1.  Obama Claims to be Attacking the Status Quo: Is he? – Expand Benefits and Control Costs – Health Care Viewed by Many as a “right” – Promoting HCR seen as Moral – Cost Controls suggest Rationing – Powerful Bias Towards Expansion Health Care Reform and its Consequences

2. History Is Clear  Medicare Originally Covered Only Those 65+ -1972 Congress Makes Disabled Eligible (15%) -2003 Congress Creates a Drug Benefit -Other Services (hospice care, mammograms) are Subsequently Added, Medicare Very Popular Today

3. Medicaid: Fed/State Program for the Poor  Originally Covered People on Welfare -Now, Children Ages 6 to 18 under the Poverty Line ($22,050 Family of 4) -Congress Sets Higher Limit (133%) for Pregnant Women and Children Under 6 -1997 (SCHIP) Expands Coverage

4. Ballooning Costs  1965 Health Care Spending to Individuals <1% of Federal Spending  2008 Federal Spending to Individuals 28%

5. Battle For Health Care Reform  Wasn’t Just About Health Care—For Conservatives it is About Killing a Progressive Agenda  Wanted This Policy Debate to be Obama’s “Waterloo”  If Defeated, They Could Block Climate Change Leg, Immigration Reform, Marriage Equality, Bank Reform, Educ

6. Obama and Progressives  Disappointed Progressives on Several Fronts: – Wall St. Bailouts – Weak Foreclosure Plan – Expansion of War in Afghanistan – Catering to Insurance Companies

7. Lessons From the Last Year  It Takes Social Movements that Exhibit, Tenacity, Intensity, and Imagination to Get Big Things Done – E.g., Abolition, Women’s Suffrage, New Deal, Great Society – Not Won in a Single Election

8. Why Health Care Reform Was So Contentious  Tactical and Strategic Errors  Failing to Confront Powerful Interests  Massive Corporate Resistance to Reform  Tea Party Movement Successfully Tapped into Public Populist Anger  Massachusetts Special Election  Rules of the Senate

9. Thursday, April 08, 2010  Obama Approval Index -14  Strongly Approve 28%  Strongly Disapprove 42%  Taxes Will Go Down 8%  Gov't Spending Will Go Up 67%  Obama on Economy - Ex/Good 41%  Obama on Nat'l Sec - Ex/Good 43%  Leadership - Ex/Good 44%  Trust Obama on Economic Crisis 27%

10. Any Questions?