While health care reform has been on the backburner since the election of Republic Senator Scott Brown (R-MA) ended the Democrats supermajority, President Obama is hoping to work with Republicans to save the health care bill.
This Thursday February 25, lawmakers from both parties are scheduled to go to Blair House, across the street from the White House, for a televised clash of health policy ideas. According to the New York Times, the White House planned this meeting as a “strategy to intensify its push to engage Congressional Republicans in policy negotiations, and to share the burden of governing and put more scrutiny on Republican initiatives.”
Mr. Obama challenged Republicans to attend the meeting with their plans for lowering the cost of health insurance and expanding coverage to more than 30 million uninsured Americans. Republican leaders said they welcomed the opportunity and called on Democrats to start the debate from scratch, which the president said he would not do.
Republicans are planning to propose making health insurance more widely available and affordable, by emphasizing tax incentives and state innovations, with no new federal mandates and only a modest expansion of the federal safety net. Some of the Republican goals for health care reform include:
– Not requiring employers to provide insurance.
– Opposing the Democrats’ call for a big expansion of Medicaid
– Allow insurance companies to sell policies across state lines
– Offer federal money as a reward to states that achieve specified reductions in premiums or in the number of people without insurance.
– Offer federal money to states to establish and expand high-risk pools, for people with chronic illnesses who cannot find private insurance at an affordable price.
– Changes in state medical malpractice
– Expand the use of health savings accounts, to cover routine expenses for people who enroll in high-deductible health plans.
– Expand the role of private insurance companies in Medicare.
– Help small businesses band together and buy insurance through trade associations and professional societies.
Some Republicans, like Senator Tom Coburn of Oklahoma and Representative Paul D. Ryan of Wisconsin, would replace the tax-free treatment of health benefits with a refundable tax credit for the purchase of insurance. They would also encourage the use of state health insurance exchanges.
Republicans and Democrats agree on the need to emphasize wellness and preventive health programs; to provide more transparency for price and quality data on doctors and hospitals; and to speed the approval of lower-cost generic versions of high-cost biotechnology medicines. Both parties also agree to require insurers to let dependent children stay on their parents’ policies through age 25 or 26, and to offer tax credits for two years to businesses with 25 or fewer employees to help them buy coverage.
Senator Lamar Alexander of Tennessee, the No. 3 Republican in the Senate, said Republicans favored “a step-by-step approach” focused on lowering health costs for families and businesses.
Senator Judd Gregg of New Hampshire, the senior Republican on the Budget Committee, suggested that there are two plans that could serve as a basis for compromise: a proposal that he developed called “Coverage, Prevention, Reform” — C.P.R., for short — and a bill put forward by Senators Ron Wyden, Democrat of Oregon, and Bob Bennett, Republican of Utah. His own plan is described in an op-ed piece on Yahoo with further details provided on his Web site (pdf), and Mr. Wyden and Mr. Bennett’s bill would end the tax exclusion for employer-provided health benefits and provide more choice and flexibility for consumers (pdf), including those who already have insurance.
Most media report that it is not clear that Republicans and the White House are willing to negotiate seriously with each other, and Mr. Obama has rejected Republican demands that he start from scratch in developing health care legislation. With the meeting shortly approaching, and Congress getting ready for mid-term elections, this may be the last full effort to keep the health care debate alive.
After Thursday’s summit we will know more.