot for a Democratic Party counting on its leader to help stave off expected losses in elections this fall.

The latest Associated Press-GfK poll found that fewer people approve of Congress than at any point in Obama’s presidency. Support has dropped significantly since January to a dismal 22 percent as the health care debate has roiled Capitol Hill. Neither Republicans nor Democrats are safe; half of all people say they want to fire their congressman.

Conversely, Obama’s job-performance standing is holding fairly steady at 53 percent. And over the past two months, the Democrat has gained ground on national security issues, specifically the subsiding Iraq war and the escalating Afghanistan war, as he has spent most of his time — at least publicly — on domestic matters like the economy and health care. On those issues, he still has the support of about half the people.

“I agree with what Obama is trying to do, but nobody is listening to him,” said Grace Pope of Waterville, Maine. But this 75-year-old Democrat added, “I don’t think that the Congress is doing anything.”

Such sentiments and the survey’s results make clear that Obama remains far more popular than House and Senate members as he leads a Democratic Party facing a volatile election-year environment that, so far, seems to be trending in Republicans’ favor. Judging by his standing at this point, Obama seems to be an asset for his rank and file.

But, given the fickleness of this electorate, the uncertainty of the health care debate and the stubbornly high unemployment rate, the president could just as quickly turn into a liability. His own clout will be on the line in the first midterm elections of his presidency. And the outcome is certain to shape the remainder of his first term, if not his likely re-election bid in 2012.

For now, it’s unclear just how much Obama can do to prevent midterm election shellackings. Democrats lost recent statewide elections in Massachusetts, New Jersey and Virginia even though he campaigned for them. Presidents typically lose House and Senate seats in their first midterm elections. And the party in power usually bears the brunt of voters’ ire when the country is in turmoil.

Thus, another of the poll’s findings may not bode well for Obama and his Democrats: A clear majority of Americans — 56 percent — now say the country is headed in the wrong direction.

Democrat Benny Newman of Tulsa, Okla., laid the blame for the nation’s ills on both Obama and the Democratic-controlled Congress.

“Just bundle them in the same bag,” said Newman, who at 79 just lost a job with a local public school district because of budget woes. “I don’t think either one of them is interested in the general public. … They’re always stalling, playing politics, trying to jockey for a better position for their own re-election.”

In recent weeks, Obama has increasingly blamed the ways of Washington for a lack of progress on his agenda — even though he’s in the White House and his party is leading Congress. The disparity between his popularity and Congress’ shows his pitch may just be working.

Obama’s overall standing hasn’t really moved since January. Neither have his ratings on health care and the economy.

But his marks have jumped on Iraq and Afghanistan. More than half of people approve of how he’s handling the wars, with 55 percent backing him on Iraq and 57 percent supporting him on Afghanistan. That’s compared with 49 percent for each two months ago. The new poll was taken during weekend elections in Iraq, where a U.S. troop drawdown is under way, and in the midst of a buildup in Afghanistan, as the U.S. notches victories in rooting out suspected terrorists.

By comparison, Congress’ approval rating has dropped 10 percentage points since January, perhaps an indication that people are blaming lawmakers more than the president for gridlock that has paralyzed Washington on a host of fronts.

It is quite unusual for voters to tear down their own member of Congress. People often dislike the institution of Congress but usually support their own representatives. But not this year. Half said they wanted to elect someone other than their current congressman; only 40 percent wanted to re-elect their lawmaker.

“I don’t think anybody up there is doing a good job. … We need to get rid of them all and institute term limits,” said Republican John Campbell, 52, of Del Rio, Texas, a warden at a federal detention center. He castigated Washington as full of “cronies” and Congress as a “bunch of entitled prima donnas.”

“Washington,” he said, “is broke.”

As poor as the ratings are for Congress in general, people seem slightly more unhappy with Republicans than Democrats — another bit of potentially good news for Obama’s party.

Just 30 percent approve of how Republicans in Congress are doing their jobs compared with 36 percent for Democrats.

Republicans still trail Democrats on the question of who should win control of Congress come November; 44 percent say Democrats, 38 percent say Republicans.

And the GOP has a slight disadvantage on two issues that voters deem among the most important — the economy and health care.

Still, Democrats are vulnerable, and perhaps nothing illustrates that vulnerability better than this: By 67 percent to 59 percent, more independents disapprove of Democrats in Congress than disapprove of Republicans. This matters because independents usually determine who wins elections. And they have been moving away from Democrats, after heavily supporting them in 2006 and 2008.

The AP-GfK Poll was conducted March 3-8, 2010, by GfK Roper Public Affairs & Media. It involved landline and cell phone interviews with 1,002 adults nationwide, and had a margin of sampling error of plus or minus 4.2 percentage points.

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Associated Press Polling Director Trevor Tompson, AP News Survey Specialist Dennis Junius and AP Writer Ann Sanner contributed to this report.

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Obama ups the sales pitch on health care

President Barack Obama: Does he still have the power? (AP)

President Barack Obama, facing a public that no longer trusts him, Republicans who dog his every move and Democrats who prefer re-election to supporting the leader of their party, bumped up the rhetoric Saturday in a last-ditch effort to sell his faltering health care program.

In his Saturday radio and Internet address, Obama honed in on Republicans and insurance companies in another desperate plea to convince Congress to finally pass reform of the health care system.

