The ACP Advocate Blog
by Bob Doherty
Monday, February 22, 2010
"We can work it out"
"Life is very short, and there's no time
For fussing and fighting, my friend.
I have always thought that it's a crime,
So I will ask you once again.
Try to see it my way,
Only time will tell if I am right or I am wrong.
While you see it your way
There's a chance that we may fall apart before too long.
We can work it out,
We can work it out."
After a year of deferring to Congress, President Obama today released his own health care reform proposal (although it largely borrows from the bills already passed by the House and Senate).
The proposal is part of a coordinated effort by the White House to say to GOP opponents that "we can work it out" . . . but only if they are willing to see it his way. The White House's web site lists 14 Republican ideas that it says are included in the Obama proposal, in the president's budget, and/or in the bills passed by the House and Senate. It also says that "the president remains open to other policies as well. And the purpose of the Bipartisan Summit is to review all ideas and ensure that the best ideas are included in the plan."
The GOP isn't buying it.
Roll Call reports that the President's plan has ignited a partisan backlash. House minority Leader John Boehner (R-OH) and Senate minority leader Mitch McConnell (R-KY) each released statements to make it clear that they will not budge from opposition to Obama's plans. McConnell accuses the president of "completing ignoring what Americans across the country are saying."
Is McConnell right? The "By the Numbers" blog written by Washington Post pollsters suggests that Obama may have stitched together proposals that have "broad, but often malleable, public support." Large majorities, they report, support creation of a new health exchange to give people the same insurance choices that members of Congress have, ending discrimination against persons with pre-existing conditions, enacting reforms to reduce the deficit, closing the Medicare Part D doughnut hole, requiring large employers to provide coverage, financing the changes by raising taxes on higher income persons, and requiring plans to cover adult dependents to age 26 - all features of the President's proposal (and, for that matter, the bills that have already passed the House and Senate).
How does Obama's proposal differ from the bills that passed by the House and Senate? The Kaiser Health News "Blog Watch" has a good summary of the changes he proposes. The proposed changes include increasing the subsidies for people to buy coverage, providing more funding to states to expand Medicaid coverage (applied to all states - no special deals), increased penalties on employers who don't buy coverage, delaying and raising the ceiling for a tax on Cadillac plans, and getting more money out of Medicare Advantage plans. One of the biggest - and controversial - changes is a new proposal to create a new "Health Insurance Rate Authority" to "provide needed oversight at the Federal level [over health insurers' premium increases] and help States determine how rate review will be enforced and monitor insurance market behavior."
In the end, I don't think the changes proposed by President Obama will win over any GOP support. But by embracing changes that have broad "but malleable" support from the public, and daring Republicans to see it his way (or, presumably, get out of the way), he may have charted a way for the Democrats to finish the job, presumably using the "majority rules" reconciliation route.
Today's question: Do you agree with the changes proposed by President Obama? Do you think it will help get health care reform over the finish line?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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