Health Care: The White House Readies Its Own Plan?

The signals are growing louder that the Obama White House is readying its own health care plan in advance of next week’s summit. Press secretary Robert Gibbs fueled the speculation in his briefing yesterday. Asked about the possibility, Gibbs replied: “Stay tuned.”

If so, it would be a sharp break from the strategy that the White House has followed thus far, which is to let Congress work out the details of the legislation. As Steven Pearlstein (one of President Obama’s favorite columnists) pointed out in this morning’s Washington Post, that has been part of the problem:

Over the past year, Obama’s singular mistake was to think he could rely on the Democratic leadership and a Democratic majority in Congress to deliver on his electoral mandate. Caught in crossfire between the House and Senate, liberals and centrists, Democratic special interests and independent voters, he wound up raising too much doubt about his most fundamental promise — to change the way business is done in Washington. Worse still, he wound up convincing members of Congress that he needed them more than they needed him.

It should be obvious now that the president cannot leave it to Congress to sort things out.

Right now, what is needed, more than a new policy, is something that can break the deadlock over process. I got into all of this a couple of weeks back, and not much has changed. House Democrats continue to insist that the Senate pass a reconciliation bill amending the Senate-passed legislation, before it will consider taking up the underlying bill. But the Senate Democrats and the White House believe that is simply impossible to pull off, because even under reconciliation rules, Senate Republicans could bog down the measure with unlimited amendments. So what Obama feels he needs now is something to change the dynamic.

So what might that White House plan look like? There are two schools of speculation. The first is that the substance will not yield much by way of surprises. Before the Massachusetts election put the entire effort on life support, negotiators for the House and Senate were pretty close to a deal.

One official told me that a White House measure is likely to look very much like the Senate bill, with a few changes: It would be stripped of some of the controversial special deals, such as the now-infamous “Cornhusker Kickback,” and there would be instead a more equitable provision to help states deal with their increased Medicaid costs. There would also likely be some kind of revision (and probable retrenchment) on the deal that was struck with the unions on the “Cadillac Tax.”

Then there is the second possibility: Triangulation, and a last-ditch effort to bring aboard some Republican votes. What many Democrats on Capitol Hill most fear right now–despite Obama’s promises to the contrary–is that this new bill would be a dramatic scaling-back of the whole endeavor, to a more piecemeal approach that would not go nearly as far to cover the uninsured. At the same time, however, some suggest that this is a bow to political reality. “If he doesn’t do this, nothing is going to get done–nothing,” says one veteran Democratic strategist in the House.

Related Topics: House, steven pearlstein, white house health care plan, Barack Obama, Congress, Health Care, Republican Party, Senate
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  • kevin

    Dear God, please not triangularization. They’ve already compromised a great deal with Republicans, and they’ve been rewarded with zero support.
    .
    When will the White House realize that Republicans won’t take yes for an answer?

  • nflfoghorn

    Oh, NOW he decides to lead on this. Great.

  • kristiia

    Karen – so they don’t think Reconcilliation is an option anymore? Can’t they do it going into a vacation and if the Republicans want to make Amendments go on and on then there can be no break.

    They better just get ready for a marathon and do it.

  • stuartzechman

    So what might that plan look like? There are two schools of speculation.

    Well, if we’re only speculating, then there’s no need to specifically worry about the White House proposing the unpopular Senate bill or going back to the failed Baucus strategy, right?

  • http://theblindspotsofgod.wordpress.com lawyermommy

    The Democrats are a sorry bunch. The Healthcare bill in large part has failed because of the Blue, Yellow, progressive and disconnected Democrats.

    They were unable to gauge the serious ramifications of the NOW near certain failure of the Healthcare reform plan on this Presidents agenda, preferring instead to focus on their own re-election prospects.

    I hope most these Democrats in congress know that their fate is inevitably tied to his own and if he fails, their prospects for re-election could be affected by his failure.
    Emmmm…..The Anti-Obama sentiment can be used in a subtle way to thwart the re-election of many of these discombobulated, greedy and confused Democrats.

