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Obama's announcement could give wavering Democrats political cover by showing that the White House has been willing to compromise in the wake of last week's health care summit.
updated 3/2/2010 8:23:41 PM ET 2010-03-03T01:23:41

President Barack Obama embraced a handful of Republican health care ideas Tuesday to lure votes of Democrats wary of a more partisan approach as he prepared to spell out his final package for a sharply divided House and Senate, where its fate is unsure.

In a bit of political sleight of hand, Obama said he might include four GOP-sponsored ideas in his plan, even though virtually no one in Congress or the White House thinks it will procure a single Republican vote.

The move is aimed instead at wavering Democrats, especially in the House. Some of them might find it easier to vote for the health care package if they can tell constituents it had bipartisan elements that Republicans should have supported. Yet there is no guarantee that Democratic leaders will incorporate Obama's suggestions in revised legislation.

Senate Republican leader Mitch McConnell warned that Democrats will enact their health care plan at their own political peril, vowing to make it an issue in every congressional race this fall.

In remarks at the White House on Wednesday, the president will describe the final elements of his proposal and then ask Congress to enact it, aides said. Obama was expected to reiterate why changing the system is so important and again explain what his plans would mean to families and businesses. The aides also expected Obama to talk about the Republican ideas he wants woven into the Democrats' plans.

He is expected to leave no doubt that, barring an unexpected change in Republican tactics, he wants Congress to pass the legislation using budget reconciliation rules, which prohibit Senate filibusters. Obama is unlikely to use those exact words, as Democratic leaders are emphasizing they want to pass a bill with simple majority votes in the House and Senate.

"He'll urge Congress to move swiftly toward votes on this legislation," said a White House official who described Obama's remarks on condition of anonymity to avoid upstaging the president.

It takes 60 votes to halt a filibuster, and Democrats can count on only 59 in the 100-member Senate.

In a letter to congressional leaders Tuesday, Obama said he would consider four ideas floated by Republican lawmakers: sending investigators disguised as patients to uncover fraud and waste in Medicare and Medicaid; expanding pilot programs to bring more predictability to medical malpractice lawsuits; increasing payments to Medicaid providers; and expanding the use of health savings accounts.

"I said throughout this process that I'd continue to draw on the best ideas from both parties, and I'm open to these proposals in that spirit," Obama wrote.

In a nod to his 2008 presidential rival, he said he had eliminated a special deal for Medicare Advantage beneficiaries in Florida and other states that drew criticism from Sen. John McCain, R-Ariz.

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But Obama again rejected Republican appeals to restart the health care debate or dramatically scale back his proposals.

"Piecemeal reform is not the best way to effectively reduce premiums, end the exclusion of people with pre-existing conditions or offer Americans the security of knowing that they will never lose coverage," his letter said.

House Speaker Nancy Pelosi said the letter "brings us just another step closer to passing the bill." She said she hopes to incorporate some of the GOP ideas.

Republicans, meanwhile, made it clear the president's overtures will not win their hearts or votes.

Sen. Tom Coburn, an Oklahoma Republican who proposed some of the notions Obama is weighing, said that "merely incorporating these ideas into the deeply flawed House and Senate bills will not bring us any closer to real reform."

In a letter to Obama, Coburn noted that opinion polls show extensive opposition to the Democratic plan. "An all-or-nothing reconciliation strategy will give the American people nothing," Coburn wrote.

White House chief of staff Rahm Emanuel, after meeting with top Democrats in the Capitol, told reporters: "Reconciliation is a vehicle that's been used many times. This is a normal procedure."

The Democratic package would extend health coverage to 30 million uninsured Americans over 10 years, with a first-time mandate for nearly everyone to buy insurance. It would provide subsidies to help low-income people buy insurance, and it would impose several new requirements on insurers and employers.

Video: Has Obama tried to accomplish too much? It will be less expensive than the health care bill the House narrowly passed in November, and will contain no government-run insurance program to compete with private insurers.

Those changes might appeal to some of the three dozen Democratic House moderates who opposed the November version of the bill. The revised bill may die if none of those Democrats vote for it, because some Democrats appear likely to switch from yes to no because of a dispute over abortion funding restrictions.

Obama signaled a willingness to take a small step farther into the contentious issue of limiting lawsuits that allege medical malpractice. Plaintiffs' lawyers, a key fundraising source for Democrats, staunchly oppose such limits. But Republicans and many doctors have demanded them for years.

Obama's letter said he was open to appropriating an extra $50 million for pilot programs that experiment with specialized health courts rather than jury trials. A judge steeped in medical matters would hear evidence and render verdicts for patients alleging injuries from wrongful acts.

A plaintiff lawyers' group, the Center for Justice & Democracy, said it strongly opposes such health courts, calling them "anti-patient."

It was unclear Tuesday when the House and Senate might vote on the revised health care proposals. Some Democrats hope to do so before Obama leaves for a trip to Asia on March 20.

Data from a Democratic pollster has been circulating on Capitol Hill showing that opposition to the health care plan drops substantially when people learn more details about how it might help them. This is especially true of independent voters, who fear the plan involves too much government intervention until they learn more about it, the poll states.

Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Video: Will reconciliation work?

  1. Closed captioning of: Will reconciliation work?

    for younr looking skin: well, the president is in savannah, georgia, today. had to mention it one more time. talking economy. but tomorrow, yet again, a major speech on health care , this one promising to lay out the path forward for congress.

