For Rep. Luis Gutierrez, a Democrat from Chicago's West Side, it was an assurance from the White House to push an overhaul of immigration policy that won his backing for the health bill.
... lots of back and forth between Gutierrez and the White House ...
Mr. Obama asked for Rep. Gutierrez's health-care vote. "The president came by and he said, 'Can I have your support?' " Mr. Gutierrez recalls. "And I said, 'yes.' "
It's easy to forget that Democrats have substantial majorities in the House and Senate, and control the White House, given how the party has struggled during its yearlong march to pass the overhaul. Democrats spent months fighting over the measure's contents, and blamed the president for not settling their disputes.
But in recent days, that same control of the executive and legislative branches formed the backbone of the party's efforts. In addition to the pledge on immigration, the White House tapped officials from its transportation secretary to its top agricultural official. And after staying quiet during the bill's past disputes on abortion, White House officials over the weekend drafted an executive order reinforcing a federal funding ban, securing vital votes.
Republicans accused Democrats of dealing for votes. On Tuesday, the Department of Interior said it sped up an announcement to increase water supply to California's Central Valley, a hot issue for California Democratic Reps. Jim Costa and Dennis Cardoza. Other wavering Democrats secured increased Medicare payments to hospitals and doctors in rural states.
Transportation Secretary Ray LaHood, a Republican, worked longstanding connections as a former member of Congress and penned an editorial in the Chicago Tribune on why Republicans should support the bill. Budget director Peter Orszag made the case to conservative Democrats worried about cost control, calling Rep. Brian Baird of Washington three days in a row. Agriculture Secretary Tom Vilsack also worked the phones with members of Congress.
At two points in the past year, the bill appeared doomed. After a swarm of criticism at August town hall meetings, some centrist Democrats began urging party leaders to scale back the proposal. Other Democrats wondered if they should retreat altogether.
For the White House, turning back wasn't an option because Mr. Obama's first year partly depended on passing the bill. "We were more than half pregnant at that point," said one White House official.
The president wrote a speech to a joint session of Congress—by hand, on legal yellow notepads—aimed at defining what he wanted.
Democrats then spent months debating everything from the structure of subsidies to whether the government should create a new federal insurance program. The White House had been determined not to repeat President Bill Clinton's mistake of delivering to Congress a fully written bill, and the president refused to settle those disputes.
That burned up time, and left the party sewing up details when Republican Scott Brown won an open Massachusetts Senate seat in January. It deprived Democrats of their filibuster-proof Senate majority, leading some to think the bill might be scaled back or die.
In the following weeks, led by the president and House Speaker Nancy Pelosi of California, the Democrats pulled out of their post-election funk. Aides seized on a planned 39% premium increase for some customers by Anthem Blue Cross in California, and the White House dragged insurance executives to the White House for a dressing down. In the last week, the president held 92 meetings or phone calls with members of Congress on health care.
Mr. Obama's most effective move may have been calling for a bipartisan summit on health care, shifting the conversation from Democratic paralysis. Aides knew there was little chance they would reach a bipartisan agreement, but it forced Republicans to put ideas on the table, framing the choice as between two sets of ideas, rather than simply a referendum on one.
"Democrats came out of that believing they could win the national debate," said former Senate Democratic leader Tom Daschle.
Yet in the final days, some Democrats bristled at the campaign by the White House.
Rep. Henry Cuellar, an antiabortion Democrat from Texas, wanted tougher abortion restrictions. He consulted with "my nuns in Laredo" and pored over academic research. Unsure of his position as of Friday, he made phone calls up until 10:30 p.m. to groups in his district to solidify his decision.
Rep. Cuellar said he turned down a conversation with Dan Turton, a White House deputy director for legislative affairs.
"Let me make this my own decision," Rep. Cuellar said. "It's my district. This is something I want to decide on my own." He said this weekend he would vote yes.
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