WASHINGTON — She has become one of the Obama administration's most visible surrogates on health care, announcing the release of $851 million in federal financing for health clinics, calling for tougher nutritional standards in the government's school lunch program and urging Democrats to rally around the president's efforts to revamp health care.
"We're at a critical juncture in the debate about health care in this country," first lady Michelle Obama said at a clinic here in June. "The current system is economically unsustainable, and I don't have to tell any of you that. And despite having the most expensive health care system in the world, we're not necessarily healthier for it."
After several months of focusing on her family, her garden and inspiring young people, Obama is venturing into more wonkish terrain. She is toughening her message and talking more openly about influencing public policy as she works to integrate her efforts more closely with those in the West Wing.
In June, Obama went to San Francisco with Melody C. Barnes, the president's domestic policy adviser, for the start of the administration's initiative to promote volunteerism.
A week later, she went to a Washington clinic with the director of the Health Resources and Services Administration to announce the release of stimulus money for clinics. This month, her policy director joined a new interagency working group, including health, agriculture and housing officials, that will develop policy, legislation and public outreach to combat obesity.
While her efforts are most visible in the health care arena, Obama is focusing on other issues.
In May, she convened a meeting — with James L. Jones, the president's national security adviser; Gen. James E. Cartwright, the vice chairman of the Joint Chiefs of Staff; and Peter R. Orszag, the White House budget chief, among others — to consider new policies and programs to help military families. Her staff also is working with non-profit, corporate and philanthropic groups to help rally resources to support such families.
Obama's aides say the substantive speeches and increased coordination with the West Wing reflect the first lady's determination to have an impact on issues she cares about.
"The listening portion of this is over," said Camille Johnston, communications director for the first lady. "Let's make sure that we're having an impact and delivering things as well."
But Obama, a Harvard-educated lawyer and former hospital executive, is still treading cautiously as she fleshes out her priorities.
Susan Sher, the first lady's new chief of staff, emphasized that Obama would not testify before Congress or argue the merits of competing health care plans.
Obama has chosen instead to deliver her recent remarks in more traditional settings for a first lady — at a clinic, a playground and in the White House garden. Her aides say she will promote policy, not make it, and will continue to concentrate on children and families.
They say they do not expect her to be accused of overstepping her bounds, as Hillary Rodham Clinton was when she tried to remake health care as the first lady.
