‘Jumping-Off Point’: Will White House Posting Give Health Care a Shot in the Arm?

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February 22, 2010 7:00 AM

As what White House officials call “a jumping-off point” for Thursday’s bipartisan discussion on health care reform, on Monday at 10 am EST, on the White House website, officials will post the Democratic health care reform legislation that passed the Senate on December 24, 2009, and a list of changes they would like to make to that bill.

Some of the changes include more generous subsidies for low and middle income Americans to purchase health insurance, and a removal of the controversial Medicaid subsidies that Sen. Ben Nelson, D-Neb., secured for his state in order to win his vote.

The White House will also include a new proposal from Sen. Dianne Feinstein, D-Calif., that would give the Secretary of the Department of Health and Human Services the power to block insurance company premium increases if they don’t meet certain criteria, for states where regulators do not already have that authority. Feinstein came up with the proposal after news that the largest insurer in her home state, Anthem Blue Cross, was proposing premium increases of up to 39% on individual health insurance plans.

“This is our take on the best way to merge the House and Senate bills,” a senior White House official told ABC News. The official said the proposal was “informed by our conversations from negotiations” before Sen. Scott Brown, R-Mass., was elected, thus depriving Democrats of their 60-vote supermajority, as well as from subsequent discussions.

“We thought it would be a more productive meeting if we brought one consolidated plan to use as jumping-off point,” the official said. “We hope the Republicans do the same.”

By posting their proposals in such a form, White House officials are providing a roadmap for how they think they can best pass health care reform in the new post-Massachusetts Senate race reality: have the House pass the Senate bill, then use reconciliation rules requiring only a majority Senate vote to pass the “fix” to make the bill more palatable.

White House officials are thus signaling that Thursday’s discussion won’t be just a parlor to chat about health care principles, though they insist their minds will be open to incorporate some Republican ideas.

“Maybe we’ll sit across from each other and identify 10 things we can move forward on,” the official said. “We hope new ideas come to the table. The proposal we’re walking into the meeting with is not the same one we will walk out of the meeting with.”

Under the new proposal suggested by Sen. Feinstein, the HHS Secretary would work with state regulators to develop an annual review of rate increases. A new body called the “Health Insurance Rate Authority” would be created and would every year issue a report setting guidelines for reasonable rate increases. If proposed premium increases are not justifiable per those Health Insurance Rate Authority guidelines, the HHS Secretary or state regulators could block them.

The Democratic Senate bill includes a tax on insurance companies for high-cost health so-called “Cadillac” insurance plans, but the White House is not proposing as a “fix” the phased-out exemption for union members that had been worked out in post-Christmas negotiations to secure the support of labor unions.

Health insurance exchanges for consumers would be created at the state level, and all Americans would be mandated to have health insurance coverage. The bill expands Medicaid to cover those at 133% of the poverty level, adding 15 million to the Medicaid rolls.

The bill does not include a provision many House Democrats believe to be key to bringing down health insurance costs: a government-run “public option” to compete with private insurers. Rather, the Senate bill empowers the Office of Personnel Management, which administers the Federal Employees Health Benefit Program, to enter into contracts with private insurers so at last two multi-state plans in each health insurance exchange, including at least one offered by a non-profit.

As with the House bill, the Senate bill proposes insurance reforms, such as prohibiting insurers from being able to deny coverage because of a consumer’s pre-existing condition. The Senate bill also would limit the potential profits an insurance company could make by requiring insurers to spend around 85 cents of every dollar from premiums on medical care.

The language regarding abortion, also from Nelson, would allow women who receive government subsidies to purchase insurance policies that cover abortion, but they would have to write separate checks. In some ways this is less restrictive than the House language from Rep. Bart Stupak, D-Mich., that would prohibit women who receive government subsidies from taking out plans that provide abortion coverage.

House Speaker Nancy Pelosi, D-Calif., has signaled to the White House that it’s unclear if there are enough votes in the House to pass the Senate bill.

The House version passed in November by a vote of 220-215, but since then three “yea” votes have vanished: Rep. Robert Wexler, D-Florida, retired; Rep. John Murtha, D-Penn., passed away; and Rep. Anh “Joseph” Cao, R-Louisiana, has signaled he will not vote for the final bill.

That puts Pelosi in a starting-off point of 217 votes which is a majority of the current 433-member House of Representatives, but is also a tough starting line given the prevailing political winds and the lack of desire of many House Democrats to re-enter this discussion at a time when many Americans want the Capitol to focus on job creation.

Other senior Democrats argue that passing nothing will be a worse option, politically speaking, because Democrats have already been branded with the caricature of the bill.

Pelosi believes passing the bill is “possibly doable,” the senior White House official said. “But she may ultimately decide the math is impossible.”

Were that to happen, White House official plan on pushing for a more modest bill, perhaps including the insurance reforms, some tax breaks for small businesses to help provide insurance for employees, a more modest expansion of Medicaid, and the creation of the health insurance exchanges.

