The draft legislation, based largely on the Senate’s healthcare bill and including several concepts from the House bill, would extend coverage to 31 million Americans at the cost of $950 billion. While the White House estimates it would actually reduce the deficit by $100 billion in 10 years as a result of spending cuts and new taxes, very few members of Congress, whether Democrat or Republican, seem to perceive it will truly reduce costs.
The Congressional Budget Office has not yet scored the plan, and most lawmakers seem to agree that these savings are unlikely to materialize. Dramatic cuts in Medicare payments included in the legislation are likely to be revisited over the next 10 years, likely reducing the savings the plan will ultimately provide.
The Wall Street Journal Health Blog reported that the summit produced “no significant breakthroughs,” and the New York Times reported both parties remained divided at the end of the summit.
According to a New York Times’ article:
Republicans said there was no way they would vote for Mr. Obama’s bill, and Democrats were talking openly about pushing it through Congress on a simple majority vote using a controversial parliamentary maneuver known as reconciliation (Feb 25, 2010).
Although the summit was promoted as an forum for reconciling legislation, Washington Post’s Michael Gerson called the Democrats outreach a “sham”:
By signaling a willingness to use reconciliation in passing a Democrat-only bill, Democratic leaders have revealed their outreach to be a pose, a sham. The purpose of reconciliation is to dramatically reduce the influence of Republicans and moderate Democrats in the Senate negotiating process (Gerson, Febuary 25, 2010).
For a discussion of 12 key concepts in President Obama’s proposed healthcare bill, click here.
2. There is a very clear divide between Democrats and Republicans as to whether healthcare reform should be approached with a comprehensive plan or on a more issue by issue basis. President Obama vowed to move forward with plans for sweeping legislation with or without Republican support, and “chided Republicans for advocating ‘baby steps,'” according to the New York Times‘ report.
The Republicans, in contrast, advocate addressing healthcare on an issue by issue basis beginning with issues where there is very broad agreement (e.g., not permitting the denial of coverage to people with pre-existing conditions). Most Republicans contend that the best way to fix healthcare is to start over. House Minority Leader John Boehner (R-Ohio), for example, called for current Democratic legislation to be “scrapped,” according to a report by the Wall Street Journal.
The Republicans, even if there are parts of the bills they agree with, generally seem uninterested in providing the President a large legislative victory, even if it may harm Democrats in the November elections. While they may not admit this explicitly, it is pretty clear they do not want to provide the President with this victory.
Despite Republican calls for beginning anew, the Democrats may try to push ahead, using the budget reconciliation process if necessary, according to statements by President Obama and other high-ranking Democratic leaders in this regard. It is unclear whether President Obama actually has the votes to achieve this.
For a discussion of the budget reconciliation process, click here.
3. Despite vows by Democrats to push ahead, it remains unclear whether or not Speaker of the House Nancy Pelosi will have enough votes to push forward legislation based on the Senate bill. If Democrats use the budget reconciliation process, the House must pass the Senate bill or some type of legislation advanced by President Obama, which is likely to be based largely on the Senate bill. Although the House needs only a majority vote to move the legislation through, remember that the original House bill passed 220-215 in Nov. 2009, with 219 Democrats and one Republican, Anh “Joseph” Cao (R-La.), voting in favor, according to a Wall Street Journal report. Since then, a handful of Congressmen have said they no longer will vote for legislation based on the Senate bill.
Moreover, in a show of either political smarts and/or a lack of political courage, Speaker Nancy Pelosi has signaled to Senate Majority Leader Harry Reid that he ought to try and pass reform legislation among Senators first.
4. Moderate Democrats, including those representing moderate to, in some cases, Red states, are in a very bad spot, politically. As Democrats push to move legislation ahead and Republicans work to block it, moderate Democrats will face difficult decisions regarding whether or not they align with the left wing of their party or side with the constituents of their states.
Some, as a result, are simply choosing to quit politics for the time being and not run for office this November.
5. While both parties remain largely divided, there was a general consensus on some issues. Both parties generally agreed that some type of legislation to curb medical malpractice suits would be included in final legislation. Here, the Republicans drove the issue with President Obama yesterday agreeing to address it in some form. Both parties also generally agreed that legislation should prohibit insurers from denying healthcare coverage to individuals with pre-existing conditions, according to the Wall Street Journal Health Blog report. However, these areas of consensus did not help to move either party toward agreement on how to address them, thereby failing to build consensus on any particular language that could be included in legislation.