    I still think the President can reign them in much better than he has done thus far. The Democrats are beginning to look sillier than the Republicans—this is not a good thing!

    LM

    http://theblindspotsofgod.wordpress.com/2010/02/15/stalking-criminality-the-law-and-women/

  • http://twitter.com/ktumulty Karen Tumulty

    The question is whether you do reconciliation first, which is what the House demands, or you do it after the underlying Senate bill is passed and reaches the President’s desk, which is what the Senate and the White House say has to happen. Both houses say they simply don’t have the votes to do it the way the other one wants.
    .
    Ah, the legislative process…

  • Paul-no not that one

    “Then there is the second possibility: Triangulation, and a last-ditch effort to bring aboard some Republican votes”
    .
    I can’t tell if my tears are from laughing or crying.

  • stuartzechman

    KT:

    What many Democrats on Capitol Hill most fear right now…is that this new bill would be a dramatic scaling-back of the whole endeavor, to a more piecemeal approach that would not go nearly as far to cover the uninsured.

    Who are these “many Democrats”?
    .
    What kind of Democrat are they, i.e. are they the Ron Wyden kind of Democrat or the Max Baucus kind of Democrat? Is Bernie Sanders worried or is Blanche Lincoln?
    .
    When you say they’re worried about an approach that “would not go nearly as far to cover the uninsured,” is that code for worries that Obama won’t include questionably popular measures like the individual mandate –after Senators have already voted for it?

  • http://twitter.com/ktumulty Karen Tumulty

    Some of them are in leadership offices. I can’t be more specific than that.

  • stuartzechman

    Completely understood, KT.
    .
    Thanks so much.

  • Paul-no not that one

    A shame we need to rely on anonymous sourcing for simply voicing concerns.

  • kbanginmotown

    The optimist in me sees this as an opportunity for Obama to provide political cover to Dems who seem to feel that they are making a tough vote.
    .
    The pessimist in me believes that the *moment* that Obama releases the his plan, Ried, Pelosi and 433 other posers are going to tut-tut about the WH interfering in the legislative process, take pot-shots and nit-pick the plan, and the proceed to either announce or treat it as DOA.

  • allthingsinaname

    “What many Democrats on Capitol Hill most fear right now…is that this new bill would be a dramatic scaling-back of the whole endeavor, to a more piecemeal approach that would not go nearly as far to cover the uninsured.”
    .
    .
    Sounds like they have finally found out what Obama is about. Bend until you break

  • charlieromeobravo

    Well, the blue dogs and progressive Dems definitely haven’t made things easy. Sometimes I wish that the Dems would show the sort of party unity that the Republicans do but in the end I respect the intraparty differences and debate than I do the forced conformity that Republicans practice. Any Republican that deviates from the party platform ends up walking back on their statement which makes me think that they value party support during elections more than they do their personal convictions.
    .
    Obama could have avoided this had he not left things up to our broken congress. His approval ratings were so strong after the election that he could have promised political cover to some Dems and used the bully pulpit on others. Having more specifics at the outset would have given him firm facts to use to counter Republican lies about the intent and practical effects of the legislation too. I can understand not wanting to repeat Clinton’s mistakes but clearly going 180 degrees from that approach hasn’t worked out all that much better.

  • http://journeyhomeburke.wordpress.com/ journeyhomeburke

    The golden rule – the guy with the gold makes the rules – is what governs this Country – everything else and I mean everything is window dressing. Stop wasting time arguing among yourselves and focus on solutions –

    Everyone – everyone agrees health care is crippling the overall economy bleeding the middle class and making business less competitive – here’s a solution to HELP those of us not in politics and who could give a hoot over which side scores political points – vote your pocket books!

    “Use Senate reconciliation and expand Medicare via the Senate’s buy-in provisions. The CBO has already signed off on this as a means of saving money.

    More importantly, if more Americans can do a buy-in with Medicare, it creates more cost control (because there’s a genuine “public option” competitor).

    It also helps to solve the problems of pre-existing conditions, because Medicare does not deny coverage on this basis.

