Obamacare Goes Beyond Federal Lawmakers' Constitutional Powers

5 Things to Watch at Obama's Health Care Summit

February 25, 2010

TIME - Will Thursday's much-anticipated health care summit be much more than a political show? Probably not. Will it make any difference in the prospects for health reform legislation? That's entirely possible.

While it is being billed as a negotiating session, the six-hour meeting will in fact give Republicans and Democrats a chance -- perhaps their last one -- to lay their best arguments before the American people. For the White House, it is also a badly needed opportunity to change the dynamic around the President's signature domestic policy initiative, support for which has been sinking in public opinion polls.

What's Up Obama's Sleeve?

The whole exercise on Thursday is being framed as a bipartisan outreach. But there was one thing missing from the health care proposal that President Obama put forward on Monday: Any new ideas that might appeal to Republicans.

Has Obama been holding back? He is certain to make the point that a number of ideas that have been put forward by Republicans in the past have already been incorporated in the bill -- including, a requirement that individuals buy health insurance [which many Republicans lately have been decrying], and a new marketplace where individuals can shop for coverage ...

Stagecraft

In public, the Republicans have been dismissing the health care summit as meaningless. But if you want an indication of how seriously they are actually taking it, consider how much attention they are giving to the smallest details.

First, there was the question of a podium. They insisted that there not be one.

"We don't want any more of that Professor Obama lecturing to us," one GOP staffer told Politico.

And where the White House originally proposed a U-shaped table, the two sides ultimately settled on a hollow rectangular shape. Why? Because then there would be no head position ...

Who's Not There?

This is President Obama's summit and discussion will largely revolve around Democratic plans for health reform. But Republicans aren't totally out of the driver's seat -- even if they have decided not to present a unified competing proposal, they still control who they bring to the table. The President gave House and Senate leaders freedom to choose 16 additional members of Congress to attend the summit beyond those on the initial invite list. Which members were tapped to suit up, however, may be far less interesting that who had to stay on the bench.

Notably absent from the Republican list is Olympia Snowe. She is the only Republican in the Senate to have voted in support of health reform in 2009 -- for the Senate Finance Committee bill -- and her presence would have sent a major signal that the GOP is serious about bipartisanship. (The White House independently invited Snowe on Wednesday, but she deferred to her leadership and will not attend.) Also left behind is Judd Gregg, a retiring, independent-minded Republican Senator who's serious about comprehensive health care reform and has been touting his own plan -- which would tax some health benefits and require individuals to maintain coverage -- in recent weeks ...

No staff members from the Congressional Budget Office or the Joint Committee on Taxation, which advise Congress on the budget and tax revenue, will be on hand.

Tone

... In recent days, Senate Majority Leader Harry Reid has told Republicans to "stop crying" over reconciliation, the process by which his body may try to pass health care reform with only 51 votes ...

Pelosi's Mood

For all the talk of bipartisanship that you will be hearing on Thursday, the simple fact is that the health care bill, if it passes, will get to the President's desk on Democratic votes alone. The fate of the legislation very much hinges on whether the House Speaker can convince 217 members of her caucus to vote for the Senate-passed version of the bill.

As it stands, the bill could not pass her caucus, the Speaker has said. But the legislation that Obama proposed on Monday nudges the Senate bill to the left, in ways that would make it more acceptable to the House. Most important is the scaling-back of the "Cadillac Tax" on high-priced insurance policies. That change -- and the others outlined in the Obama plan -- would be accomplished on a second piece of legislation, which would be put before both houses under a controversial procedure misnamed "reconciliation." It would require only 51 votes, rather than the 60 it typically takes to overcome a filibuster in the Senate.

So keep an eye on Pelosi -- what she says, her body language, what ideas she brings to the table. Does she sound confident? Combative? Determined? And what is the dynamic like between Pelosi and Senate Majority Leader Harry Reid? Therein may lie the clues as to whether this conference is leading anywhere at all.

Rep. Price Derides Health Care Summit

February 12, 2010

The New York Times Blog - In some of the harshest criticism yet of the effort by Democrats to overhaul the nation’s health care system, Representative Tom Price, Republican of Georgia and chairman of the conservative Republican Study Committee, on Friday dismissed President Obama’s bipartisan health care session as “simply an attempt by the president to use the White House as a political tool to intimidate his way into a government takeover of health care.”

Representative Tom Price of Georgia.In an opinion article on the conservative Web site BigGovernment.com, Mr. Price, who is a doctor, said:

“The American people and Republicans in Congress will not be taken by this Chicago-style politics.”

He accused Mr. Obama of “pretty audacious spin” by portraying Republicans “as the obstructers to health care passage.” And he called “laughable” the assertion that Democrats included Republicans ideas in their legislation.

For days, Congressional Republicans have voiced apprehension about the half-day session that Mr. Obama has invited them to attend on Feb. 25. The House Republican leader, Representative John A. Boehner of Ohio, has urged Democrats to scrap the bills approved late last year by the House and Senate and agree to start over at the meeting.

Mr. Obama has rejected that demand, and Democrats say it is evidence that some Republicans only want to destroy any chance of passing health care legislation this year.

Mr. Price began his op-ed by suggesting that Mr. Obama was running out of options to save the health care legislation.

“Oh, the president must be really desperate,” he wrote.

