"Reid under pressure to rein in centrists"

The Hill:

Liberal activists are pressuring Senate Majority Leader Harry Reid (D-Nev.) and party leaders to crack down on renegade centrist Democrats who might block President Barack Obama’s healthcare overhaul.

Democratic leaders should make it clear to Sens. Ben Nelson (D-Neb.), Evan Bayh (D-Ind.), Mary Landrieu (D-La.) and other centrists that they have an obligation to help the party advance a Democratic healthcare bill this fall, the activists say, and those that disregard the call and join in a Republican filibuster should face real consequences.

For months they have been frustrated with Reid’s tolerance for Senate Finance Committee Chairman Max Baucus (D-Mont.), a centrist who has kept the party waiting for weeks while pursuing an elusive bipartisan deal with Republican members of the committee.

Now liberal activists say it is time to instill some party discipline so that Democrats can take full advantage of the power they have controlling 60 Senate seats. They have gone so far as to suggest that centrists should be threatened with lack of financial support from the Democratic Senatorial Campaign Committee (DSCC).

"There ought to be real pressure in terms of making it clear to people what is expected,” said Robert Borosage, co-director of Campaign for America’s Future. “They are not going to get support from DSCC if they’re not going to be loyal on basic procedural votes to give the president an up-or-down vote on his plan.

“Inside and outside the Senate, real pressure needs to be put on folks to let them know that supporting the Republican minority’s right to block something is a lot different from opposing the program [on a final vote]," Borosage added, noting that it is Reid’s job to put this pressure on party renegades.

Liberal activists say centrists should be allowed to vote their conscience on final passage. Cloture votes, first to call up contentious legislation and then to end debate, require 60 votes; final passage only requires a simple majority.

A Democratic leadership aide, however, said that it is too soon to say how Reid will handle a final vote on healthcare reform.

The aide noted that Democratic leaders do not know whether they will be able to coax a handful of Republicans to support a healthcare reform bill, which would make it unnecessary to pressure centrists to vote to quash a GOP filibuster.

“We cannot and will not be able to determine how we will proceed until we know whether we are able to do so with Republican cooperation,” said the aide.

When pressed about the slow pace of healthcare talks, Reid has said that his job is to ensure that a bill can get 60 votes on the Senate floor. The implication is that Democratic leaders believe they need Republicans on board to make up for potential defections by conservative Democrats.

Reid, a supporter of the Second Amendment who has voted with Republicans on gun issues, has been a sympathetic leader for the more conservative members of his conference.

Unlike his predecessor, former Senate Majority Leader Tom Daschle (D-S.D.), Reid has shown more patience with party centrists.

Reid, for example, gave Baucus a lead role in fighting efforts by former President George W. Bush to privatize Social Security and this year he has waited patiently, despite mounting liberal criticism, for Baucus to negotiate a deal with Republicans.

Liberal activists say that it's time for Reid to wield more of a stick.

"The definition of leadership is getting those who are with you on your side,” said Charles Chamberlain, the political director of Democracy For America, a liberal advocacy group founded by former Vermont Gov. Howard Dean (D).

“The Republicans want to filibuster to stop the top priority of the president's agenda,” Chamberlain said. “If you can’t keep the entire Democratic Party in line to avoid that, what kind of leader you have? This comes down on the shoulders of Harry Reid and any Democrats in the Senate who consider themselves leaders."

Adam Green, co-founder of Progressive Change Campaign Committee, said: “There’s growing sentiment that all Democrats should be asked by the Democratic leaders to vote for cloture and let the chips fall where they may on a final vote on healthcare reform."

The inability of Senate Democratic leaders to rely on party unity on healthcare reform has forced them to look more closely at using a special procedure known as budget reconciliation to pass the most contentious elements of their plan.

Under a strategy that has gained more consideration in recent days, Democratic leaders would split healthcare reform into two bills. This option has been discussed for weeks in the Senate but has recently gained traction as Democrats grow increasingly pessimistic about winning GOP support.

Under the split-legislation strategy, one bill would include provisions such as a government-run health insurance program, federal subsidies for individuals to purchase health insurance and employer mandates to provide insurance to workers. It would also include an expansion of Medicaid and new taxes to pay for reforms.

This bill could be passed under reconciliation protection, allowing Democrats to use special rules to pass it with a simple majority.

Budget rules, however, require that legislation passed under reconciliation have an impact on spending or revenues, and the impact cannot be merely de minimis or incidental.

This would force Senate Democrats to pass major elements of healthcare reform that do not have a significant budgetary impact in a separate bill, one without reconciliation protection.

Provisions prohibiting insurance companies from discriminating on the basis of pre-existing conditions; limiting out-of-pocket expenses; and setting up insurance exchanges, from which consumers may pick plans, would likely find their way into a bill that requires 60 votes to advance. These provisions are not considered eligible for budget protection because they do not affect spending or revenues significantly.

There is some disagreement over whether a government-run insurance program, known as the public option, would be eligible for reconciliation protection. Reid told reporters last month that the public option could be passed under reconciliation but GOP experts disagree.

Ultimately the Senate parliamentarian will decide what can pass under reconciliation, a potentially messy process that would be subject to waves of Republican objections.

Speaker Nancy Pelosi (D-Calif) said during an appearance in San Francisco on Thursday that she would prefer a single healthcare bill, according to a Democratic aide briefed on her comments. Liberal activists have expressed the same preference.

