Health Care Via Reconciliation May Spell Political Doomsday For Dems 2010, 2012

House Republican Leaders Demand Halt to Talks on Compromise Bill


House Republican leaders on Friday demanded that House and Senate Democrats halt their ongoing efforts to resolve differences between the versions of major health care legislation adopted by each chamber late last year.

In a letter to House Speaker Nancy Pelosi and the Senate majority leader, Harry Reid of Nevada, the House Republican leaders asserted that the efforts by Democrats to reach a compromise plan would undermine negotiations at a bipartisan summit scheduled by President Obama for Feb. 25.

Mr. Obama has said all along that he wants to be able to present a unified Democratic health care proposal at the summit and then debate the major provisions with Republicans and independent experts to see if they have better ideas.

But in their letter, House Republicans suggested that the ongoing work by Democrats to resolve their differences would amount to a “backroom deal among the White House and Democratic leaders” that would “make a mockery of the president’s stated desire to have a ‘bipartisan’ and ‘transparent’ dialogue.”

The letter was signed by the House Republican leader, Representative John A. Boehner of Ohio; the party whip, Representative Eric Cantor of Virginia; and the Republican conference chairman, Representative Mike Pence of Indiana.

The letter was the latest sign that Republicans are increasingly anxious that Mr. Obama and the Democrats will score a political victory with the bipartisan summit. Earlier on Friday, Representative Tom Price, Republican of Georgia, published an op-ed piece online in which he accused Mr. Obama of using the summit “to intimidate his way into a government takeover of health care.”

The Republicans have demanded that Democrats discard the health care bills adopted by the House and Senate late last year and start the process over. Mr. Obama and the Democrats have refused, and they called on Republicans to negotiate on the proposals already approved by majorities in both chambers.

In the letter to Ms. Pelosi and Mr. Reid, the Republican leaders wrote, “Your response will help clarify whether Democratic leadership is serious about genuine bipartisan negotiations and whether the proposed summit will be a truly open forum or merely an intramural exercise.”

By raising questions about the Democrats’ motives, Republicans seem to be anticipating that Mr. Obama will move quickly after the summit to win passage of a revised health care bill, and they seem to wish to blunt any effort by the president to suggest that Republicans offered few workable alternatives.

Even as they have criticized the Democrats and cast doubts on the summit, Republicans have not put forward any new, comprehensive health care proposal that would meet the president’s goal of extending coverage to most of the nation’s uninsured. Republicans say that doing so would be too costly and that they do not share the president’s goal of a broad expansion in coverage, but instead want more modest efforts to help control costs.

Here is the full letter:

February 12, 2010
The Honorable Harry Reid
Majority Leader
United States Senate
Washington, DC 20510

The Honorable Nancy Pelosi
Speaker
U.S. House of Representatives
Washington, DC 20510

Dear Mr. Leader and Madam Speaker:

As you know, we welcomed the President’s call for bi-partisan health care talks. The American people have made it clear that they strongly oppose the comprehensive health care bills you have passed and want them shelved in favor of a step-by-step approach focused on lowering costs for families and small businesses.

Given the President’s statement that he is “open to any ideas” at the proposed summit, it is our responsibility as congressional leaders to see that the views of our Members and our constituents will be heard in good faith. The existence of any kind of backroom deal among the White House and Democratic Leaders would certainly make a mockery of the President’s stated desire to have a “bipartisan” and “transparent” dialogue on this issue.

To that end, we were taken aback by a report in the Tuesday, February 9 edition of Politico stating that President Obama “hopes to walk into the Feb. 25 summit with an agreement in hand between House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid on a final Democratic bill, so they can move ahead with a reform package after the sit-down.”

We were further taken aback by a report in CongressDaily later the same day in which an aide to the Speaker, appearing at the National Health Policy Conference, described the legislative “trick” Democratic Leadership intends to use to jam through a “pre-negotiated” health care bill. It has also been reported that other congressional aides present concurred with this assessment.

Additionally, the Christian Science Monitor reported today that special interest groups are calling for Democrats to finalize a deal in advance of the proposed summit.

To ensure we can move forward in good faith, we ask that you publicly disavow these reports and assure the American people that Democratic Leadership is not putting together any kind of backroom deal or plotting any kind of legislative trickery to pass it. Your response will help clarify whether Democratic Leadership is serious about genuine bipartisan negotiations and whether the proposed summit will be a truly open forum or merely an intramural exercise.

We appreciate your immediate response in this matter and look forward to further efforts to foster bipartisan cooperation.

Sincerely,

House Republican Leader John Boehner (R-OH)
House Republican Whip Eric Cantor (R-VA)
House Republican Conference Chairman Mike Pence (R-IN)









Failure Of Health Care Overhaul Will Add More Woes


It's anybody's guess whether Obama's health remake will survive in Congress, but there's no doubting the consequences if lawmakers fail to address the problems of costs, coverage and quality.

