Health Care Now

Jon Cohn talks to the ubiquitous "senior administration official" who says that Obama will move from the stimulus package right to health care.

The Obama administration’s health care czar may be gone, but here is one hint that its commitment to pursuing major health care legislation in 2009 remains in place. On Sunday, a senior administration official told me that health care would be a “central focus” of Obama’s first budget proposal.

The official didn’t specify precisely what that meant: Would the administration be asking for funds to make sure every American has insurance, or just a portion? Would there be major reforms of the way medical care is delivered? But even with that ambiguity, the statement seems to signal that Obama still takes health care seriously and hopes to pass significant legislation in the next year [...]

In interviews over the past week, administration officials have said repeatedly that the dobuts about Obama’s commitment are unfounded. They say Obama himself has indicated health care is a top priority, to be pursued shortly after the debate over the economic stimulus package is over.

They also say he believes it is important to make sure everybody (or almost everybody) has insurance, because it’s not possible to control costs while so many people lack health benefits. "I've been in meetings with him and it's clear this guy is committed to getting health care and getting coverage to everybody," says one high-ranking member of the administration. "There's no question in my mind."

And while these advisers acknowledged that the question of whether to deal with health care in the next budget had been under discussion, another senior official on Sunday indicated a decision had already been made: “Health care reform will be included--and indeed a central focus--of the budget,” this official said, while declining to offer more details. Another adviser subsequently confirmed that. (All of these sources asked not to be named.)

Tom Daschle was not the only man in America who could deliver health care reform, the media's focus on personality over policy notwithstanding. What was always needed is a commitment at all levels to pursue reform and to use all instruments in the policy toolkit. While the Presidential budget isn't binding, it speaks to the Administration's priorities. The top leaders in the Congress are putting out joint statements calling for health care reform "this year." And embedding the reform in the budget not only shows the commitment, but raises the possibility that it will be addressed through a budget reconciliation bill, which requires only 50 votes. This is a great sign for comprehensive health care reform. Now we have to see what model that reform will take.