Joe Conason takes on Rhambo

Joe Conason:

If the Democrats fail to pass real changes in the health care system this year -- rather than a sham that mimics and mocks reform -- they will have nobody to blame but themselves. Or at least nobody to blame but other Democrats, notably those in the White House who have never been committed to this most venerable and fundamental aspect of party policy.

Of course, the right-wing rumormongers have done their share of damage, spreading lies about "death panels" and stirring up the boob cohort with warnings about socialism. Republican elected officials have decided to damage the president rather than address an issue they know is critical to the nation's future. Health insurance lobbyists and corporate leaders have spent millions of dollars to kill reform, buying legislative obedience the same way they buy advertising time or legal advice.

Yet in the months that followed the momentous election of November 2008, the Democrats have possessed the power to fulfill the moral imperative -- good, affordable health care for all Americans -- that they have pursued since the Harry Truman era. Both the new president and the new majorities in both houses of Congress declared their determination to create the kind of health care system that other developed nations have enjoyed for the past 50 years or so.

Now competing measures that might or might not accomplish that worthy goal are stalemated in Congress while the White House dithers over how best to placate Republicans and conservative Democrats who have opposed serious reform from the beginning.

The ultimate responsibility for this sorry state of affairs belongs with the president, who vacillates between speaking out boldly for a "public option," and permitting his aides and appointees to undermine his message by confiding their plans to sell out.

His worst tendency, to exalt bipartisan compromise above progressive policy, has left him at the mercy of senatorial frauds like Charles Grassley, the Iowa Republican who pretended to negotiate over details while denouncing the president for seeking to terminate America's grandmothers. He assigned far too much responsibility for health care reform to aides who exacerbate that weakness -- and in particular to Rahm Emanuel, the current chief of staff and former congressman from Chicago.

Every mistake made by the Obama White House in the pursuit of health care reform can be traced to the political style and ideological prejudices of Emanuel, who has sought to intimidate progressives and empower conservatives, always in the name of winning elections and "getting things done."

A self-styled tough guy who famously likes to prove his point with abusive language and threats, he led the Democratic Congressional Campaign Committee during the years when the party regained its majority -- when he spent millions to elect the "Blue Dogs," who have done so much to thwart the president's agenda on health, energy and economic recovery.

He repeatedly intervened in primary elections around the country to promote GOP-lite candidates against challengers who actually represented the party's bedrock beliefs. Around that same time, he co-authored a lightweight volume on national policy, titled "The Plan," that explained why he believed that universal health coverage could not be passed, so Democrats should settle for covering the nation's children, which had largely been achieved by then.

All this dubious history was no secret when Obama appointed the combative Chicagoan to run his shop. Although few Democrats trusted Emanuel to hold true to principle, many hoped that he would get things done -- and that those things would reflect the progressive outlook of his boss rather than the attitude of accommodation he picked up on Capitol Hill.

Instead and perhaps inevitably, his narrow pragmatism is shaping the Obama administration's approach to reform. As long as some kind of bill passes, Emanuel won't worry when the corporate powers override the public interest once again. He will congratulate himself on a job well done. His Blue Dogs will boast of frustrating that liberal Obama. Everyone will get a nice check from the insurance lobbyists.

But the president's promise will be soiled, and the nation's future will be dimmed.

Progressive Pundits to Obama: "Grow a pair" (with video)

Paul Krugman

Arianna Huffington (with video)

Eugene Robinson

John Aravosis

Matt Taibbi on Health Care Reform: "Sick and Wrong" (with video)

Rolling Stone, with video:

America’s disastrous health care system is responsible for incalculable amounts of illness, death, lost productivity and federal deficit — not to mention anxiety, anger and disgrace. And it’s not going to get fixed, writes Matt Taibbi in the new issue of Rolling Stone, because it’s encased in another failed system: the U.S. government. Rather than attempt to remedy the problem this summer, our government sat down and demonstrated its dizzying ineptitude. “We might look back on this summer someday and think of it as the moment when our government lost us for good,” writes Taibbi. “It was that bad.”

Taibbi breaks down the five steps Congress took to be sure no bill would pass — aiming low, gutting the public option, packing it with loopholes, providing no leadership and blowing the math — in his story, which is available on stands now. In a series of video interviews for RollingStone.com, Taibbi explores one of our system’s most severe flaws, explains how the government wedged itself into an awkwardly damning position, and looks at how the proposed bill would change the ordinary American’s life.

Perhaps the biggest flaw in the American health care system is that 31 percent of costs are associated with administration and paperwork. Here Taibbi examines the easiest way to eliminate the red tape:

Taibbi on how the Democrats wound up on the defensive — and theories that the government struck a sideline deal with the pharmaceutical industry:

Inside the “individual mandate” that would require people to buy insurance and how the bill might make conditions worse than before:

Howie P.S.: Taibbi paints a gloomy picture but for some reason I feel better after listening to him.

"Cantwell to Obama: Mr. President, heal thyself"

Joel Connelly (Seattle PI):

President Obama must "double up" in use of the presidency's bully pulpit to convince Americans their country's current health care system is unaffordable, or so argues Sen. Maria Cantwell, D-Wash.

"I think the president can help focus the country on controlling costs for the 80 percent of the country that IS insured," Cantwell, a member of the Senate Finance Committee, said in an interview.

"If the president gets back to this message, he will help secure the path for reform, whatever its eventual details," she added.

In short, recapture the argument -- on cost and care.

The two-term Washington senator represents a corner of the country lately getting praise on both fronts, for innovations that stress healthy patients rather than the amount of tests done on them.