What could be worse than health care overhaul? No health care overhaul.

It's anybody's guess whether President Barack Obama's health remake will survive in Congress.

But there's no doubting the consequences if lawmakers fail to address the problems of costs, coverage and quality: surging insurance premiums, more working families without coverage, bigger out-of-pocket bills, a Medicare prescription gap that grows wider and deeper, and government programs that pay when people get sick but do little to keep them healthy.

"They complained, 'If you pass this bill, prices will go up,'" said Sen. Maria Cantwell, D-Wash., who helped shape the Senate Democrats' bill. "Well, you don't pass it, and prices will still go up."

For economist Douglas Holtz-Eakin, a top adviser to 2008 GOP presidential nominee John McCain, "no one has the luxury of saying we're not going to worry about this." While he's no fan of the Democrats' approach, he said Republicans "are going to have to deliver something at some point. The question is whether they do it with this president leading or wait for a Republican president."

Health care spending hit $2.5 trillion last year, growing faster as a share of the economy than at any time in a half century, yet with results that compare poorly with other advanced countries spending less. Government programs — mainly Medicare and Medicaid — will soon cover more than half the nation's health care tab, a staggering burden for federal and state budgets.

For those with private insurance, the recently announced double-digit premium increases for people purchasing their own coverage with Anthem in California could be a harbinger. Medical costs are rising in a weak economy, causing healthy people to drop coverage and raising costs for those left behind, with no limit in sight.

"We will see real changes in the way health care is delivered, regardless," Holtz-Eakin said. "The question is whether they are coordinated and done proactively or whether they are done on the ground by providers, insurance companies and employers, reacting to their costs and their risk pools."

A look at how some major groups would fare if the health care overhaul collapses and present trends continue unchecked:

OLDER PEOPLE

Both Democratic bills would begin experiments aimed at providing quality care at lower cost for Medicare recipients, particularly those with chronic conditions such as heart failure and diabetes. Co-payments for preventive care would be eliminated. The House bill gradually would close the "doughnut hole" prescription coverage gap, now growing wider and deeper because of inflation. Those improvements would be lost.

On the plus side, private insurance plans in the Medicare Advantage program, serving about one-fourth of seniors, would be spared cuts proposed by Democrats. Still, insurers and other service providers won't get a free pass. With Congress looking to cut the federal deficit, Medicare will be on the chopping block again.

"The irony is that major interest groups — hospitals and drug makers — had agreed to take reductions this time," said John Rother, top political strategist for AARP, which supports the Democratic bills.

WORKERS

The divide between those who have health insurance and those who don't will get deeper. Many more will find themselves with inadequate coverage that leaves them with hefty bills if they get seriously ill.

"More employers will drop coverage. More consumers will get increased co-payments and deductibles," said Sen. Ron Wyden, D-Ore., a moderate who has not given up hope of a deal with Republicans. "I believe that would be so corrosive for the country that we would not let it be the outcome."

By 2019, the number of uninsured would rise to 54 million, most of them low-income workers paying federal and state taxes to support health care programs for older people and the poor. The Democratic bills would expand Medicaid to pick up more people near the poverty line, while providing subsidies for many middle-class households to buy private coverage.

PEOPLE WITH HEALTH PROBLEMS

Insurers would be able to continue denying coverage to people with medical problems, or charge them higher premiums. People who get sick could face cancellation of their coverage in certain circumstances.

People in their 50s and 60s, when many medical conditions emerge, would face premiums up to six times or seven times higher than what those in their 20s pay.

Conversely, 20-year-olds would continue to enjoy access to low-cost health insurance. The Democratic bills would have forced them to subsidize premiums for older generations. Still, young people would not escape unscathed. The Democratic bills would have allowed children to stay on their parent's coverage until their mid-twenties, a particularly valuable benefit for those with health problems.

EMPLOYERS

Big employers were hoping that the Medicare experiments would provide a template for their own efforts to try to control costs and maintain quality. Small employers were leery of the Democratic bills, although some would have received subsidies to help them provide coverage.

If nothing gets done, large employers will be the front line in efforts to rein in health care spending. They will keep passing on costs to employees through higher premiums and copayments. But they're also expected to take a more aggressive approach to get workers to shape up by quitting smoking, losing weight and making other lifestyle changes. Employers won't just be insurance sponsors any longer; they could start acting more like the health police.

Small companies are likely to keep dropping coverage, as are employers with lots of low-wage workers.

"The fact that we had a mandate from voters to do something, and that a major effort to respond led to such a deep partisan divide and gridlock is not positive," said AARP's Rother. "The gridlock that's developed on health care is a very serious and negative omen for our ability to tackle Social Security and deficits."


View Larger Map

Sources: Fox News, NY Times, Google Maps