Washington Matters


Health Summit Sets Stage
for Democratic Action

Martha Lynn Craver

Obama got what he needed to push forward without the GOP.



President Obama’s summit may have helped to get a health care bill moving again. The day-long discussion didn’t produce an agreement with Republicans. In fact, it highlighted the deep political and philosophical divide that makes a bipartisan bill impossible.

The greatest is over whether the government has an obligation to help the uninsured get coverage, but there are also major differences on the role of regulators and whether reform should be incremental or part of a comprehensive overall.

The summit changed no minds, but it gave Obama another chance to take the lead and shore up nervous Democrats. As President, Obama clearly controlled the summit, and he’s now clearly the point man in the debate. He used every opportunity to make the Democrats’ case for health reform and will continue doing that. And going forward there is just one bill -- his bill -- one he can explain without the confusion of a smorgasbord of different versions.

Moreover, the president added popular provisions to sweeten the pot, such as closing the infamous doughnut hole in Medicare prescription drug benefits. The bill also gives the federal regulators the power to curb rate hikes, provides bigger subsidies so low income workers can buy care, and it includes more money to help the state expand their Medicaid coverage.

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There’s a good chance the President will revise his bill, to show he was open to GOP suggestions. But those changes will be minor -- using undercover patients to help detect Medicare fraud, tweaking medical malpractice language and a nod to selling insurance across states line. He mustn’t go too far lest he rile members of his own party.

Businesses will remain opposed. They like the proposal to delay the so-called Cadillac tax until 2018 and to allow a 90-day waiting period without penalty before providing health care coverage to workers. But they’re sore about the higher fees they’ll have to pay Uncle Sam if their workers get government subsidies to help them buy health care coverage.

Most importantly, the summit cleared the slate for Obama with the public. Having tried to get the Republicans on board in a very public way, he can make a stronger case that he has no choice but to proceed on his own, with just Democratic support. The plan is to push the Obama plan through with Democratic majorities, using a parliamentary rule to skirt the need for a filibuster-proof 60 Senate votes. Corralling a majority in the House will be tough, especially among some of the more conservative Democrats who want anti-abortion language in the bill. But there’s a growing realization among Democrats that the political costs of not passing health care reform are greater for them than passing a bill. Such a defeat would call into question their ability to govern if, with large majorities in both houses and a president of the same party, they cannot get health reform approved.




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