Cantwell says she supports a "public option," but is vague on its definition. She is, however, on "pushing hard" that the final health care plan includes, in her words, innovations "on which the Northwest has led the way."

These include:

* Incentives to let persons needing long-term care stay in their homes, receiving help there rather than being forced by circumstances to move to a care facility.
* Provisions for providers and insurers to link up people with a personal physician and a "medical home," where access, early diagnosis and treatment cut down on costly acute care. A new partnership between Swedish Medical Center in Ballard and Premera Blue Cross --stressing preventive care, care coordination, and expanded interaction with medical staff -- is pilot project for a needed national reform..
* Reform of Medicare reimbursements, in a way that doesn't just reward the volume of services, but recognizes healthy patient outcomes.

"The Northwest subsidizes inefficient care in the rest of the country: I will put my foot down to change that," Cantwell said.

Low Medicare reimbursements are a critical issue. Not only are doctors being shortchanged, but costs are passed on to insurers and the insured. A recent (very good) Puget Sound Business Journal article reported:

"Without the larger private-insurer payments, The Everett Clinic could not stay open, its executives say. The clinic, one of Washington's largest, employs 320 doctors. Dr. Al Fisk, the clinic's chief medical officer, said that last year the clinic lost $11.7 million in serving its 28,000 Medicare patients.

"Fisk said the clinic has kept its doors open by charging more for patients covered by private insurance. This, he said, amounts to a hidden tax of about 10 percent that commercial carriers pay to subsidize Medicare patients."

The Mayo Clinic, the Everett Clinic, and 11 other Northwest and Midwest providers sent a recent letter to Congress, backing health care reform -- but saying it must reform costs.

"Our health care systems are among the most cost-efficient in the country in caring for Medicare patients," they wrote. "However, many of us operate in states with some of the lowest Medicare reimbursement rates in the nation."

The bottom line, they wrote: "The system must be reformed to compensate for value instead of volume."

Cantwell can't forecast the future, but sought to evaluate the political climate on three fronts:

* Prospects: "I'm still optimistic that reforms to the system that will lower costs and broaden coverage can be done (this year)," she said.The senator was pleased that a bipartisan group of six Senate Finance Committee members were still talking by phone on Thursday, despite partisan rancor of the past week.Two Republicans, Sens. Chuck Grassley, R-Idaho, and Mike Enzi, R-Wyoming, have made incendiary partisan remarks. But Cantwell singles out a GOP moderate from the opposite corner of the country. "Olympia Snowe gets it," she said.
* Going it Alone: Cantwell acknowledged that Democrats, who control both houses of Congress, could try to forge a reform plan without Republican votes. But it won't be easy."It may come to acting alone, but the Senate is a diverse place even among its Democrats," she said. "We range from very liberal senators to Ben Nelson of Nebraska." (Nelson opposes a government option).
* Co-ops: East Coast media has been abuzz with rumors that the Obama Administration will jettison a government-run "public option" and opt instead for co-ops as an alternative to private insurers.

Cantwell noted that public power has given the Northwest low electrical rates, and Group Health's presence from urban Seattle to rural Idaho. But she wondered how newly created health co-ops would get the strength to compete.

"You have to have access to the market," she said. Cantwell argued that plans now on the table in Congress "need more teeth" to create a viable competition with private insurance.

When the shouting dies down, Cantwell says, the public "gets it," that reform can control cost and deliver better care.

Obama did seem to shift emphasis, in a Thursday radio interview and a rally kicking off the Democratic Party's "Organizing for America" weekend events. He touted "prevention and wellness programs -- That's got to be part of the deal." Interviewed by conservative radio host Michael Smerconish, Obama talked dollars and sense: "The costs of Medicare and Medicaid will bankrupt this country if we don't reduce the cost inflation of health care." As for Cantwell, a test-weary visitor to her Senate office has provided a mantra for what health care reform must do: "I don't want to be 'Medicaided': I want to be cured."

Howie P. S.: know sbe's a Senator and all and is very busy, but it seems I already hear from Obama a helluva lot more than I hear from our junior Senator, on a variety of issues.

"Time running out: Nickels trails in latest mayor vote count"

Chris Grygiel (Strange Bedfellows):

Mayor Greg Nickels remained in third place behind challengers Joe Mallahan and Michael McGinn following the latest primary vote count released Thursday afternoon.

The top two finishers advance to the November general election, and Nickels, the two-term incumbent, is running out of time to make up ground.

Nickels scheduled a news conference for 10 a.m. Friday. Spokesman Sandeep Kaushik said the mayor "will address all of the questions about the election then." Kaushik didn't elaborate.

Mallahan, a T-Mobile executive, is still in the lead, with 27.22 percent of the vote. McGinn is in second place, with 26.69 percent. Nickels trails, with 25.56 percent.

McGinn, the attorney and former Sierra Club leader, now leads Nickels by 1,170 votes, compared to 1,016 votes on Wednesday. Elections officials counted about 18,500 votes in the mayor's race Thursday.

More than a third of the ballots cast have yet to be counted, it's estimated.

After Wednesday's count, Mallahan was at 26.76 percent. McGinn was at 26.48 percent and Nickels was at 25.19 percent. That represented about 81,000 Seattle ballots counted.

Following Tuesday's initial count of about 64,000 ballots in Seattle, McGinn was at 26.6 percent, Mallahan at 25.8 percent and Nickels at 25 percent.

Another vote count will be released Friday afternoon.

Obama: "we are going to get health care reform done" (with video)

Sam Stein (HuffPo) with video (03:00):

President Barack Obama guaranteed on Thursday that health care reform will be achieved, and he stuck by the public option as his preferred choice for revamping the insurance market.

