WASHINGTON — When Newt Gingrich’s Congress was moving full-speed in its efforts to shrink the government more than a dozen years ago, Ralph G. Neas, an indefatigable champion of liberal causes, threw up his hands and declared that his side had been outmaneuvered.
Liberals who had grown up pressing their case with marches and old-fashioned door-knocking campaigns, Mr. Neas said, were no match for conservatives with big business allies and a commanding understanding of the new talk-radio, cable-news battlefield, where former President Bill Clinton’s signature health care plan lay bleeding.
Recent days have found Mr. Neas in a new perch, preparing to join the coming fight over President Obama’s sweeping health care proposals, with plans to coordinate a campaign of television advertisements, “blogger outreach” and community meetings. This time, he is supported by his own phalanx of big business backers, including the Exelon power company and Giant food stores.
“We get another chance to do it again, and win this time,” he said in an interview in his new office at the National Coalition on Health Care, which recently named him its chief executive.
The battle to grow the government, just getting under way, promises to be no less intense than the battle to shrink it was.
The rush of activity, particularly as it relates to health care, is illuminating a realignment of interests and a shift in the public debate, with liberal interest groups rising up to run vigorous — and expensive — campaigns in support of Mr. Obama’s agenda in a way they did not for the Clinton White House. And they have brought to their side some unexpected corporate support.
The health care fight is one of many looming clashes likely to be set off by Mr. Obama’s aggressive spending and proposed regulatory and tax policy changes.
Less than 48 hours after Mr. Obama released his budget outline last week, oil and gas executives closely aligned with Republicans telegraphed a major fight against several tax provisions proposed for their industry. And real estate executives made it clear they would resist new limits on deductions for interest paid on mortgages for higher-income households, an area of common cause with Republicans.
In his weekly radio and Internet address on Saturday, the president predicted that his agenda would draw attack from “special interests and lobbyists” on several fronts. “I know they’re gearing up for a fight as we speak,” he said. “My message to them is this: So am I.”
Mr. Obama can, however, expect help from several outside groups as he labors to shift the government in a different direction. The efforts are in many ways the result of planning that took place in the years Democrats spent in the wilderness — which grew thicker around them as President George W. Bush and his political guru Karl Rove built an army of influence with conservative activists, backed by big business.
Spurred in part by former Clinton White House aides seeking a return to power, and inspired by the success of the activist group MoveOn, liberals formed organizations like Media Matters for America, which calls attention to what it considers conservative-slanted news coverage, and the Center for American Progress, a group founded by John D. Podesta, Mr. Clinton’s former chief of staff and Mr. Obama’s transition director, to promote liberal solutions to major problems. With support from the billionaire George Soros and the Hollywood producer Steve Bing, among other undisclosed donors, the group became a liberal government in exile, developing a full range of policy prescriptions.
So Mr. Neas, a longtime combatant in judicial appointment battles who famously led the successful fight against President Ronald Reagan’s nomination of Robert H. Bork to the Supreme Court, is emerging in the health care fight to find a newly robust liberal apparatus. His organization is among a handful of moneyed groups that will be pressing for Mr. Obama’s proposal to make health care more accessible and more affordable.
The National Coalition on Health Care was formed in 1990 to push for universal health care and is supported by a mix of business, labor, religious and health care organizations. It has spent several years focused on policy, but its founder, Dr. Henry E. Simmons, said he brought in Mr. Neas as its chief executive because, “It’s time to move into the campaign mode.”
Mr. Neas said that members had already been walking the halls of Congress to lobby lawmakers and that his group was identifying local bloggers and editorial writers for support.
Mr. Podesta’s group is cooperating with two separate coalitions planning to fight for Mr. Obama’s health care plan with television advertisements, interview appearances on cable news talk shows and e-mail campaigns.
“This is no longer going to be Barack Obama standing by himself getting pilloried by the special interests with no one pushing back — if I can describe what it felt like in the White House in 1993,” Mr. Podesta said Friday.
The defeat of the Clinton health care plan was a hard learning experience for Democrats. They were caught flat-footed by an insurance industry-backed campaign to kill the proposal. It is best remembered for advertisements featuring a yuppie couple, Harry and Louise, worrying about limits on quality health care.
“The battle had been lost by the time the progressive community and its allies began rallying around the Clinton bill,” Mr. Neas said. “Now, people are prepared.”
This time, too, the ground has shifted in the debate, with new support for a sweeping overhaul of the health care system from some quarters of the business community, where the crushing effect of benefits costs and the impetus to contain them through new governmental policies are a regular topic of discussion.
Wal-Mart and AT&T, for example, are members of Better Health Care Together, a group Mr. Podesta’s organization helped found with the leader of the Service Employees International Union, Andy Stern.
Even the insurance industry group that ran the “Harry and Louise” spots — now called America’s Health Insurance Plans — says it wants to play a different role this time around.
For the moment, Mr. Obama has set out principles for creating a near-universal health care system, setting aside $630 billion in his new budget toward that purpose. The mechanics are still under discussion, and the administration has been careful to try to bring Congress and the many competing interests into the process. When the Clinton administration tried to create universal health care, it presented Congress with an elaborate scheme that was set upon by critics.
“There’s a different atmosphere — there’s widespread recognition that this needs to get done,” said Robert Zirkelbach, a spokesman for the group. Though the group criticized Mr. Obama last week over a new Medicare-related proposal, Mr. Zirkelbach added, “we’re confident at the end of the day we will be on the side of health care reform.”
Yet an opposition infrastructure is beginning to come into view, with Democrats closely monitoring a new organization, Conservatives for Patients Rights, that told The Wall Street Journal last week it was devising plans for a multimillion-dollar campaign calling for free market solutions.
Sara Taylor, a political director in the Bush administration, said critics of Mr. Obama could find a receptive public. “The fundamentals haven’t changed: huge majorities of Americans don’t want the government meddling with their health care,” Ms. Taylor said.
Betsy McCaughey, a former lieutenant governor of New York who was a leading critic of the Clinton health proposal, jumped back into the fray recently with an attack on the Obama plan.
But even Republicans say the Democrats seem better prepared for the fight this time.
“For a while there was a lack of cohesion on the Democratic side that was preventing them from putting together the same level of grass-roots organizations as the Republicans,” said Brian Jones, a former Republican National Committee communications director. “Now they have the intensity, they have the mechanics.”
Mr. Neas also sees a difference. Pondering his movement’s progress since its darker days, he said, “To say the least, we’re doing much better.”
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