Watch our GMA report here:

-jpt

February 22, 2010 in health care, Obama, Barack, White House | Permalink | Share | User Comments (25)

User Comments

JOBS JOBS JOBS sort of a forgoten promise huh.

Posted by: joe averagae | Feb 22, 2010 8:41:33 AM

Forgotten by the Republicans, for sure, and the broken Senate. The House has already stepped up.

Posted by: deanna | Feb 22, 2010 8:58:34 AM

Lastly any plan that does not start with controlling the cost of health care procedures is a PLAN TO FAIL.

Posted by: rick1957 | Feb 22, 2010 8:47:51 AM

Atul Gawande, a well-respected medical writer for the New Yorker wrote a great article awhile back called Testing, Testing, which undercuts your message and talks directly about the pilot programs included in the Senate health care reform and how they all tackle medical inflation and the cost curve, and may be one of the best ways to do just that. You might want to read it and open up your mind, because there are three major issues– a growing number of uninsureds, cost and, of course, consumer protections. Cost also gets at various inefficiencies.

Posted by: progressive mama | Feb 22, 2010 8:56:42 AM

Good try Obama. Lets see if we can take the same old bill and put it in a different box and wrap it up real nice and then maby the American public will be dumb enough to buy it????? DUH.

Posted by: Billy Bob | Feb 22, 2010 8:54:38 AM

That is arrogance! It is saying to the American people: “You don’t know anything! I know better than you do!”

—

Oh sheesh. The arrogance canard again.

As Steve Benen at the Political Animal blog for Washington Monthly puts it: “Is it “arrogant” for GOP lawmakers to take positions that run counter to public attitudes? Americans didn’t want to see escalation in Iraq in 2007 and Republicans said, “Well, we’re going to give it to you anyway.” Americans didn’t want to see federal lawmakers intervene in the Terri Schiavo case in 2005 or spend time working on an anti-gay constitutional amendment in 2006, but Republicans said, “Well, we’re going to give it to you anyway.” Americans weren’t especially fond of the bank bailout in 2008, but that didn’t stop Mitch McConnell from voting for it, effectively telling Americans, “Well, we’re going to give it to you anyway.”

The inverse is true, too. Americans support reforming the way Wall Street does business, passing a climate bill, and ending “Don’t Ask, Don’t Tell.” In each instance, McConnell, apparently feeling “arrogant,” has decided to tell the country, “Well, we’re not going to give it to you anyway.”

Even someone of McConnell’s limited skills should be able to understand this — Democrats were elected to tackle health care reform. So, they’re trying to do that. This isn’t “arrogant”; it’s policymakers following through on their promises to the electorate.”

Posted by: political mama | Feb 22, 2010 8:52:23 AM

This is merely a rehash of the mess made by a closed underhanded process. It is interesting that rather than say that Mandated purchase has ever failed to control cost where ever it has been tried (see Massachusetts where ABC reports as much a 40% increase in the cost of policies) and that Mandates are very likely to be found Un-Constitutional. He Proposes a rate board.
What they have come up with is the system that is Bankrupting Massachusetts right now. As a result of this system Ma has the most expensive health care in the nation and the most expensive health care insurance.
If the President were actually serious about Health Care Reform he would acknowledge the following: The process used so far has alienated the american public. The lack of real public forums and use of canned audiences in Phone forums and the fact that many Democratic congressman hid from the people they are supposed to represent have given ( Paul Hodes for example) American as a whole that his version of Health Care reform as little more than a political stunt.
Real reform will come from exploration of the issue in open public forums . Know that it will take a year for the lunatics on either side to stop screaming.
Another year or 2 for a plan that is acceptable to all Americans.

Lastly any plan that does not start with controlling the cost of health care procedures is a PLAN TO FAIL.

Posted by: rick1957 | Feb 22, 2010 8:47:23 AM

Anyone want to guess how many pages are in this plan?

Posted by: JoeHanson | Feb 22, 2010 8:44:16 AM

JOBS JOBS JOBS sort of a forgoten promise huh.

Posted by: joe averagae | Feb 22, 2010 8:41:33 AM

Americans have rejected this type of health care legislation since 1912. The sooner that Obama realizes this, the sooner we can move on to more pressing issues such as JOBS!

Posted by: Alex | Feb 22, 2010 8:39:54 AM

THIS IS JUST AN END AROUND FOR MORE BIG GOVERNMENT INTRUSION INTO THE LIVES OF THE AMERICAN PEOPLE. SCRAP THE BILL AND START OVER>>>>>>>>>

Posted by: joe averagae | Feb 22, 2010 8:36:46 AM

Well, did I miss something? I thought the American people already rejected this bill! And from what I understand it will be difficult for it to pass the house. What part of “we don’t want it, Mr. President, doesn’t Obama understand?” That is arrogance! It is saying to the American people: “You don’t know anything! I know better than you do!” And I know the liberal/progressive/socialists believe that, but we don’t!