In an interview with Philadelphia-based radio talk show host and MSNBC analyst Michael Smerconish, Obama continued to talk about his desire to bring Republican lawmakers on board. He also chastised, ever so slightly, the press and progressives for getting "a little excited" in their suspicions that he was abandoning the public plan. "Our position hasn't changed," he said.

Obama's most powerful moment, however, may have come when he addressed a caller who had supported his 2008 campaign but was concerned that the president's knees were "buckling" when it came to getting health care reform passed.

"I guarantee you," he told the caller, "we are going to get health care reform done. And I know that there are a lot of people out there who have been hand wringing and folks in the press are following every little twist and turn of the legislative process. You know, passing a big bill like this is always messy. FDR was called a socialist when he passed Social Security. JFK and Lyndon Johnson, they were both accused of a government takeover of health care, when they passed Medicare. This is the process we go through because understandably, the American people have a long tradition of being suspicious of government, until the government actually does something that helps them, and then they don't want anybody messing with whatever gets set up. And I'm confident we're going to get it done."

Obama and his Democratic allies are making a renewed push to bolster public opinion behind his health care agenda. On Wednesday, Obama hosted a call with religious leaders who backed his proposal. Later on Thursday, he is hosting an open strategy session with his campaign arm - Organizing for America - to discuss the political landscape surrounding the health care debate.

Through it all, he has stuck to a familiar script: health care reform needs to expand coverage, lower costs, and increase competition. A public option, Obama said on Thursday, is the best vehicle for achieving these goals. But no one should be "obligated to go into a public plan."

On Thursday, Obama showed a certain amount of frustration with the GOP, but he did little to indicate he was willing to give up on recruiting bipartisan support.

"As far as negotiations with Republicans, my attitude has always been, let's see if we can get this done with some consensus," he said. "I would love to have more Republicans engaged and involved in this process. I think, early on, a decision was made, by the Republican leadership that said, look, 'let's not give them a victory. Maybe we can have a replay of 1993, '94 when Clinton came in, he failed on health care and then we won in the midterm elections and we got the majority. And I think there are some folks who are taking a page out of that playbook."

"But this shouldn't be a political issue," he added. "This is an issue for the American people. There are a bunch of Republicans out there who have been working very constructively. One of them, [Sen.] Olympia Snowe in Maine, she's been dedicated on this. [Sens.] Chuck Grassley (R-Iowa) and Mike Enzi (R-Wyo.) are others. They've been meeting in the Senate Finance Committee. I want to give them a chance to work through these processes and we're happy to make sensible compromises. What we're not willing to do is give up on the core principle."

"Obama needs to forego bipartisanship" (video)

MSNBC-ED Show, video (16:26).

Howie P.S.: Howard Dean joins ED and teases him: "ED, Tell me how you really feel about this." Jonathan Alter also guests and joins the political strategy discussion. Alter proceeds to get ED all riled up.

A different "split"--"Dem-GOP Split on Health Care Goes Beyond Public Option"

ABC News:

Senate's No. 2 Republican Opposes Guaranteed Issue and Community Rating of Health Insurance--If you were to listen to most coverage of the health-care debate, you would be excused for thinking that the public option is the only significant difference between the parties.

It's not.

Republicans and Democrats are at loggerheads on a far broader set of issues.

The distance between the parties' leaders on health care was made clear on Tuesday when the No. 2 Republican in the Senate held a conference call with reporters.

Asked by ABC News about a package of insurance market reforms that have been endorsed not only by President Obama but also by the insurance industry, Sen. Jon Kyl came out against all three proposals.

In particular, the Arizona Republican signaled that he opposes requiring insurance companies nationwide to provide coverage without regard to pre-existing conditions; requiring them to charge everyone the same rate regardless of health status; and requiring all Americans to carry health insurance.

"One of the concerns I have about the approach of the Democrats ... is an assumption that there has to be a national mandate on all insurers to do various things," Kyl told ABC News when asked for his position the three issues.

"Those are techniques that states can, and some have, used in the past with fairly disastrous consequences," he said.

Although the public option has dominated coverage of the health-care debate, Kyl's comments underscored that the rift between GOP leaders and Democrats runs much deeper.

"The more you look into [the views of congressional Republicans], the more you are going to find significant opposition up and down the board to most ideas on the table when it comes to comprehensive health-care reform," Jim Manley, the senior communications adviser to Senate Majority Leader Harry Reid, D-Nev., told ABC News. "Republicans are betting that the president will fail."

Kyl said he opposed guaranteed issue -- requiring insurers to provide coverage without regard to pre-existing conditions -- and community rating -- requiring them to charge the same rate regardless of health status -- because of concerns about cost.

"There's no question that it does raise costs," Kyl said. "And the objective here is to reduce costs."

Obama Supports Mandating Individuals to Have Health Insurance

Two years ago, the insurance industry commissioned a study of states that have pursued guaranteed issue and community rating.

The study, which was conducted by Milliman, Inc., found that these policies "have the potential to cause individuals to wait until they have health problems to buy insurance. This could cause premiums to increase for all policyholders, increasing the likelihood that lower-risk individuals leave the market, which could lead to further rate increases. If this continues, the pool or market could essentially collapse or shrink to include only the high risk population."

The insurance industry has since concluded, however, that these problems can be overcome by requiring all Americans to purchase insurance.

