Behind the scenes of the negotiations has been President Obama's chief of staff, Rahm Emanuel. The hard-charging, high-octane Emanuel is a former influential congressman from Chicago, who is known as an arm twister on Capitol Hill, an enforcer with a reputation for getting things done. He was brought into the Obama administration for moments just like this.
Ironically, when health care reform began encountering opposition last summer, Emanuel reportedly urged the president to scale back his ambitious plans.
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"If you had your druthers, would you have said, 'Let's take smaller bites that, that are more palatable to the American people?" Couric asked Emanuel.
"My druthers is whatever the president wants," the chief of staff replied.
Once President Obama made the decision to go forward with a massive overhaul of health care, his chief of staff started selling the plan; according to senior White House advisors, health care reform would have died long ago had Rahm Emanuel not worked the phones and prowled the halls of the Capitol, pushing for support.
"Many people have suggested spending all this time on health care reform while the economy was in such bad shape was a big mistake," Couric remarked.
"The president is working on the economy every day. It's not an either or choice," Emanuel replied,
"But that wasn't the impression a lot of people had, you know that," Couric pointed out.
"I understand. What is basically the most fiscally dangerous part of the American economic system? Both its budget, what it affects families, small businesses, is health care costs," Emanuel replied.
"Are you concerned that pushing health care legislation through Congress without any bipartisan support is gonna leave a bad taste in voters' mouths?" Couric asked.
"The process does not trump the product. And if we get pre-existing conditions banned as discriminatory process, if we get people who are uninsured, health care that they never had, get senior citizens complete coverage of their prescription drugs…," Emanuel said.
Asked if opposition will fade if they do all that, Emanuel told Couric, "Yes. I absolutely believe that. Because people will see the immediate benefit. Right now, it's kind of out there. It's not touching their lives."
The bruising fight over health care contributed to President Obama's sinking approval ratings and polls show a vast majority of Americans think Washington is dysfunctional.
Asked if he thinks Washington is working, the chief of staff replied, "Yeah.""
"So you, you don't…believe this whole premise that Washington is broken?" Couric asked.
"I mean, look. Washington can deal with these issues. If you didn't think it could, you wouldn't get out of bed at 5 in the morning to go attack the day. I fundamentally believe America's set up to deal with this," he replied.
"Why do you think the impression, though, around the country in every news magazine you pick up it says, 'Washington is broken. Why can't Washington get anything done?' So are you saying, this isn't real?" Couric asked.
"Let me say this. You can get bipartisanship to get certain things done. Sometimes you will have differences, and that's not a negative. Just because there's politics or principle difference doesn't mean it's a negative. It means we have fundamental, philosophical policy differences. That's what elections are about. That's what governing's about," Emanuel argued.
"But what if they get in the way of progress or actually getting something done?" Couric asked.
"No, Katie, then there's a legitimate criticism. But that's not the total picture," he replied.
The total picture, he believes, includes several bills that had bipartisan support. Just this past week the president signed a $17 billion jobs package that had the backing of 11 Republican senators.
"What I do is, every day, I start the day with a to-do list," Emanuel told Couric, standing in his West Wing office.
Emanuel believes his job as the White House chief of staff is to put ideas into action.
His office, which is bigger than the vice president's, sits only 40 feet away from the president himself.
Asked how often he goes into the Oval Office on a daily basis, Emanuel said, "You know, I've never counted, but you know, more than eight, less than 15."
"But every day, you meet with him first thing in the morning when he gets in?" Couric asked.
"He walks in, I'll head down. We do about three minutes or four minutes…. There's the schedule. And I'll see him, at the end of the day, we do this thing called 'wrap up,'" Emanuel explained.