Thursday’s healthcare reform summit was, in many ways, a last-ditch opportunity for President Barack Obama to try to win bipartisan support for the centerpiece of his legislative agenda. The marathon session did, in fact, turn out to be the “frank and honest†conversation he’d hoped for, but in the end it only highlighted the two parties’ differences in even starker contrast.
Faced with the reality that there remained at day’s end profound disagreement on how to move forward, Obama seemed to have come to terms with the fact that a divide remained. He issued an ultimatum to members of both parties, saying that if Republicans could not find ways to work with Democrats to create a comprehensive bill in the next six weeks, his party would have to go it alone.
“We cannot have another yearlong debate about this,†the president said.
It’s a risky proposition, given that many lawmakers are concerned about the political ramifications they may face during November’s midterm elections. All House members and a third of the Senate are up for re-election. But Obama thinks it’s a risk well worth taking, noting “that’s what elections are for.â€
The summit was premised on the idea that there was perhaps more common
ground between Democrats and Republicans than they realized. In his opening remarks, the president stressed how everybody is faced with the challenges of healthcare costs and recalled his own personal experiences with family medical emergencies, such as the time his daughter Sasha had meningitis as a baby.“I remember thinking, while sitting in the emergency room, what would have happened if I didn’t have reliable healthcare,†Obama said. He added that “everybody understands the problem is not getting better; it’s getting worse,†but also acknowledged that there was a possibility that Democrats and Republicans would remain deadlocked.
One of the most fundamental differences to emerge during the summit was whether to pass one big bill or a series of bills that attack issues one-by-one. Throughout the day, Republicans repeated a mantra to “scrap†the House and Senate bills already on the table, to “start over†and take a “step-by-step†approach.
Senator Lamar Alexander (R-Tennessee), a former governor, said that the Democrats’ proposals include too many tax increases and spending cuts on Medicare and would dump millions of Americans into a Medicaid program. Likening the summit to a Detroit auto show where customers leave unimpressed with the newest model, he said, “This is a car that can’t be recalled and fixed, and we ought to start over.â€
A few areas of agreement did emerge, such as greater provider regulation, which would enable children to stay on their parents’ plans longer. Lawmakers agreed on allowing consumers to buy coverage across state lines and allowing small businesses to form purchasing pools, but they differed on how to accomplish that and how much government involvement there should be.
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Lawmakers agreed that consumers shouldn’t be denied coverage or penalized because of pre-existing conditions or if they fall sick. But Democrats believe that’s why coverage should be mandated while Republicans countered that there should instead be high-risk pools [JJ2] from which people could buy coverage. Democrats who think such pools would come with an astronomical cost that few people could afford decried the latter notion.
Republicans also argued against the White House proposal [JJ3] delivered earlier this week, which is closely based on the Senate bill and would cover more than 30 million people over 10 years, saying it was unaffordable.
“Today’s summit should have been used to start anew because Americans simply don’t agree with the Democrats’ approach,†said Rep. Tom Price (R-Georgia), who chairs the Republican Study Committee[JJ4] . “Amidst
all the talk, one contrast stood out with crystal clarity. The Democrat plan operates on the assumption that Washington knows best while we believe the best solutions will be found by putting patients first. This fundamental divide has been the basis of debate for the past year. All we saw today was another seven hours of it.–One of the repeated references throughout the day is that the American people don’t want this,†said Dr. Henrie Treadwell, director of Community Voices at Morehouse College of Medicine. “I think when they say that it’s a way of segregating Americans who are people of color and who work in jobs that don’t provide insurance or who’ve been chronically unemployed for so long that nobody counts them anymore, but they still get sick.â€
Treadwell added that many African Americans who don’t get coverage at work actually buy insurance, but the deductibles are so high that they get little or no value for the dollars spent.
A huge majority of the 30 million people that Obama’s plan proposes to cover would be African Americans and other minorities, and includes significant emphasis on wellness and prevention, said Rep. Elijah Cummings (D-Maryland).
“That’s very important in our community because one of
the many reasons we have such a high level of health disparity between whites and blacks is because, so often, we get treatment late. And that’s a problem,†Cummings said. “So we go in sicker and it takes a lot more to get us well.â€(Continued on next page)
Cummings does not suffer any illusions that Republicans will get on board with a comprehensive plan.
“We’re at a point where we have no choice but to proceed without the Republicans, period. If the day brought out anything, it’s that the Republicans want to obstruct what the president is trying to do.â€
But the best way to move forward is still a big question. House Majority Whip James Clyburn hinted Thursday night that there are enough votes in the House to pass the Senate version of the bill, which Obama has said he wants to see happen.
Throughout the summit, however, Republicans warned of the perils of using the controversial reconciliation procedure, which would allow the Senate to pass a bill with a simple majority of 51. Senate Majority Leader Harry Reid told Republicans to “stop crying†about it, noting that they’d used the procedure 21 times, more than any Democratic majority has.
Stay tuned.