"If we can get everyone in the health-care system, we can do guaranteed issue, which means no denials on the basis of preexisting condition, and no rating by health status or gender," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans (A.H.I.P.), the insurance industry's trade group.

Obama originally opposed requiring all adults to purchase health insurance. In fact, his opposition to an individual mandate was a flashpoint in his fight for the Democratic nomination against then-Sen. Hillary Clinton, D-N.Y.

Since becoming president, however, Obama has changed his stance and he now supports an individual mandate, viewing it as essential to winning the insurance industry's support for guaranteed issue and community rating.

"So it's important when people ask me, why don't you do the insurance reform stuff and not expand coverage for more people, my answer is I can't do the insurance reform stuff by itself," Obama said Friday during a town-hall meeting in Montana.

"The only way that we can change some of the insurance practices that are hurting people now is to make sure that everybody's covered and everybody's got a stake in it," he said. "Then the insurance company are able and willing to make some of the changes."

GOP 'Not Relevant' to Health-Care Debate, Liberal Blogger Says

A liberal blogger spearheading efforts to raise money for progressives who see the public option as an essential element of health-care reform, reacted to Kyl's comments on Tuesday by saying that it reconfirms her view that Democrats should be reluctant to make concessions to Republicans since most of them are likely to oppose whatever bill emerges from Congress.

"Democrats don't need Republicans to pass health care,"

Jane Hamsher, the founder and publisher of the liberal FireDogLake blog, told ABC News. "The issue is going to be: 'How am I going to get health care?' Republicans are not relevant to this debate -- except if the Democrats decide to make them relevant."

"Dean Challenges Obama to Deliver Reform"

Philip Rucker (WaPo):

'Public Option' Non-Negotiable, Democrat Says---Former Democratic National Committee chairman Howard Dean is emerging as a thorn in the side of a White House that effectively swept him out of Washington, regularly challenging President Obama and Congress as he crisscrosses the country preaching his progressive vision for universal health care.

Although he is lending voice and brand to the liberal cause in the intraparty health-care debate, Dean hardly considers himself a spoiler. Rather, he sees his role as fighting for progressive values, asserting again and again that health-care reform without a government-run insurance option is hardly reform at all.

When he visited this tranquil corner of New England last weekend, Dean warned that if Democratic leaders abandon the "public option," they surrender their principles to politics.

"The worst thing that could happen is to pass a bill without a public option," he told about 200 union workers and Democratic volunteers in a fiery speech at a pep rally and picnic here Sunday. "Then we'd put 60 billion new dollars a year into the health insurance industry that is busy taking away your health insurance when you need it most, stopping you from getting health insurance, taking it away if you lose a job and not giving it back to you if you get it back."

"We all voted for change we can believe in. If we don't get it, we'll get some more change in 2010," Dean roared, the crowd applauding between bites of hamburgers, hot dogs and macaroni salad.

'We've Got to Get It Done'

In a wide-ranging interview Sunday on his way to the rally, Dean said he believes his appearances, many of which are organized by the Service Employees International Union, help support Obama's stated preference for a publicly financed insurance option.

"I think Obama's plan is very good," said Dean, a former physician who has made health care a key focus of his political career. "In fact, I think it's the most practical, most likely-to-succeed plan I've seen in 30 years, and we've got to get it done. This is the time."

"Any bill is not going to be a victory," Dean added, noting that he considers one without a public option a "terrible waste of money. . . . The fiscal conservative side of me is saying, 'Oh my God, what are we doing here?' "

But in his appearances, which are not coordinated with the administration, Dean is helping to fuel what could become a calamity for the White House.

"What Howard is doing is principled but destructive," said a Democratic strategist and former Dean adviser who spoke on the condition of anonymity because of the sensitivity of the intraparty debate. "If health-care reform goes down because of the public option, it's going to be the liberals that bring it down, the Democrats doing it to themselves."

Dean, 60, has become a politician without an office. Seven months removed from the DNC chairmanship and seven years away from being governor of Vermont, he appears to enjoy the freedom to speak his piece. And on this day, he did not appear concerned about the potential consequences for Obama.

"This vote is not about Democrats versus Republicans and conservatives and liberals and all that stuff," Dean said, his voice growing louder and his cadence faster. "This is about whether you're going to vote for the people who donated to your campaigns -- the health insurance industry -- or you're going to vote for the people who pay your salary. And we're going to be watching, because there are going to be 535 people casting that vote."
Free to Speak Out

These days, Dean moves without the trappings of Washington -- or even of Montpelier, the Vermont capital. He traveled to Maine alone, flying commercial from Ohio, where he had spoken the day before. His flight got in late, and he checked into an Embassy Suites at the Portland airport, but despite being a "diamond" member of the chain's frequent-guest program, Dean was stuck with a room that reeked of cigarette smoke.

In the morning, for the 40-minute drive to Poland Spring, Dean rode not in a Town Car but in a Toyota Prius driven by a local Democratic activist. "I've cursed the stimulus package more than once as I've been trying to drive in various places," Dean joked from the front seat as the car meandered past orange construction cones.

Progressive Democrats in Congress, and the volunteer activists who helped put them there, revolted this week over comments from top administration officials that Obama was willing to give up a public insurance option to strike a deal with Congress. Some are frustrated after working for years to help Democrats win back the White House and big majorities in Congress.

"They are like, 'What's the fruit of our labor?' " said Joe Trippi, a Democratic strategist who managed Dean's 2004 upstart presidential campaign but has publicly feuded with him since. "Howard's giving that voice. . . . He's definitely speaking out for a legitimate, sizable portion of rank-and-file progressives."