    Allowing a Medicare buy-in to Americans under 65 would give people a genuine alternative to private insurance and thereby render the pre-existing question moot.

    It would also lower Medicare costs by expanding the risk pool of patients (the great bulk of medical expenses are accounted for by a small number of people, mostly the elderly, requiring very expensive treatment).

    And it would substantially enhance the global competitiveness of American corporations. After all, in what other country in the world is health care a marginal cost of production for business?” – Roosevelt Institute Marshall Auerback

  • 70northsullivan

    Amen!

  • shepherdwong

    “Use Senate reconciliation and expand Medicare via the Senate’s buy-in provisions. The CBO has already signed off on this as a means of saving money.”
    .
    Same with the public option (and it’s popular too). “The Senate” stripped both the PO and (a much more limited) Medicare buy-in from their bill, even though both are popular and fiscally conservative (see: “…the guy with the gold makes the rules…”). So what’s changed?

  • spob

    KT, had they gotten some GOP votes earlier in the process by playing a little nicer and compromising, no one would be whining about the legislative process.
    .
    Besides, I don;t think it can be forgotten that Obama himself has said that the legislation doesn’t meet two core pledges–that pretty much justifies the GOP saying no to HCR as it stands now.
    .
    By the way, anyone notice Obama’s factually-challenged description of the situation faced by Melanie Shouse?

  • apr2563

    It figures that Pearlstein is one of Obama’s favorite opinionators. I read his column and Q and A on the WP before coming here today amazed at Pearlstein’s denseness. Most of his Q and A was spent chastizing the President for not reaching out to the Republicans more. He should put together a group of Rep Senators to work with him. He even listed some that the President already asked for help (Grassley, Collins, Snowe, etc) and was summarily thrown under the bus. Pearlstein believes in “radical centerism”. None of the press ever defines centerism. If they did it would look remarkably like conservatism. Progressives have been caving into compromise for decades. Enough.

  • apr2563

    Amen and hallelujah.

  • apr2563

    Actually I wasn’t amazed at all. Pearlstein has always been a New Dem, DLC promoter. Also, he is a great admirer of his colleague, David Broder.

  • stuartzechman

    I’m going to get killed by the Wongster for saying this, but, no, they’re not conservatives, they don’t look like conservatives, they don’t act like conservatives, they don’t think like conservatives.
    .
    Conservatives don’t fetishize compromise, do they?
    .
    It looks right-wing to us because we’re liberals, and it looks like liberalism to rightists because they’re not conservative.
    .
    For example, Nate Silver, who doesn’t really know or care much about political philosophy, makes the case that Evan Bayh is really a fine Democrat in his voting record, because, compared to his state, he’s liberal: (link to “Bayh, Relative to His State, Was Valuable to Democrats”):

    The positive score indicates that we’d expect a Senator from Indiana to be slightly more conservative than average. Bayh’s score is -.171 instead, meaning he is slightly more liberal than average. In total, he’s .274 DW-NOMINATE “points” further to the left than we’d typically expect of a Senator from Indiana.
    .
    Note that, conditionally upon his being a Democrat, Bayh is conservative, even relative to his fairly conservative state. Other Democrats like Mary Landrieu and Blanche Lincoln, for instance, are slightly more liberal than Bayh, even though they hail from more conservative states. And some other red-state Democrats like Mark Begich and Jon Tester are much more liberal than him. Nevertheless, a Republican from Indiana would probably also be at least reasonably conservative, and would rarely align with the Democrats on key votes.

    In Nate Silver’s world (as in much of the horse-race reporting world), there’s no separate, distinct “Third Way,” there’s only a single line from conservative on the right all the way to liberal on the left, and Evan Bayh sits on that line somewhere, either being more or less conservative or liberal.
    .
    That’s how he can make a nonsensical statement like “Other Democrats like Mary Landrieu and Blanche Lincoln, for instance, are slightly more liberal than Bayh” without expecting raucous laughter to greet it.
    .
    If there wasn’t such a thing as the New Dems and the DLC, if there wasn’t such a movement as Pearlstein advocates called “the Radical Middle” (Google it!), then there wouldn’t be such a thing as an Evan Bayh or a Blanche Lincoln.