Said the President:

Now, despite all the progress and improvements we’ve made, Republicans in Congress insist that the only acceptable course on health care is to start over. But you know what? The insurance companies aren’t starting over, I just met with some of them on Thursday, and they couldn’t give me a straight answer as to why they keep arbitrarily and massively raising premiums — by as much as 60 percent in states like Illinois. If we do not act, they will continue to do this.

Obama’s strident remarks signal his strongest rhetoric yet on health care reform, which has languished in Congress for a year now but critics say his renewed push for reform ignores the facts.

Responding to the President’s remarks, Alabama Republican Rep. Parker Griffith, a former Democrat who switch parties last year to showcase his displeasure with the President’s policies, said:

It’s not too late: we can, and we must, stop this government takeover of health care. Make your voice heard now. America deserves better.

For (Democrats), health care reform has become less about the best reforms and more about what best fits their ‘Washington knows best’ mentality — less about helping patients and more about scoring political points. This is no idle observation. I’ve witnessed it firsthand.

To pass the health care bill, Obama and Democratic leaders need some of the 55 Democrats who voted against health care reform in the House last year to change their vote.

But some strategists tell Capitol Hill Blue that a bigger problem lies with Democrats who voted for the bill last time around.

“There’s no guarantee the majority that voted with the President will do so again,” one said. “They want to be re-elected this November.”

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Obama courts uneasy Democrats on health care ‘reform’

Obama huddles with House Majority Leader Steny Hoyer (Reuters)

President Barack Obama hopes he can convince reluctant Democrats who voted against his health care “reform” plan on its first trip through the House of Representatives.

The vote counters in the Democratic whip’s office say nine of the 39 Democrats who voted against the health care bill have softened their opposition and might be convinced to support the bill on its second trip through Congress.

So Obama will call them in for a White House version of “Let’s Make a Deal” to see what it will take to buy their support.

It’s a long shot and a risky move because nervous Democrats read the polls that say the American public thinks the current health care bills are a crock. The wavering Democrats are also unhappy with Speaker of the House Nancy Pelosi‘s comments that they should vote for the health care fill even if it costs them re-election in November.

To make matters worse, those who change their vote face being tagged as a “flip-flopper” by their opponents.

Obama is releasing a revised health care proposal Wednesday, the latest revision in a string of revamps that have failed to ignite any public passion for the bill or change anyone’s mind in Congress.

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Pelosi: Back the health care bill even if it costs you your job

Speaker of the House Nancy Pelosi has an incredible message for her Democratic colleagues: Support health care even if it costs them their seat in Congress.

Appearing Sunday on ABC’s “This Week” news talk program, Pelosi said health care is too important to play it safe politically.

“We’re not here just to self-perpetuate our service in Congress. We’re here to do the job for the American people,” Pelosi said.

Pelosi’s ultimatum is not likely to sit well with Democrats facing tough re-election campaigns in an election year when polls show most Americans don’t care for the so-called “reform” packages currently before Congress.

Moderate Democrats have come under fire from constituents over the massive, expensive health care “reform” bills in both the House and Senate. Polls show most Americans don’t support the legislation and recent gains by Republicans in special elections have Democrats nervous.

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Congress endorses, extends Patriot Act abuses

Congress, under a Democratic leadership that once promised to roll back the excesses of the USA Patriot Act, gave overwhelming approval to an extension of the act without any new protections or restrictions to curb widespread government spying and other widespread intrusions into the lives of American citizens.

By a 315-97 vote Thursday, the House approved the bill and sent it to President Barack Obama, who not only will sign it but insisted on the extension without any new safeguards.

The approval overrides campaign promises to curb abuses of civil rights which flourished under the Bush administration and helped Democrats seize control of Congress in the 2006 mid-term elections and put Obama in the White House in 2008.

While Democrats gave the bill the margin it needed for passage by a wide count, some opposed extended the law without new restrictions.

“Congress must revise and narrow — not extend — Bush era policies,” said Democratic Rep. Jane Harman, who voted against the bill.

Obama, however, has not only back away from promises to curb the constitutional abuses of the Patriot Act but now supports measures that would expand the government’s right to snoop into the lives of Americans without court oversight or Congressional review.

Democrats in the Senate tried to add new restrictions but faced still blocking efforts from Republicans. Democrats didn’t even try in the House.

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Winning campaign strategy: Bash Pelosi

Nancy Pelosi

Time-proven ploy of politics: Identify an enemy and then run against that enemy.

Many candidates run for Congress not by opposing the record of their opponent but by running against the President. Many Democrats who won House and Senate seats in 2006 won by running against then-President George W. Bush.

Republicans who hope to win elections this year have two enemies: President Barack Obama and Speaker of the House Nancy Pelosi.

And bashing Pelosi seems to be paying off.

Just ask Jimmy Higdon, a Kentucky Republican who won a state Senate seat by ignoring local issues and turning his race into a referendum on Pelosi. His opponent outspend him 4-to-one and still lost.

Higdon used Pelosi’s pictures in most of his TV ads and campaign propaganda.

“It worked for me,” he told McClatchey Newspapers. “I’m really happy that I had a good team that recognized that, because that’s not something I would have dreamed up.”

Republican political pros plan to put the strategy to work in other races this year

“The strategists will try to make her the lightning rod who represents all that is wrong in Washington ,” says Jeffrey McCall, media studies professor at DePauw University in Indiana .

Pelosi, like Senate Majority Leader Harry Reid, is in trouble back home as well. Her job approval rating in her district is an uber-low 39 percent and she is under fire not only from Republicans but also from Democrats.

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