After regrouping, lawmakers seek new path to passage

Jerry Geisel

WASHINGTON—President Barack Obama and top congressional Democrats are preparing to mount a new and perhaps final drive to pass health care reform legislation.

Last week, the president signaled that he has not given up on the reform drive and is prepared to play a commanding role as Democrats recovered from losing a filibuster-proof majority in the Senate.

For the first time since the reform drive began a year ago, President Obama last week moved beyond endorsement of broad reform principles. Instead, he presented an 11-page package that bridges some of the key differences between House- and Senate-passed reform bills and perhaps lays out a blueprint for a final measure.

“He is taking the best of the two bills and pulling more to the center to make reform more palatable” to more legislators, said Helen Darling, president of the National Business Group on Health in Washington.

President Obama dominated an unprecedented seven-hour nationally televised health care summit in Washington, where congressional Democrats and Republicans again expressed their different views on the direction of health care reform legislation.

His participation in the summit was “really an important step. He is asserting his influence as a leader on this issue,” Ms. Darling said.

Meanwhile, congressional Democrats appear poised to resume the reform drive.

Following the summit, Senate Majority Leader Harry Reid, D-Nev., said, “It is time to do something and we’re going to do it.”

Democrats’ interest in reviving the reform drive is obvious, observers say.

“Clearly, the Democrats are not done. They will give it one more push,” said Steve Raetzman, a senior consultant with Towers Watson & Co. in Arlington, Va.

“We have been advising employers that health care reform is not dead,” said Frank McArdle, a consultant in the Washington office of Hewitt Associates Inc.

The renewed reform push, especially by the Obama administration, is a political necessity, some say.

“When you make health care reform your No. 1 campaign issue, to then throw in the towel would have been a political disaster,” said Chantel Sheaks, a principal with Buck Consultants L.L.C. in Washington.

“Politically, the Democrats could not let this drop,” Mr. Raetzman said.

While the reform drive has resumed, the legislative road map congressional Democrats and the administration may use to try to win passage of a reform measure is likely to change.

There is widespread expectation that House Democrats will try to pass the health care reform bill approved by the Senate in December. Then, both chambers would approve changes to that bill as part of a so-called budget reconciliation measure. The advantage of that procedure is only a simple majority of senators is required to win approval. By contrast, other bills can be blocked unless 60 Senate members agreed to halt debate.

With 57 Democrats, plus two independents who typically vote Democratic, and 41 Republicans in the Senate, reconciliation may be the only politically feasible way to win passage of a reform bill, observers say.

“Unless some Senate Republicans support the legislation, budget reconciliation is the most likely procedure,” Mr. McArdle said.

Still, there are problems with including health care reform in budget reconciliation bill. Such bills can include only items that affect the federal budget, making it uncertain which reform elements could be included in such a bill.

“There is an issue of exactly how far you can go with reconciliation,” Ms. Sheaks said.

Another issue that remains is whether there are enough votes, especially in the House, to win passage of reform legislation.

“Senate Democrats seem comfortable that they can get 51 votes. But whether there are enough votes in the House is not clear yet. The House may well get there, but at this point we don’t know,” Mr. McArdle said.

As for last week’s summit, experts say it is unlikely the gathering changed legislators’ opinions.

“While President Obama gave a spellbinding performance, he may not have changed any votes,” said Gretchen Young, vp-health policy with the ERISA Industry Committee in Washington.

Meanwhile, benefit observers describe the administration’s health care reform plan as politically savvy, especially a provision that would impose a 40% excise tax on group health insurance premiums that exceed a certain threshold (see box).

The Senate bill includes such a provision and attempts to later modify it ignited a political firestorm. Under the Senate bill, the excise tax would begin in 2013 and apply to health insurance premiums exceeding $8,500 for single coverage and $23,000 for family coverage. The House bill lacks a comparable provision.

Unions assailed the provision and fought hard to remove or modify it. Their efforts bore fruit when the White House brokered a deal in early January in which the thresholds would be set slightly higher, while health care plans provided under collective bargaining agreements would be exempt until 2018, five years after the effective date for nonunion plans.

That special treatment triggered a wave of protest in Congress and in the business community. Seeking to defuse that anger, President Obama’s plan would increase the thresholds to $10,200 for single coverage and $27,000 for family coverage, with a 2018 effective date for all plans.

By delaying the effective date to 2018, “Obama has taken the health care plan tax off the table,” Ms. Darling said.

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This entry was posted by Adam V. Russo on Wednesday, March 3rd, 2010 at 9:05 am and is filed under Health Care Legislation. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.