    These are not “moderate conservatives,” since they do vote reliably Democratic and against the Republicans most of the time (which is why the right labels them liberals). They’re not “moderate liberals” –I think they’d be insulted by that characterization– since we know they always vote against liberal ideas that haven’t been compromised in some significant way.
    .
    The centrists are the centrists, and people like Pearlstein don’t believe in conservatism or liberalism, they believe in centrism.
    .
    For whatever reason, the press corps has largely disappeared the topic of the Third Way (much of the mainstream press corps bought into the Third Way along with Broder, and so, as reporters, they can’t come out with their ideology), but it is distinct from liberalism and conservatism.
    .
    Conservatives believe in a market in which the dominant forces are private corporations operating free from government interference. Liberals believe that the state needs to step in to stop private corporations from ruining the market for everyone (big and small) in blind pursuit of their individual interests. Centrists believe that the government should work with the biggest corporations to keep things the way they are, which means only interfering in the market when the biggest corporations want the state to interfere, in exchange for only the regulation that industry agrees it can handle –that’s the Third Way.
    .
    The fake-populist mythology of the Radical Middle is the politics of the Third Way. That’s the mythical “independent voter” that Pearlstein and Broder adore.
    .
    If the press corps were ever to define centrism, it wouldn’t look like conservatism and it wouldn’t look like liberalism –it would look remarkably like the Village press corps itself.
    .
    Thanks so much for taking the time to read this.

  • shepherdwong

    “I’m going to get killed by the Wongster for saying this, but, no, they’re not conservatives, they don’t look like conservatives, they don’t act like conservatives, they don’t think like conservatives.”
    .
    If that’s my new handle (I understand) I should probably point out that I haven’t actually killed anyone in weeks.
    .
    I should also point out what I think distinguishes all corporatist conservatives from Reagan to Clinton to Bush and it’s not what they look like (though all being white middle-aged men in suits, I’m not sure how you can say they don’t look alike), how they “act”, or their espoused ideology. If you want to know who’s a corporatist conservative you watch what they do. And what three things do corporatist conservatives do when they get power?: 1) they deregulate business, 2) they cut taxes for the rich and 3) they increase corporate welfare. That’s it. And that’s the entire agenda for the “conservative” movement, everything else is a lie designed to get average citizens to let them accomplish the agenda.
    .
    The different stylings of different corporate conservatives are just more bullsh*t marketing to widen the pool of hoodwinked victims of corporatism beyond the easily fooled and manipulated authoritarian-following right. And, by all appearances, it seems to work. At least until you learn ignore what they say about themselves and watch what they do.

  • stuartzechman

    shepherdwong:
    .
    I in no way mean this as an argumentative shot, I’m really trying to understand how you come by these ideas of yours.
    .
    I’m going to put aside for a second the notion you’ve put forward regarding the equivalency of Clinton and Bush.
    .
    When you say :

    …what three things do corporatist conservatives do when they get power?: 1) they deregulate business, 2) they cut taxes for the rich and 3) they increase corporate welfare. That’s it.

    , how do you fit the Senate health care reform bill into that calculation?
    .
    The Senate bill: 1) regulates business, 2)increases taxes on the middle class and 3) increases corporate welfare.
    .
    Is that Senate bill therefore progressive?
    .
    I sure as hell don’t believe that this version of “reform” is liberal policy. Everything I know about liberal policy says that 2) and 3) aren’t supposed to be in there.
    .
    So no, the Senate bill is obviously not the work of liberals.
    .
    But, even by your ad hoc definition of corporatist (I’m assuming not social or popular) conservatives, the Senate bill isn’t the work of conservative thought. I certainly don’t think that the Senate bill the work of conservatives.
    .
    So what could this mean?
    .
    Isn’t it possible, shepherdwong, that there is something else?
    .
    Well, there is something other than your 1) 2) 3) conservatives, and that something is the Third Way ideologues who are never satisfied with policy unless it 1) regulates businesses according to the dictates of industry and their own crackpot Tom Friedman-essque theories, 2) increases taxes on the middle-class to emphasize “shared sacrifice” and keep the burden of the welfare state off of the (capital-endowed) productive rich and 3) increases corporate welfare, especially largess that entrenches the largest corporations (and banks), in the hopes that a more stable economic partnership between the state and industry will lead to predictable prosperity.
    .
    What they do is precisely what they say they will do, if you will take time away from condemning conservatism to listen to their lunacy.
    .
    Joe Klein said it best in 2005 (link to “The Incredible Shrinking Democrats”):


