Pelosi, House Democrats Afraid To Pass Senate Bill As Is

Nancy Pelosi: "I Don't See The Votes"



As top Democrats cast about for a way to get health care reform back on track, House Speaker Nancy Pelosi took one option off the table Thursday, saying her caucus doesn't have the stomach to pass the Senate bill unless changes are made.

"In its present form, without any change, I don't think it's possible to pass the Senate bill in the House," Pelosi said. "I don't see the votes for it at this time."

The White House and Senate Democrats had hoped the House could simply approve the Senate's bill and send it to President Barack Obama's desk, easily the quickest option available to the Democrats. But Pelosi's remarks remove that option from the mix of strategy and policy solutions party brass has considered to move forward in the health care fight.

"'Unease' would be a gentle word in terms of the attitude of my colleagues toward certain provisions of the Senate bill," Pelosi told reporters Thursday morning.

Pelosi’s remarks don’t preclude the possibility of the House passing a so-called “corrections” bill to fix parts of the Senate bill Pelosi’s members don’t like. Then the House would send the corrections bill to the Senate with a chance of melding the two pieces of legislation once the Senate has enacted the changes.

That’s one of two leading options for completing health reform now. The other — being floated by White House chief of staff Rahm Emanuel, sources say — is to pass a scaled-down bill that would focus on insurance reforms and some expansion of coverage. But neither has emerged as the most likely route to a final bill.

Also Thursday, Sen. Chuck Schumer (D-N.Y.) said that congressional Democrats are weighing a quick pathway to passage because “I don’t think we want to do health care the next three months.”

“Obviously, you cannot just proceed as if nothing happened, because something very significant happened,” Schumer said referring to the party's defeat in the Massachusetts Senate special election. “There is a strong view in both caucuses that we want to do some good things in health care and the question is how — how much and how quickly.”

Asked whether he thought Democrats should simply move on from health care, Schumer was coy.

“I don’t think you can answer that question ‘yes’ or ‘no’,” Schumer said. “I think we need to do something on health care. The question is when and how much.”

But Pelosi foreclosed moving the Senate bill through the House absent some attempt to fix it, noting several provisions of the Senate bill that won’t fly in the House.

"There are certain things that members just cannot support," Pelosi said, citing the deal on Nebraska Sen. Ben Nelson cut with Senate leaders and the White House to shield his state from future changes in Medicaid.

She added, "There's always been unrest in our caucus about the excise tax on so-called Cadillac benefits." That’s a tax on high-cost insurance policies that are held by many union members.

The White House and congressional leaders cut a deal with top union leaders last week to shield their members from the tax through 2017 — but that deal is not included in the Senate bill.

"We have to get a bill passed," Pelosi said. "We know that."

Earlier Thursday, Pelosi left a morning meeting with her caucus to meet with Senate Majority Leader Harry Reid to plot the path forward.

On Wednesday, President Barack Obama called for a quick consensus behind popular elements of the reform plan, even as sources insisted that the White House hasn’t fully gravitated to the stripped-down bill as the only path to saving reform.

“I would advise that we try to move quickly to coalesce around those elements of the package that people agree on,” Obama said in an interview with ABC’s George Stephanopoulos. “We know that we need insurance reform, that the health insurance companies are taking advantage of people. We know that we have to have some form of cost containment because if we don’t, then our budgets are going to blow up, and we know that small businesses are going to need help so that they can provide health insurance to their families.”


Sources: Politico, MSNBC, TPMTV, Youtube

Pelosi Says House To Fight For "Real" Health Care Reform...Wink, Wink!

Nancy Pelosi's Uphill Health Hill Battle



Speaker Nancy Pelosi is telling her caucus not to believe stories that the U.S. House will simply roll over and accept the Senate’s hard-fought health care bill.

“That’s not true for one second,” Pelosi told her agitated rank-and-file in a call this week.

But she may not have a choice.

Any major changes to the Senate bill threaten to upset a delicate détente Majority Leader Harry Reid (D-Nev.) built over months of cautious negotiations to hold together 60 votes in his divergent caucus.

The public option is out. Employer mandates could prove too tough to change. And the president has already taken the Senate’s side in the fight over a tax on high-end health care plans.

“Each of the provisions at issue has already been negotiated ad nauseam in the Senate,” said a Senate Democratic aide. “The physics of this are unlikely to change much.”