On Sunday at the Androscoggin County Democrats picnic, many showed their displeasure with any health-care deal that does not preserve a public option.

"I would like to see single-payer health care in this country," said Randy Huber, 64, a retired state government worker from Canaan. "To me, the public option is only a start."

Marianne von Nordeck, 29, a labor organizer from Portland, added: "We think real reform means a public option, and [Dean] has the freedom to get up there and advocate with us."
'No More Compromises'

Dean received a hero's welcome when he addressed hundreds of progressive bloggers last week at the Netroots Nation convention in Pittsburgh. He was their favored messenger in 2004, when his innovative campaign fueled the rise of the "Net roots" in the Democratic Party. Now, five years later, Dean is speaking for them again.

"The president has put together the best health-care [proposal] I've ever seen," Dean said. But, he added, the public option itself is a compromise between liberals who supported a government-run single-payer system and moderates. "We have already made our compromise, and there will be no more compromises in this bill."

Asked in the interview whether he sees himself as a spokesman for the progressive wing of the party, the man who ran for president saying that he represented the "Democratic wing of the Democratic Party" replied, "I don't spend a lot of time seeing myself in general."
A Matter of Perspective

Dean, who was a family doctor for two decades, has a unique perspective on the issue. In 1991, then-Lt. Gov. Dean was examining a patient when he received a call telling him the governor had died and that he would take over. As governor, he helped pass laws ensuring near-universal coverage for residents younger than 25.

"Health care was the primary driver of him getting into politics a long time ago," said his brother, Jim Dean, who chairs the Democracy for America political action committee. "He's very committed to getting health care for everybody. He tried it nine ways, sideways, here and angled a way to do it for kids. But he really views this as being a core issue for him."

What Dean is selling is his latest book, or at least the proposal outlined in it. "Not to shill for my own book, but if you have $12.99 or whatever it is to spare, 'Howard Dean's Prescription for Real Healthcare Reform' actually explains all this in plain English in about 130 pages, and you can get through it in a good afternoon," he told the Poland Spring crowd.

'He Didn't Walk Away'

As DNC chairman, Dean campaigned hard for Obama, and former aides said he was interested in working for the administration, perhaps as health and human services secretary. Asked if he would rather be in Washington, Dean demurred but did not hesitate to tout his credentials. "I know this stuff from a public policy point of view pretty well inside out," Dean said, "and I've also got a reasonably good political sense."

"I think Howard Dean would've loved to have been in the room hashing out health-care reform, whatever the role," Trippi said. "I think he would've relished that. He's passionate, he's a doctor, he knows it. But, look, that wasn't in the cards, and to his credit he didn't walk away. He's leading the charge on issues he cares about."

Howie P.S.: I'm wondering who could be the source of the "destructive" comment.

"New Rx for Health Plan: Split Bill" (with video)

Jonathan Weisman and Naftali Bendavid (Wall Street Journal), with video (01:55):

The White House and Senate Democratic leaders, seeing little chance of bipartisan support for their health-care overhaul, are considering a strategy shift that would break the legislation into two parts and pass the most expensive provisions solely with Democratic votes.

The idea is the latest effort by Democrats to escape the morass caused by delays in Congress, as well as voter discontent crystallized in angry town-hall meetings. Polls suggest the overhaul plans are losing public support, giving Republicans less incentive to go along.

Democrats hope a split-the-bill plan would speed up a vote and help President Barack Obama meet his goal of getting a final measure by year's end.

Senators on the Finance Committee are pushing ahead with talks on a bipartisan bill. Democratic leaders say they hope those talks succeed but increasingly are preparing for the possibility that they do not.

Most legislation in the Senate requires 60 votes to overcome a filibuster, but certain budget-related measures can pass with 51 votes through a parliamentary maneuver called reconciliation.

In recent days, Democratic leaders have concluded they can pack more of their health overhaul plans under this procedure, congressional aides said. They might even be able to include a public insurance plan to compete with private insurers, a key demand of the party's liberal wing, but that remains uncertain.

Other parts of the Democratic plan would be put to a separate vote in the Senate, including most of the insurance regulations that have been central to Mr. Obama's health-care message.

That bill would likely set new rules for insurers, such as requiring they accept anyone, regardless of pre-existing medical conditions. This portion of the health-care overhaul has already drawn some Republican support and wouldn't involve new spending, leading Democratic leaders to believe they could clear the 60-vote hurdle.

(Senate Democrats are considering a radical approach to passing the health-care bill by splttiing it into two parts. White House correspondent Jonathan Weisman explains how the strategy would work. CLICK ON VIDEO LINK, ABOVE)

Senate Leader Harry Reid is the key decision-maker on whether to use the tactic, but several congressional aides said White House officials are being kept abreast of the talks.

"We will not make a decision to pursue reconciliation until we have exhausted efforts to produce a bipartisan bill," said Jim Manley, a spokesman for Mr. Reid. "However, patience is not unlimited, and we are determined to get something done this year by any legislative means necessary."

Privately, those involved in the talks now say there is a 60% chance the split-bill tactic will be used. Mr. Obama is huddling with aides next week, and Senate leaders are likely to review their options when Congress reconvenes after Labor Day.

The likelihood of a strategy shift has grown after the negative response of Republicans to overtures of compromise.

On Sunday, Health and Human Services Secretary Kathleen Sebelius said a public plan, strongly opposed by Republicans, wasn't the "essential element" of a comprehensive bill.

