[This is a guest post by Jonathan Cohn; photo from White House Flickr stream]

During the debate over health care, there were a handful of moments when President Obama presided over a serious discussion of whether to pull back--that is, to give up on comprehensive reform, at least for the moment, and hunt for quick agreement on a much smaller bill. One of these moments came in early August, as polls showed the public was turning against reform and the prospects of getting legislation out of the Senate Finance Committee seemed bleak.

In today’s excerpt from my history of the health care reform debate, I describe the atmosphere inside the White House at that time--and a series of meetings in the Oval Office where the president’s advisers debated what to do. Robert Gibbs pointed out that it was hard to talk about progress that wasn’t happening; David Axelrod relayed the dismal polling numbers. They weren't advocating a course of action, but Rahm Emanuel was. He wanted Obama to seek quick agreement on a bill that would have insured kids and their families--a substantial investment in coverage, to be sure, but not the comprehensive reforms Obama had in mind.

Emanuel is a big believer in “putting points on the board.” And, as my colleague Noam Scheiber reported a few months ago, he thought speed was essential to getting a law enacted. As you can imagine, I’m glad Obama ultimately rejected Emanuel’s advice. But that doesn’t mean Emanuel was wrong to offer it. That was his job. Similarly, Axelrod has spoken frequently about his own personal experience struggling with insurance companies and medical bills, years ago, while his daughter was getting care. After the Affordable Care Act passed, I’m told, he got choked up talking about it. But the president depended upon Axelrod to present the polling numbers honestly and, as far as I can tell, he did just that. 

At the same time, White House sources have said, other members of the administration were making the case that comprehensive reform remained viable. Nancy-Ann DeParle, who led the health care reform team, was apparently among them. So was Phil Schiliro, assistant to the president for legislative affairs, whose name appears in virtually no accounts of the debate (including mine) but was a key player in and out of the White House. By the time the health care debate was over, Obama had come to rely on those two heavily. For proof, just look at where Obama sent the pens he used for signing the bill into law. He gave most of them to members of Congress. But he gave one each to DeParle and Schiliro. They were the only White House staff to receive them.

It is, I think, to the president's credit that he encouraged such lively debates and took them so seriously. The only downside is that it sometimes left uncertainty, among Obama's allies and even among some of his own advisers, over what he really wanted to do. But that's a topic for another installment.

In the meantime, if you want to read more about this particular episode, I highly recommend Jonathan Alter’s just-published book, The Promise. His sweeping narrative of the Obama presidency’s first year includes the story of the health care campaign, offering some terrific insights into what the president and his advisers were thinking. One of my favorite passages come from his characterization of the late summer debates:

One advisor called Rahm’s approach ‘the Titanic strategy’: insure women and children first. Later, aides were less comfortable with the Titanic metaphors.

You can imagine why.