After months of cutting deals and stroking drug makers, hospitals and doctors, the president’s aides are laying the groundwork for a final round of Congressional arm-twisting, with Mr. Obama increasingly in a hands-on role.
As the Finance Committee wrestles with the bill, which could form the backbone of an eventual Obama plan, the lobbying effort is already bearing fruit. One Democrat who consults frequently with the White House said that a main goal of the administration has been to prevent any Democrat from publicly declaring opposition to the measure. So far, the only one who has, Senator John D. Rockefeller IV of West Virginia, has scaled back his criticism after a private Oval Office session with the president.
Rahm Emanuel, the chief of staff, runs the campaign out of his West Wing office. A former congressman, he knows how to count votes. (It was Mr. Emanuel, for instance, who suggested Mr. Orszag reach out to Ms. Collins.) Aides say he does not host a regular health care meeting, but rather summons his team several times a day, typically with e-mail messages ordering colleagues to drop everything and show up right that minute.
Mr. Emanuel oversees two working groups: a policy group, run by Nancy-Ann DeParle, the head of the White House Office of Health Reform, and a political group, run by Jim Messina, the deputy chief of staff. They are deeply engaged in what Chris Jennings, who advised President Bill Clinton on health policy, calls “intelligence seeking” — trying to learn who has problems with the legislation, what those problems are and what it will take to win each member’s vote.
“We are at the concern-addressing stage,” said Dan Pfeiffer, Mr. Obama’s deputy communications director, adding, “This is a political and policy challenge of epic proportions, and it takes a lot of effort and attention to achieve it.”
Everyone who has relationships on Capitol Hill is expected to pitch in. Mr. Messina, a former chief of staff to Senator Max Baucus of Montana, the Finance Committee chairman, is the link to the finance panel. Phil Schiliro, the head of legislative affairs, spent years working for Representative Henry A. Waxman, the California Democrat who is an architect of the House bill. Vice President Joseph R. Biden Jr., who served for 36 years in the Senate, has been making calls to former colleagues, especially those on the Finance Committee.
Kathleen Sebelius, the secretary of health and human services, Tom Vilsack, the agriculture secretary, and Gary Locke, the commerce secretary, have also been working the phones. Their notes are passed on to Mr. Schiliro’s shop, which catalogs them for future use. The cabinet secretaries have also been doing interviews with select regional news outlets to shore up wavering Democrats in districts where Republicans are attacking Mr. Obama’s plans.
And the president has been holding more private meetings, aides say, with Democrats like Senator Maria Cantwell of Washington, who said she received an invitation to the Oval Office on a recent Friday, when she had hoped to spend the morning at home. She said she told the president the legislation would have to do more to rein in Medicare spending. “He was, like, ‘I’m all for this,’ ” Ms. Cantwell said.
“He is leaving no stone unturned,” said Senator Mary L. Landrieu, the Louisiana Democrat and Finance Committee member, who received an unsolicited call from Ms. Sebelius last week. She said they spent 20 minutes going over what she perceived as flaws in the bill.
The White House is carefully monitoring what senators say. When Senator Joseph I. Lieberman, the Connecticut independent, said on a Sunday morning talk show that health legislation should be delayed until the economy improves, his chief of staff got a telephone call from a worried-sounding Louisa Terrell, the White House legislative liaison assigned to monitor his office.
“She said, ‘Does he want to speak to Sebelius, does he want Peter Orszag?’ ” the senator said. He said it was not necessary. But last Friday, while Mr. Lieberman was at home preparing for Rosh Hashana, Mr. Locke, the commerce secretary, called. “He wanted to lobby me on health care,” Mr. Lieberman said.
At least one White House official, Ms. DeParle, has gone so far as to make a house call. When Senator Dianne Feinstein, Democrat of California, expressed misgivings about how expanding Medicaid would affect California’s budget, Ms. DeParle gathered some charts and dropped in on a Saturday. They spent nearly three hours talking over coffee in Ms. Feinstein’s den.