White House spokesman Robert Gibbs continued to insist Wednesday that Ms. Sebelius didn't mean to signal the White House was abandoning the public plan. A senior Democratic congressional leadership aide said weekend statements were calculated to test Republican responses.

Sen. Jon Kyl of Arizona said Tuesday nonprofit insurance cooperatives, which centrist Democrats have suggested as an alternative to a public plan, were nothing but a "Trojan horse" that would lead to excessive government control of health care.

"It's fair to say the steam is going out of these bipartisan negotiations," the Democratic aide said.

House committees have passed bills that include a public option and new programs that would make insurance available to most Americans who lack it. If the Senate passes its own bill, the two chambers must hash out a compromise that could go to the president for signing. The public option could be the biggest point of contention between House and Senate.

Senate Finance Committee members working on a bipartisan bill are scheduled to talk Thursday on a conference call. "The Finance Committee is on track to reach a bipartisan agreement on comprehensive health-care reform that can pass the Senate," Sen. Max Baucus (D., Mont.), chairman of the Finance Committee, said in a statement.

But other senators noted privately that several factors are working against any deal. Many Democrats now believe it's a long shot. Mr. Baucus has set a deadline of Sept. 15 to reach agreement.

Several softer deadlines have already come and gone without a deal. One Republican senator, Orrin Hatch of Utah, has dropped out of the talks. The remaining Republicans have suggested they would only support something that had the backing of many GOP colleagues.

Still, the three Republicans negotiating with Sen. Baucus said Wednesday they believed a deal could be reached. "I'm hopeful," Sen. Olympia Snowe (R., Maine) said. "It's not without challenges, because of the complexity and the costs associated with it. We recognize that. And that's why it has consumed the amount of time that it has."

Sen. Mike Enzi (R., Wyo.) said the Democrats would be making a mistake by forging ahead on their own. "We need to get a bill that 75 or 80 senators can support," he said. "If the Democrats choose to shut out Republicans and moderate Democrats, their plan will fail because the American people will have no confidence in it."

Democrats also must deal with intraparty differences. They can't agree whether a public-insurance option is essential, as liberals say, a "preferred option" -- the White House stance -- or a bad idea, as some on the Finance Committee believe.

If a deal is not reached by mid-September, Mr. Baucus plans to present a bill that is likely to have little if any Republican support. At that point, Democrats will have to decide whether to proceed under the reconciliation process, which allows legislation to pass with a filibuster-proof 51 votes.

The idea of using reconciliation angers even such moderate Republicans as Ms. Snowe. "At a time when we need to bolster the public's confidence in whatever we do with health care, I don't think the reconciliation process will serve the purpose of providing affordable health security for all Americans," she said.

Howie P.S.: The sausage-making is getting ugly.

"Mallahan takes lead in latest Seattle mayor's vote count"

Chris Grygiel (Strange Bedfellows):

Businessman Joe Mallahan jumped ahead in the latest vote count in the Seattle mayor's race.

Environmentalist Michael McGinn dropped to second and two-term incumbent Greg Nickels remained in third place.

Mallahan was at 26.76 percent. McGinn was at 26.48 percent and Nickels was at 25.19 percent.

Following Tuesday's initial count of about 65,000 ballots in Seattle, McGinn was at 26.6 percent, Mallahan at 25.8 percent and Nickels at 25 percent. The top two finishers advance to the November general election.

There will be another vote count released Thursday, and it could be several days before the primary winners in the mayor's race are known. On Thursday elections officials released a count of just under 16,000 votes in Seattle races. McGinn now leads Nickels by 1,016 votes.

Mallahan's spokesman, Charla Neuman, said Mallahan "is the only candidate that can deliver what Seattle clearly needs -- an open and accountable leader that can effectively manage the city ... Joe Mallahan is the only one offering that message and new leadership to the voters."

McGinn, who surprised many by getting the most votes in Tuesday nights counts, met with the media Wednesday morning. He said his approach to the race would remain the same.

"We had to have a grassroots campaign," he said, noting that Nickels and Mallahan had a lot more money. "I don't really see that changing."

McGinn, whose signature issue is opposition to the $4.2 billion tunnel replacement for the Alaskan Way Viaduct, wasn't backing down on that stand. He has said the $930 million the city would contribute to the project would be better spent elsewhere. "If I'm elected mayor we are not going to allocate $930 million for that tunnel," he said.

"Mallahan says Nickels' 'slur campaign' hurt Nickels, helped challengers"

Seattle PostGlobe:

Supporters of Joe Mallahan who gathered in the two backrooms of Fado’s Irish Pub were stunned – yet jubilant – by the early results.

“Oh my God,” shouted one supporter.

“Look at that,” said another, as KING/5 showed Mallahan in second place behind Mike McGinn with 40 percent of the vote in.

The comments turned into cheers and applause as the candidate arrived, at 8:43 p.m.

“Thank you. And wow!” were the first words out of Mallahan’s mouth.

“You’ve got a lot to celebrate. It’s all of you volunteers from work and the school that turned out to work. And, hey, you got it done.”

Mallahan attributed his success to what he called Mayor Greg Nickels’ “slur campaign.”

“Greg’s slur campaign seemed to hurt him more than me,” he declared, as supporters cheered. “Hey, we all knew we needed a change. We had 32 years of Greg’s service, but his way was the old way, and we needed to move away from that.”

He added later in a conversation with reporters that voters with whom he spoke this week had told him they decided to support him because of – not despite – Nickels’ attacks.

