Health Care Summit: Not So Great Expectations

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There’s little bipartisan agreement on what President Barack Obama’s health care summit on Thursday will truly be, though low expectations are popping up across the political spectrum.

“What’s disturbing is the continued media reports that [Democrats] already have their plan to move forward … no matter what the result is of the meeting,” Sen. John McCain told reporters at the Capitol on Tuesday. “That certainly gives anybody reason for cynicism.” When asked what would be on the tip of his tongue as he entered the Blair House on Thursday, he simply said, “Start over. Start over [and get rid of] all of the sweetheart deals.” He later said the country is with him on that point: “The American people are very smart. That’s why two-thirds of them want to either stop or start over.”

The so-called “Louisiana Purchase” and Nebraska “Cornhusker Kickback,” which involved the federal government picking up part of the Medicaid tab in states where certain votes were needed, have led to bellowing about corrupt back room deals. Many of those sweeteners were noticeably absent in the bill Obama’s proposed Monday.

But despite making some changes, the President’s proposal largely resembles the Senate’s health care bill. “Now the Republicans’ mantra is ‘starting over.’ That really is not a realistic request, I think,” said House Majority Leader Steny Hoyer at a press conference down the hallway. “They don’t like some of the things in the bill that came from the Senate and had some reservations about ours.” The people, Hoyer said, want to move forward on health care, not backwards.

Politicians and the press anticipate squabbles about many potential roadblocks — whether or not they were present in Obama’s proposal – such as a government-funded “public option” (absent), “Cadillac taxes” on high-cost plans (present) and language determining whether federal dollars could subsidize abortion (present but too wishy-washy for Michigan Democrat Bart Stupak who potentially has the votes to block the bill in the House).

“This bill is just a warmed over version of the bill that’s already been rejected by the American people,” said Sen. Lamar Alexander, a Republican from Tennessee. Others put that sentiment more warmly. “A good percentage of it is pretty much the Senate blue print,” said Nebraska Sen. Ben Nelson, a Democrat who made a point of supporting the president’s kicking-out of his state’s previous kickback.

Many Republicans believe the summit is just for theater as the President, they contend, is already moving ahead to push the bill through budget reconciliation – a parliamentary procedure that would only require 51 votes but could potentially be vulnerable to unlimited amendments. “They’re obviously planning it,” McCain said.

Senator Kent Conrad, chairman of the Senate Budget Committee, Tuesday told reporters that if such a move were to be used, the House would first have to pass the Senate version of the health care bill before the fixes could be made in reconciliation. “You can’t have reconciliation to a bill that’s never passed,” Conrad warned. The House has been pressing the Senate to go ahead with the fixes before they pass the Senate bill, in an effort to ease what will surely be a tough vote in the House. Conrad ruled out pushing the entire bill through the budgetary process as nearly impossible to accomplish given the looming threat of hundreds of GOP amendments and points of order as to the germaneness of provisions to the budget. (Under the so-called Byrd rule, all provisions of reconciliation must be directly related to the underlying bill and, if not, may be challenged).

Using the budgetary bypass “would be the ultimate trick to get votes,” Alexander said. “The reason for the American people rejecting the health care bill so far is because of the tricks. So I think if the Democrats try to jam the bill through [using] this strange process to get votes, then they’ll just be guaranteeing themselves a political kamikaze mission in November.” On the other hand, not passing health care might prove just as deadly to Dems.