    >>> how many speeches on health care have there been? and there's basically only one path left. democrats are looking to use reconciliation , that senate procedure requiring e ining only a simple majority to get to the already passed health care bill. kent conrad joins us now. he chairs the budget committee and he's been very vocal about the use of reconciliation and when is it correct and when is it not correct to use. so simply, senator conrad , are you comfortable with this idea that the fixes will be done via reconciliation in the senate if the house passes the first senate health care bill?

    >> yeah. i think maybe this will help, chuck and savannah. reconciliation , as i've said all year, would not work for passing comprehensive health care reform . that's because of the byrd rule and other technical matters that i won't go into here. i'm happy to do it if you want to ask questions about it, but i think it would probably bore your listeners.

    >> oh, they've been bored by that for a long time.

    >> we put the parliamentarian on yesterday.

    >> we know about the byrd bath and the byrd rule.

    >> but we don't need reconciliation to pass comprehensive health care s7 reform, because it's already passed the senate with a super majority 60 votes. it's now waiting action in the house . the if the house passes it, comprehensive health care reform will then go to the president for signature. and ridiculous, the process which allows just a simple majority to pass legislation instead of a super majority will not have been used for comprehensive health care reform . but that doesn't mean there is no role, no potential role, for reconciliation . because as you know, members in the house and some in the senate would like to make further improvements to the bill. they'd like to improve the affordability, they'd like to improve the medicaid provisions. those could come in a reconciliation package from the house to the senate and be entirely appropriate. that's how reconciliation has been used many times with respect to health care . again, just to review --

    >> yeah?

    >> just to review, reconciliation would not have been used to pass comprehensive health care reform . it's not necessary since the senate has already voted on it and already passed it by a super majority . if it then passes the house , it will go to the president for signature with reconciliation not have been used.

    >> but, sir, what do you make of the argument, i think i heard it from senator kyl on one of the sunday shows, that essentially, reconciliation is somehow not legitimate in this scenario because it's being used as an end-run around the requirement for 60 votes. in other words, it's not the case where he, i think, cited welfare reform when there were more than 60 votes, they happened to proceed by reconciliation , but it wasn't because that was their only option, that they did not have the votes. what do you say to that argument?

    >> well, it's like he forgot about christmas eve . on christmas eve , the senate passed, without using reconciliation , by a super majority , 60 votes, fundamental health care reform . that package, as i said, now goes to the house . if the house passes it, goes to the president for signature, without reconciliation ever having been used. now, again, the house could then pass a package to improve the health care reform with matters that are only budget related. that was the whole intention of reconciliation , that it only be used for budget-related matters. and that would be absolutely consistent with how reconciliation has been done, by both republicans and democrats. remember, it's been used 22 times and 16 of those times, the republicans controlled the united states senate .

    >> senator conrad , there's no doubt a lot of senate democrats believe you know more about this budget process than anybody in the senate . so as you see these potential fixes that are going to be put under reconciliation , what is the one or two fixes that you're concerned with that the parliamentarian may have a problem justifying under the byrd rule?

    >> well, i think changes to a#g)tion would probably not be permitted under reconciliation and the byrd rule requirement. on the other hand, those things that are budget related, for example, improving the affordability provisions --

    >> so that's the only thing. only the abortion provision, you think, wouldn't follow -- of these potential fixes the house may send over, that's the only one you think is going to be hard to justify?

    >> well, i don't know all of what the house may be contemplating, so i can't comment in terms of all of the things they might do, but anything that doesn't score for budget purposes or anything for which the score is only incidental to the policy change or subject to automatic strike under the byrd rule.

    >> okay. and on senator bunning, sir, do you think he -- do you approve of what he's doing? he's saying, with look, if congress doesn't have the money to pay for something, this shouldn't come through. also, what do you think of his decorum. i suppose you heard about the flipping of the bird --

    >> another bird rule.

    >> what do you think of that?

    >> i don't want to go into another senator's decorum. but i'll just say on the merits, look, it would be very unwise to raise taxes or cut spending when the economy is this weak. 17% of the american people are either unemployed or underemployed. that is not a time that you raise taxes or cut spending. that would be bad economics. that's why the tradition has been for extending unemployment. that can be considered as an emergency in the congress without being paid for, because people recognize when you're in an economic downturn and you need to extend unemployment insurance , you don't raise taxes, you don't cut spending elsewhere. that would only deepen the economic downturn .

    >> but very quickly, senator -- but very quickly, senator conrad , on pay-go -- but very quickly, this is where this criticism comes to congress and pay-go. they're for pay-go unless they declare an emergency, making pay-go -- when is there not -- when can you not declare an emergency and get around pay-go rules?

    >> well, when something is not an emergency. when something is foreseen. for example, if you're looking at the ten-year census, it would not be appropriate to treat that as an emergency, because everybody knows the census has got to be done every ten years. but when there is a sharp economic downturn , the tradition has been that that is treated as an emergency. and there's a very good reason for it in economics. it would be bad economics to raise taxes, cut spending in the midst of an economic downturn . so i think senator bunning is just wrong on the economics of this.

    >> okay. senator kent conrad , chairman of the budget committee , it's nice to have you on the show, sir. we hope



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