At the end of February, President Obama met with members of Congress during a bipartisan summit on health reform. This event, which lasted nearly seven hours, had been widely anticipated by Republicans and Democrats. While lawmakers were hopeful that the summit would produce a bipartisan agreement, no clear consensus was reached between the two parties. In fact, the summit further highlighted the vastly different approaches to health reform.
In addition to the Congressional attendees, several members of the Administration joined President Obama at the summit, including HHS Secretary Kathleen Sebelius, White House Office of Health Reform Director Nancy DeParle, and Vice President Joe Biden. Representatives from the Office of Management and Budget (OMB), the Joint Committee on Taxation (JCT), and the Congressional Budget Office (CBO) also attended. The folks from the Congress included the leadership of both parties, as well as the Chair and Ranking Member from the authorizing committees, which deal with healthcare.
Despite the lack of bipartisan agreement on health reform, this event highlighted President Obama’s more active role in pushing for enactment of a comprehensive reform bill. Prior to the summit, Obama released a healthcare proposal that contained significant modifications to the earlier passed Senate bill. The president’s proposal is important because it will likely set the foundation for budget reconciliation legislation that Congress will consider in the near future. The president’s proposal was designed to appease House Democrats, who have expressed opposition to many of the key provisions of the Senate bill.
Less than a week after the congressional bipartisan healthcare summit, President Obama indicated in a White House speech that he wants Congress to move quickly to pass healthcare reform legislation as early as late March before the Easter recess. The legislation will now include several new provisions proposed by the GOP including: proposals to provide an additional $50 million in grants for medical liability demonstrations; ways to increase doctor reimbursement if Medicaid is expanded; allowing high-deductible health plans to participate in the health insurance exchange; and using “medical professionals to conduct random undercover investigations of healthcare providers that receive reimbursements from Medicare, Medicaid and other federal programs.”
Whether this effort wins over some needed Republican support is still up in the air. Ultimately, this is the best last shot the White House has for reviving its top domestic priority. Meanwhile, Congressional Democrats continue their own negotiations on healthcare legislation and a procedural strategy to achieve passage. It is widely anticipated that the congressional Democratic leadership will pursue healthcare reform though the budget reconciliation process.
Budget reconciliation is the only method for Democrats to enact comprehensive health care reform. Under this scenario, House Democrats would agree to pass the Senate bill with the understanding that significant changes would be made through reconciliation. Senate leaders are working on a strategy to ensure that 50 senators would support reconciliation, partly to alleviate concerns among House Democrats about passing the Senate bill before the reconciliation bill.
Because reconciliation can only be used to address revenue and spending provisions, a third “policy” bill may have to be voted on. This bill would address those issues not having a direct impact on the budget, such as abortion. Many of these controversial issues remain unresolved and could ultimately spell disaster for Democrats’ efforts to pass a comprehensive package.