Posted by: FanDaElis | Feb 22, 2010 8:32:17 AM

Oopsie, when they post this it will be seen clearly that GOP ideas have indeed been incorporated. This will create issues with the right trying to say otherwise. Well, it would with thinking people. Their base will believe anything they are told.

Posted by: secondlook |
—-How about you telling us what ideas from the Republicans have been incorporated???? Were waiting.

Posted by: Billy Bob | Feb 22, 2010 8:27:08 AM

“If proposed premium increases are not justifiable per those Health Insurance Rate Authority guidelines, the HHS Secretary or state regulators could block them.”

Yay socialism.

Posted by: Jon | Feb 22, 2010 8:20:31 AM

Posted by: secondlook | Feb 22, 2010 8:11:33 AM

When other high-income nations, like Switzerland and Taiwan in the 90′s, realized their health care systems did not get the job done, they set up commissions, isolated from lobbyists, political posturing, etc. to get the job done and ended up providing universal coverage – in Switzerland’s case with PRIVATE insurance – with comparable quality to the USA and for almost 1/2 the GDP cost.

As long as Congress’s masters among the special interests won’t allow them to let it out of their hands, we won’t get any significant improvement on the costs of health care.

And as long as the American public will continue to support or complain about certain aspects of reforms without having done 5 minutes of googling to understand the positions and possibilities better, Congress is going to be able to make up catchy slogans like “death panels” (never existed) and “private insurance is cheaper than public” (Medicare pays private insurers 13% more per patient to run the alternative Medicare Advantage than the government does for the equivalent Medicare B) and “public option” (some countries like Japan have absolutely NO government insurance and do fine – by requiring non-profits to provide primary coverage). But, people hear what the want to hear, so as long as Congress wants to delay the gouging of Americans by health care for the benefit of the special interests, it will go on.

This “jump-off” point bill will NOT go anywhere even if it was written by a committee of Jesus of Nazareth, Moses, Mohammad, and the Buddha. The GOP is NOT going to give the Dems any victory at all before the November elections.

So the many of you who screamed all last year, “I like my health insurance the way it is,” can expect another huge jump in premiums, a jump in copays and deductibles, and greater restrictions in 2011 coverage in your policy that, in 2010, is already no longer “the way it was” in 2009.

Posted by: The_Mick | Feb 22, 2010 8:10:32 AM

RE: Jonny

Yes, in fact they do have similar laws — mandating what is covered (don’t want chiropractry? Too bad, you pay for it), staffing (the nurses union got 5 patients per nurse down to 3, now want it to 2), and so much more.

A “right-wing” proposal? Tell insurers they MUST provide “skinny” policies based on age/sex (the norm) and covering a CORE set of care — ie. stuff nobody wants (splenectomy, chemotherapy) and therefore make insurable risks.

Too much of healthcare costs are the result of misaligned incentives — put another way, if you want a Power Chair from the Scooter Store, PAY FOR IT!

Posted by: Thomas Paine | Feb 22, 2010 8:09:50 AM

Obama needs to make Republicans an offer they shouldn’t refuse, but will. The GOP is going to walk away from anything for the simple reason that it is Obama and the Dems proposing it.

Say that tort reform and some other centrist measures will be in a final bill and publicize it, then let the GOP deal with the consequences.

Posted by: matt | Feb 22, 2010 8:07:46 AM

What about removing all the pork that is attached to this bill?

Posted by: jt | Feb 22, 2010 8:06:29 AM

I am so sick and tired of paying high cost for my health insurance,rising copays and less coverage.I am a CNA in a hospital,making 14.00 an hour.I have a son with disabilities.Why do I have to pay so much out of pocket?Does Congress have this problem? NO! So stop sitting around picking your noses,and do the job you were elected to do.Help the American people with this weight on our shoulders.

Posted by: MadMom | Feb 22, 2010 8:00:47 AM

Is it me or are the Democrats rather suicidal over pushing a very flawed health care bill? The American public doesn’t appear to hold high value to this, why are the Dems?

Well… as always this is going to be fun to watch.

Posted by: Denbo | Feb 22, 2010 7:55:46 AM

The only thing transparent about the latest health care “reform,” is that now that Obama has a hint of what the Republicans want, he’s going to “publish” his NEW ideas. That’s right, you’ll likely see the GOP ideas as part of his NEW post. So why is he now going public? He wants to claim them as his own, forcing any Republican who crosses the line to support their own ideas to give him the credit in public.

Posted by: wantingbalance | Feb 22, 2010 7:42:36 AM

More source:

President Obama's Health Care Plan to Post Today Ahead of ...
The Business of Health Care - Prescriptions Blog - NYTimes.com
War Room - Salon.com
Marc Ambinder - Authors - The Atlantic

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Submited at Monday, February 22nd, 2010 at 2:01 pm on Politics by Demoli
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