    [Bush's] speech last week was striking… It could easily have been delivered by a New Democrat, with the exceptions of his empty call for a constitutional amendment banning gay marriage—a congressional nonstarter, but a sop to religious conservatives—and his continued refusal to support federal funding for new stem-cell-research lines.
    .
    No doubt, neither Bill Clinton nor Al Gore would have invaded Iraq unilaterally or lowered taxes on the rich, but this wasn’t a speech about that. It celebrated democracy abroad and proposed a reformed bureaucracy at home. Clinton was moving, before Monica Lewinsky derailed him, toward significant changes in Social Security and Medicare—especially Medicare, for which he was ready to support a market-oriented approach but retreated at the behest of congressional liberals who supported him during the impeachment fiasco.
    .
    There is, then, a profitable discussion to be had between “ownership” Republicans and “third-way” Democrats about transforming the stagnant bureaucracies of the Industrial Age. Republicans refused to play during the Clinton presidency; the stunned and churlish Democrats are refusing now.

    Joe Klein is not a corporatist conservative, shepherdwong.
    .
    He’s not a conservative in sheep’s clothing, marketing himself as something he’s not.
    .
    He’s not a liberal, either.
    .
    No liberal could propose that “Clinton was moving…toward significant changes in Social Security and Medicare—especially Medicare, for which he was ready to support a market-oriented approach but retreated at the behest of congressional liberals“, could we?
    .
    Joe Klein is describing the 2009 Senate bill, except this was back in 2005!
    .
    Don’t you see, shepherdwong?
    .
    This is the “something else”!
    .
    They’re corporatist, but they’re not conservatives. They do what they say they will do.
    .
    Seriously, let’s put aside argumentative or confrontational sh*t for a second, and let’s get extremely real.
    .
    What’s wrong with my analysis? Don’t try to win an argument, because that’s pointless –nobody gives a f*ck about whether one liberal wins an argument over another– but really read what I’ve put up for you to see, read Joe Klein’s piece, Google “Stalking The Radical Middle” and “Third Way,” and come back here and tell me that these people, these New Democrats are really just plain ol’ conservatives from Reagan’s time. But tell me why. Tell me why I’m wrong, so I can learn from you what I missed and how my thinking was taken off course.
    .
    I am perfectly aware that politicians lie, and act in ways that contradict their professed ideologies, and are hypocrites and confidence men. I understand that conservative ideology is rife with contradiction –that’s why I’m not one.
    .
    But tell me why we shouldn’t look at what the people Joe Klein and his ilk support say, then look at what they do, and then conclude that 1) it’s not quite conservatism, 2) it’s sure as hell not liberalism, so 3) it might just be the Third Way, shepherdwong?
    .
    Because I respect your analysis on many issues, I really, really hope you take the opportunity to carefully consider this line of thought.

  • shepherdwong

    “…how do you fit the Senate health care reform bill into that calculation?
    .
    The Senate bill: 1) regulates business, 2)increases taxes on the middle class and 3) increases corporate welfare.”

    .
    1) yes, 2) yes, the tax burden (in the Senate bill) is placed squarely on the middle class not our corporate owners and 3) yes, it increases corporate welfare like you’ve never seen before, sufficient to negate opposition to “1)”.
    .
    I hope you realize that the essence of your argument is that Democratic Centrists are – from a policy standpoint – intolerably conservative (i.e., not liberal) yet are, at the same time, “not conservative” when it comes to their politics and outward appearance. And you think you’re fighting to understand.

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