government
Health reform summit has Republicans skeptical
■ The Obama administration hopes the forum will get a reform overhaul across the finish line, but GOP lawmakers want Democrats to start from scratch.
By Chris Silva — Posted Feb. 22, 2010
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Washington -- President Obama is bringing together a group of top lawmakers from both major political parties for a Feb. 25 summit aimed at jump-starting the stalled health system reform effort.
The session, to be held at Blair House, across the street from the White House, is expected to take up half the day and will be broadcast live. The administration indicated that the text of a proposed consensus health reform package would be posted online before the summit. Among other provisions, the package would end insurance company abuses, extend coverage to millions of Americans, control skyrocketing costs and reduce the annual federal deficit, according to the administration.
Obama said he hoped Republicans also would put online their own comprehensive bill to achieve these goals.
Obama and GOP leaders engaged in some public relations jockeying in the weeks leading up to the summit, with the president stating his desire to secure a health reform deal to avoid "another year of partisan wrangling around these issues."
But GOP lawmakers have called on Obama and the Democrats to scrap the bills that passed the House and Senate and start the process over. "If we are to reach a bipartisan consensus, the White House can start by shelving the current health spending bill, and with it their goal of slashing a half-trillion dollars from Medicare and raising a half-trillion in new taxes," said Senate Minority Leader Mitch McConnell (R, Ky.).
Republicans also expressed their displeasure with the administration's plan to start the Blair House summit with a revised Democratic proposal in hand.
"A productive bipartisan discussion should begin with a clean sheet of paper," said House Minority Leader John Boehner (R, Ohio), who along with McConnell is part of the group invited to the summit. "We now know that instead ... the president and his party intend to arrive with a new bill written, behind closed doors, exclusively by Democrats. It doesn't sound much like bipartisanship to me."
Still, the White House appeared undeterred by the call for a clean slate, noting that the nation remains the closest it has been to comprehensive health reform "in the nearly 100 years that it has been debated."
Options on the table
Enacting comprehensive legislation appeared imminent for Obama and the Democrats as recently as the beginning of the new year. But the Senate victory by Massachusetts state Sen. Scott Brown over state Attorney General Martha Coakley in a Jan. 19 special election took away the Democrats' powerful 60-seat Senate majority and effectively stalled negotiations on the Senate- and House-passed bills.
The development has since prompted Democratic leaders to consider several different options for moving a final bill through Congress, including these scenarios:
- The House could adopt the Senate-approved measure on its own. House Speaker Nancy Pelosi (D, Calif.) has said she does not have the votes to make that happen.
- Senate Democrats could use a parliamentary tactic known as reconciliation to pass a more limited reform measure, whether as part of a deal to revise portions of the broader Senate bill that the House opposes or as a stand-alone bill. That tactic would allow simple majority approval in the Senate.
- The House could send the Senate a new bill with popular reform measures that appear to enjoy more bipartisan support, including imposing limited cost controls, ending insurance denials based on preexisting conditions and establishing minimum benefits standards.
Rep. Chaka Fattah (D, Pa.) outlined one proposed way for his party to use a consensus deal from the summit to enact reform. Using the budget reconciliation process in the Senate, lawmakers could pass amendments agreed to by both chambers and the White House -- at the same time that the House passes both the amendments and the Senate bill, he said.
But since Brown's election, Republicans have been more vocal on the need to restart the process and in their opposition to using such tactics as reconciliation to enact reform.
"As the president has noted frequently, Democrats continue to hold large majorities in the House and Senate, which means they can attempt to pass a health care bill at any time through the reconciliation process," Boehner and House Minority Whip Eric Cantor (R, Va.) wrote in a Feb. 8 letter to the White House. "Eliminating the possibility of reconciliation would represent an important show of good faith to Republicans and the American people."
Several health organizations supporting the House and Senate bills, including the American Medical Association, have insisted that comprehensive health reform still can be achieved despite the recent developments.
AMA President J. James Rohack, MD, sent a Jan. 26 letter to President Obama and Congress renewing a call to enact reform legislation, repeal the Medicare physician payment formula and implement medical liability reforms.