How Obama could lose health fight

POLITICO (Washington) - President Obama's campaign for health care reform by this fall, once considered highly likely to succeed, suddenly appears in real jeopardy.

Top White House advisers, especially chief of staff Rahm Emanuel, are still privately predicting massive changes to the health care system in 2009. But for the first time, Democrats on Capitol Hill and in the administration are expressing frank worries about stronger-than-expected opposition from moderate Democrats and worse-than-expected estimates for how much the plan could cost.

Business groups, which had embraced the idea of reform and have been meeting quietly with Democrats for months in an effort to shape the legislation, now talk of spending millions of dollars to oppose the latest proposals out of Capitol Hill. And Democrats themselves are not united, with leading party figures making contradictory declarations about how far they should go to overhaul the system when deficits are soaring and prospects for an economic recovery remain cloudy.

And top Democratic officials tell POLITICO they are increasingly pessimistic about getting any more Republican votes than they did on the stimulus package, with some aides referring to the idea of a bipartisan bill as "fool's gold" - an unattainable waste of time.

"This was always going to be messy," said a senior administration strategist. "It got messy faster and earlier than people thought. But none of it is anything that's going to stop it."

Emanuel is anxious for the president to sign the new law by October so that Democrats have a year to campaign on it ahead of congressional midterms, aides say. Administration officials concede the new kinks in the schedule make that harder.

It has been conventional wisdom Obama would overcome a sluggish start by congressional Democrats to win approval of his plan this fall - perhaps even backed by a notable number of Republicans. But there is a growing list of reasons this conventional wisdom could be wrong:

MONEY TROUBLES

Public anxiety about red ink - muted during this winter's debate over an economic stimulus package - has come roaring back, with a Gallup Poll showing deficits and spending as the only issues where more people disapprove of Obama's performance than approve of it.