“They said: ‘Joe, we know about you. We’ve been thinking about voting for you, and now that Nickels said what he said, we know you’ve got to be good.’ ”

Mallahan also credited his success to the volunteer network he was able to build, modeling the strategy that helped elect Barack Obama president. He acknowledged the help of Obama supporters as well as local Democrats, union members and his own family.

“You all know I come from a family of nine siblings,” he said. “Well, all of them were at my place this week at one point or another making calls, supporting me. There’s always sibling love, but that’s really showing some care.”

If the early results hold, Mallahan and McGinn will face off in the general election, the first Seattle mayoral race in decades that did not feature an incumbent or a clear favorite. McGinn led by a narrow margin over Mallahan and Nickels in results released earlier this evening. More results will be released late tomorrow (Wednesday) afternoon.

"75% of Seattle voters picking someone besides Nickels in race for mayor"

Emily Heffter (Seattle Times):

Even if Seattle Mayor Greg Nickels squeaks into the general election, he is in big political trouble.

Environmentalist Mike McGinn held a tiny lead in Tuesday's primary with about half the expected votes counted. T-Mobile executive Joe Mallahan was slightly ahead of Nickels for the second slot in the Nov. 3 general election.

With partial returns showing about 75 percent of city voters picking someone else in the primary, the results confirmed Nickels' vulnerability.

"It appears that the mayor is in a very deep hole," said political consultant Michael Grossman, who is not working for any of the candidates. "Even if he ekes out a first or second place ... he's going to have to make this a referendum on whomever gets through."

Nickels has never been very popular. His job-approval ratings were low even in the spring. Critics said his aggressive style alienated people.

After the city's poor response to a snowstorm in December, he drew criticism for being out of touch when he gave the city a "B" for its response. It was later revealed that a consultant's report, prepared months before the snowstorm, had documented major management problems within the city's transportation department.

McGinn garnered 26.58 percent of the votes counted. Mallahan received 25.77 percent of the vote, and Nickels got 25.06.

King County officials say it will take the rest of the week to count the remaining votes. Even then, the final outcome could be in doubt: State law requires an automatic machine recount if two candidates are separated by fewer than 2,000 votes and a margin of less than one-half of 1 percent of total votes cast.

At the McGinn party Tuesday night at a Capitol Hill bar, cheers broke out among supporters when the election results were posted. About 10 minutes later, McGinn arrived and the party moved to the parking lot, where the candidate gave a short speech.

"We went to talk to the people of Seattle about the kind of future they wanted, and I think our message kind of resonated," he said. "Even though we were outspent ... just the power of talking to people about ideas the choices we need to make and the priorities we need to make helped us really connect."

McGinn, a lawyer, a Greenwood neighborhood activist and a Sierra Club volunteer, wrapped his low-budget campaign around a single issue: his opposition to a tunnel planned for the waterfront to replace the Alaskan Way Viaduct. Nickels has championed a tunnel and reached an agreement with county and state leaders earlier this year to build it. The anti-tunnel message appeared to be effective: McGinn's fellow Sierra Club leader, Seattle City Council candidate Mike O'Brien, soared above five opponents by emphasizing his opposition to the tunnel.

"So many of these older voters who are pretty vested in Seattle ... felt uncomfortable enough with the economic issues that they would basically back a couple of single-issue candidates," said political consultant Blair Butterworth, who worked on the unsuccessful mayoral campaign of City Council member Jan Drago.

It was subdued at Nickels' party in Sodo. Supporters were silent as they stared at their BlackBerrys and other mobile devices checking results.

Speaking to the crowd, Nickels said the voters were "insecure" and "grumpy." But, he said, he was confident he would make it through to the general election.

"I said I expected the election to be close, and it is," he told a crowd of about 200 supporters. "I haven't always gotten it right, but I worked hard to know this city and its people, and we have made progress."

Tuesday's results had echoes of Nickels' first run for mayor in 2001, when he and then-City Attorney Mark Sidran ousted incumbent Paul Schell in the primary.

In his last re-election bid in 2005, Nickels emerged from the primary with 57 percent of the vote. His opponent in the general, Al Runte, had 22 percent.

A jubilant Mallahan arrived at his campaign party a little after 8 p.m. to chants of "Joe, Joe, Joe."

"Wow. Boy, I think Greg's slur campaign seemed to hurt him more than me," said Mallahan.

Nickels spent more than $500,000, running an attack ad against Mallahan and negative robo-calls against McGinn. Nickels ran other ads admitting to making mistakes as mayor.

Nickels, who was a Metropolitan King County Council member before first being elected mayor in 2001, is the ultimate political insider. The mayor has been involved in Democratic politics since high school.

In two terms as mayor, he has earned a national reputation for his leadership on climate-change issues. During the spring, he became president of the U.S. Conference of Mayors.

Mallahan, a vice president at T-Mobile who lives in Wallingford, entered the race with virtually no political experience. He made headlines early by writing his campaign a $200,000 personal check, then gained momentum among Democratic activists and district organizations. While Mallahan hired an experienced campaign staff, McGinn seemed at times to be running his campaign with little more than a bicycle and an iPhone. He spent about $87,000 for his campaign.

Small-business owner and former Seattle Sonic James Donaldson and City Council member Jan Drago were both considered serious contenders during the campaign, but trailed in partial results Tuesday.

In addition to the possibility of an automatic recount, candidates also can ask for a recount within three days of the Sept. 2 certification of the primary vote. The requesting candidate has to pay for it.

Howie P.S.: I knew Greg wasn't popular but I failed to consider how much Dan Savage and an August mail-in primary contest would work to McGinn's advantage.