Throughout the health care reform debate, Congressional Blue Dogs lobbied then-House Speaker Nancy Pelosi (D-CA) to adopt provisions that would lower health care spending and reduce the deficit, but curiously opposed the so-called robust public option. That measure reimbursed providers 5 to 10 percent above Medicare rates and would have reduced the deficit by as much as $110 billion over 10 years. In July of 2009, the fifty-member Blue Dog Coalition wrote a letter to Pelosi revealing “strong reservations” about an earlier House version of the health care bill. “After reviewing the draft tri-committee health care reform proposal, we believe it lacks a number of elements essential to preserving what works and fixing what is broken,” they wrote, noting:

A “Medicare-like” public option would negatively impact hospitals, doctors and patients…using Medicare’s below-market rates would seriously weaken the financial stability of our local hospitals and doctors.”

That argument was debunked repeatedly by MedPAC — which argued that Medicare rates are adequate and consistent with the efficient delivery of services — and relied heavily on insurance industry talking points. The industry feared that it would lose market share if forced to compete against a more efficient public plan. In March 2009, he industry’s chief lobbying arm, AHIP, provided lawmakers with this presentation, ‘What you should say when asked about the public option“:

You could end up not being able to see the doctor of your choice as the government plan would reimburse doctors so little for their services they stop accepting or dropping patients by the government plans.

And so, given all this, it is perhaps not surprising that today’s Politico Pulse reports that Erik Komendant, the policy director for the Blue Dog Coalition, has now accepted a job at AHIP as “VP for federal affairs.” After all, it’s like he was working for them already.

President Obama devoted just two paragraphs to defending the Affordable Care Act in his State of the Union Address, despite growing public opposition to the law and the GOP’s ongoing efforts to repeal, defund, or dismantle large parts of the measure. In fact, rather than empowering Congressional Democrats for the fight ahead by setting a powerful offensive tone that rebuked House Republicans for increasing taxes on small businesses during a period of economic recession or forcing senior citizens to pay back the millions of dollars in prescription refunds they received under the law, Obama struck a conciliatory note, reiterating his pledge to repeal a reporting requirement for small businesses and embracing malpractice reform.

The administration may have hoped to move health reform to the back burner, look at it through the “rearview mirror,” as today’s Politico described it, but that is unlikely to slow the coming budgetary show-down over health funding and implementation. Obama relied on the strategy that he had deployed throughout the first part of the health care reform debate: set the basic framework of discussion and let Congress figure out the details. Here, he assured the public that he would not support unwinding the law but left Democrats in Congress with the task of articulating the consequences of repeal. Needless to say, those hoping that Obama would seize on the opportunity to rebuild fledgling public support for the law and highlight the progress HHS has made in implementing the measure, were left disappointed.

Obama certainly reached out his hand to conservatives — “If you have ideas about how to improve this law by making care better or more affordable, I am eager to work with you,” he told them — but he didn’t offer any progressive proposals that would have rallied his base and improved the law. Maybe it wasn’t that kind of speech. Obama eschewed the traditional laundry list and instead delivered a thematic address about what the nation needs to do to “win the future.” But it’s troubling that the President didn’t establish a more direct contrast on the issue, particularly when the opposition is preparing to pursue a very clear agenda and stopping their attempts to undo the law will be so critical to securing that future.