Health Care: The White House Readies Its Own Plan?

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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.