But while Mr. Price rejected assertions that Republicans were blocking the legislation, the Democrats’ effort is stalled because Senate Republicans, who now control 41 seats, have pledged to filibuster the bill ...

In attacking Mr. Obama and seeking to reduce the chances of any agreement coming out of the bipartisan session, Congressional Republicans may leave themselves vulnerable to criticism that they were not willing to negotiate in good faith.

And given that the existing bills were already approved by a majority of both chambers in Congress, the unwillingness to debate specific policy points could give Democrats the cover to push through changes to the health measures as part of an expedited budget bill, a strategy that could overcome the Republicans’ filibuster threat ...

Virginia Moves to Block Federal Insurance Mandate

February 2, 2010

The Hill's Blog Briefing Room - Virginia may become one of the first states to shield its residents from a proposed federal requirement that they purchase health insurance.

A bill that cleared the Commonwealth's Democratic-controlled Senate -- and could soon win approval in the Republican-dominated lower House -- would exempt Virginians from congressional lawmakers' proposed individual mandate.

That requirement is a key feature in Democrats' stalled healthcare reforms, members say. While lawmakers could still strip it from their final bill as negotiations continue, Democratic party leaders have long maintained it is essential to ensure universal coverage and ultimately drive down national healthcare costs.

However, the mandate has proven exceptionally unpopular to healthcare critics on both the left and right. Liberals feel the mandate functions as a gift to private insurers, who would profit from an insurance requirement not linked to a public healthcare plan. Meanwhile, conservatives stress such a requirement is beyond federal lawmakers' constitutional powers -- a argument some GOP attorneys general could soon bring before courts.

That trepidation, combined, prompted Virginia to move this year to exempt local residents from the individual mandate -- a proposal that already seems to have Gov. Bob McDonnell's early support.

"I think the General Assembly is doing what they believe is right for the citizens of Virginia," McDonnell (R) told reporters on Monday. "And, like them, I oppose these broad, costly federal mandates that undermine the ability of Virginians to create more access at less cost."

Last year, McDonnell signaled more clearly he would support such an exemption.

But Virginia is hardly the only state to pursue such a measure. Since last year, 28 other states have introduced legislation or filed ballot measures that would in some way limit the effect of Democrats' healthcare bills, according to the National Council of State Legislatures. However, the constitutionality of each of those measures -- Virginia included -- remains in question.

Obama Endorses New Wealth Taxes, More Drugmaker Fees

February 22, 2010

Bloomberg - President Barack Obama, seeking to break an impasse over health-care legislation, proposed a plan that includes the first Medicare tax on unearned income such as capital gains and higher fees on drugmakers, while scaling back a levy on high-end benefits.

The measure released today marks a reversal from months of leaving the legislation’s details largely up to congressional Democrats, who have failed to agree on a plan. Obama relied mostly on a Senate bill passed in December, with elements of a House version passed in November.

The plan to cover 31 million uninsured Americans presents a challenge to Republicans before a Feb. 25 meeting at Blair House, across the street from the White House. Obama invited leaders from both parties and called on Republicans, who have almost universally opposed the Democratic plans, to offer their own “comprehensive bill” to extend coverage and reduce costs.

“We view this as the opening bid for the health meeting,” said Dan Pfeiffer, the White House communications director, on a conference call with reporters today. “The president is coming to the meeting with an open mind. He hopes that the Republicans do, too. Our hope is to find some areas of agreement.”

Republicans have criticized the Democratic legislation, saying it’s too expensive at about $1 trillion over 10 years, that it unfairly forces people to obtain insurance, and will lead to government domination of health care. The White House says the program will be fully paid for with taxes and savings.

Using Reconcilation?

House Republican leader John Boehner said today Obama was undermining the Feb. 25 meeting with his plan.

“The president has crippled the credibility of this week’s summit by proposing the same massive government takeover of health care based on a partisan bill the American people have already rejected,” Boehner, of Ohio, said in a statement.

To sidestep Republican opposition, the Democrats may use a procedure called reconciliation, which would require just 51 Senate votes to pass as long as the bill dealt only with revenue and spending issues. Pfeiffer said the possibility of using reconciliation played a part in the design of the White House plan and gives Democrats “flexibility” ...

Too Much Regulation

The trade group America’s Health Insurance Plans called on the White House to include “system-wide reforms to control the rapid increase in the underlying cost of medical care.”

“Creating a new duplicative layer of federal premium regulation on top of what states are already doing will only add regulatory complexity and increase health-care costs,” said Robert Zirkelbach, a spokesman for the Washington group.

Obama also eliminated a Senate provision that gave special aid to Nebraska to help the state cover additional costs for Medicaid, the government health program for the poor. Instead, he said he would provide greater assistance to all the states.

The president said he was proposing changes that would give more aid to Americans to help them buy insurance. Under his plan, families making between $66,000 and $88,000 a year would pay no more than 9.5 percent of their income in premiums.

He came down on the side of the Senate on the issue of how new online purchasing exchanges should be set up, opting for a state-by-state system rather than a national version. House leaders argue that state exchanges wouldn’t be as effective.

He also sided with the Senate in avoiding a mandate on employers to offer insurance while including a penalty for large companies whose employees end up buying taxpayer-funded insurance. Under his plan, companies with more than 50 workers who don’t offer coverage would be subject to a fee of $2,000 per worker, minus the first 30 employees ...