Opinion: Obama's Health Bill Aims to Win Reluctant Dems

(Feb. 22) -- In an effort to present a united Democratic front ahead of Thursday's bipartisan health care summit, the White House has released a $950 billion proposal bridging the differences between the House and Senate health care bills.

But President Obama's plan isn't designed to attract Republican support. The White House is hoping to win over House and Senate Democrats.

While administration officials insisted that the president hasn't determined "on which path to move forward with," the substance of his plan suggests that Obama hopes to bypass a prolonged Senate debate and use the reconciliation process to amend the Senate bill and convince reluctant House progressives to pass the Senate legislation.

To that end, Obama's plan improves the Senate bill's subsidies for lower-income Americans, increases the threshold on the excise tax and gives businesses more time to adapt to the policy. The proposal closes the donut hole in Medicare Part D and ensures that grandfathered policies -- which allow people who like their coverage to keep it -- adopt important new consumer protections.

The proposal also eliminates the so-called Cornhusker Kickback and provides full federal funding for Medicaid expansion for four years starting in 2014. Between 2018 and 2019, the federal government will pay 90 percent of the cost of the expansion and provide extra funds to states with generous Medicaid programs.

Importantly, the plan also includes a provision that would let the federal government review and deny excessive, unreasonable or discriminatory health insurance premium increases. It also prohibits insurers from dramatically increasing rates before comprehensive reform is implemented.

The president's move to the left is not insignificant, but it's not clear if it will be enough to sway reluctant progressives, angry at the White House for abandoning the public option, cutting a deal with Big Pharma and almost leaving reform at the alter in the aftermath of the Massachusetts election.

Obama's proposal does not include a public option. It retains the Senate bill's state-based exchanges and keeps the start date for most reforms at 2014. The plan also fails to endorse the House's push for repealing insurers' special antitrust exemption.

While Republicans have predictably responded to the White House plan by demanding he abandon his proposal and adopt all of the GOP's suggestions, House Democrats have only -- and unenthusiastically -- acknowledged the release.

The chairmen of the three House committees with jurisdiction over health policy -- Reps. Charles B. Rangel, D-N.Y., George Miller, D-Calif., and Henry Waxman, D-Calif. -- issued a general statement praising Obama for "moving in the right direction." House Speaker Nancy Pelosi, D-Calif., also only went so far as to say that Obama's plan "contains positive elements from the House- and Senate-passed bills."

Only Rep. James Clyburn, D-S.C., who had not yet seen the proposal, suggested that the House may have enough votes to pass the Senate bill with Obama's fixes.

Ultimately, however, that will depend on Obama's ability to sway enough House progressives to accept his compromise.

Igor Volsky is a health care researcher at the Center for American Progress and blogs at the Wonk Room, www.wonkroom.org.


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