President Obama long ago ceded the nitty-gritty of crafting health-care reform to Congress, and we all know how well that worked out. So this morning, a few days away from his televised bi-partisan summit, Obama unveiled his own plan. Using the Senate bill as a template, he added, subtracted, and strengthened as necessary in an effort to bridge the gap between the bills passed by the House and Senate and hopefully make health care attractive to both voters and politicians once again. So what’s in there?
For people who don’t appreciate getting hosed, perhaps the biggest news is that Obama has proposed giving the Heath and Human Services Department the power to limit drastic insurance-rate increases, such as the much-maligned 39 percent increase announced by Anthem Blue Cross of California recently. In a slight nod to Republicans, the plan would also increase efforts to crack down on waste and fraud in Medicare and Medicaid. Old people will certainly welcome the closing of the Medicare “doughnut hole.” For the cynical (and the House), the plan ditches the “Cornhusker Kickback” secured by Nebraska senator Ben Nelson and replaces it with Medicaid support to all the states. For the unions (and the House), it’ll raise the threshold for taxing expensive “Cadillac plans” and move back the implementation of those taxes until 2018.
Then there are two of the biggest hurdles to Democratic consensus on health-care reform: the public option and abortion. Despite a renewed push in the Senate, Obama’s bill has no public option, and its language on abortion is less restrictive than the Stupak amendment.
Will the bill get the support it needs? Though the White House would love to get some Republicans onboard, it seems willing to settle for a bare Democrat majority by going through the budget reconciliation process, which should make things easier. But the House, which has lost a few votes since it managed to barely pass a bill that included a public option and the Stupak amendment, could be as tricky as the Senate. We’ll know more on Thursday, when lawmakers’ feelings will be on full display for a rapt national audience.