Pelosi even seemed to concede one of her top priorities during the call – suggesting she could live with pushing the start date for reforms from 2013 to 2014, the date in the Senate bill. That alone would save $100 billion in the House bill, according to several congressional aides, money the speaker told her caucus could be plowed into making insurance more affordable.

So the ever-practical Pelosi is setting her sights on achievable goals: boosting insurance subsidies, strengthening oversight of insurers and setting up a national exchange to make sure the federal government sets minimum standards for coverage under the reforms.

Even those could prove to be a tall order.

Two key moderates – Sen. Ben Nelson (D-Neb.) and Sen. Joe Lieberman (I-Conn.) – have favored the state-based exchanges over national exchanges. The question now is whether it will prove make-or-break for either.

It’s not just the Senate. Pelosi, who relishes a good fight, finds herself locked a duel with President Barack Obama over the so-called Cadillac tax included in the Senate bill – a 40 percent levy on insurance plans that exceed $8,500 for individuals and $23,000 for families.

To win this skirmish – or any other – she needs to convince Obama her math is tougher than Harry Reid’s.

In other words, that it’s harder to corral 218 “yes” votes in the House than it is for Reid to get 60. And the House does not like the Cadillac tax, which hits the Democrats’ labor allies hard, because many unions have bargained for the high-end insurance policies over the years.

Pelosi wades into the fight with the overwhelming support of her caucus; 190 Democrats have signed a letter opposing the tax, and organized labor is making a fevered last-minute push to shield its members, including a meeting with Obama Monday.

“Two-hundred eighteen is a pretty big number to get to,” said Rep. Joe Courtney (D-Conn.), a lead critic of the so-called Cadillac tax who authored the letter. “I’m not claiming that the 190 people on my letter are monolithic in their opposition…but it doesn’t take much to go from 220 to 217.”

Pres. Obama argues that the tax would force people to re-think whether they need such expensive coverage – and in turn, help hold down cost increases in the health care industry, one of his top goals.

Democrats in the House favor a tax on the wealthiest Americans, but there’s little appetite in the Senate for their “millionaire’s tax” on individuals who make more than $500,000 and couples who make more than $1 million.

But the House won’t go quietly.

On a Thursday afternoon conference call, numerous Democrats expressed their concerns with the Cadillac tax, according to people on the call. Only one – Colorado Rep. Jared Polis – spoke up in support of the tax, telling colleagues that it would help lower health care costs across the market.

Others, like New Hampshire Rep. Carol Shea-Porter, warned the speaker that it could impose new burdens on middle-class Americans. Critics worry the tax would force employers to scale back coverage and could ensnare people in high-premium states or people with serious health concerns. Some even wonder whether the tax would raise the $149 billion over the next 10 years that the Congressional Budget Office predicts because businesses would quickly shift away from these plans.

“The fact that premiums are higher does not mean that benefits are better,” said New York Rep. Jerrold Nadler.

With organized labor up in arms, Democrats also worry that it’s unwise to undercut hard-fought collectively bargained health benefits to foot the bill for subsidies to the poor.

“It’s a political disaster,” Nadler said. “It drives a wedge between Democratic constituencies.”

Of course, institutional envy also plays a role in the skirmish because House Democrats are tired of watching holdouts force Reid to make any more major concessions.

“The [Senate] Finance Committee came up with this idea when they were still negotiating with Republicans,” Courtney said. “Somehow it took on a life of its own.”

There are plenty of signs that both sides are working toward a compromise. Publicly, labor is pushing lawmakers to back off entirely from the excise tax. But labor has signaled privately that it would back down if lawmakers raise the threshold at which the tax kicks in to around $25,000 for a family policy, according to Democratic officials. The speaker and her caucus might want to push that number even higher.

Also, they want to make sure the tax would increase at the pace of rapidly rising health insurance premiums to ensure more people aren't ensnared by the tax each year, as has happened with the Alternative Minimum Tax.

But raising the cut-off reduces the amount of tax revenue collected, so Democrats would have to fill that hole in the tax package. That could force Senate Democrats to accept a further expansion of the Medicare payroll tax, perhaps on capital gains. The Senate bill already boosts the tax rate by 0.9 percent on couples that earn more than $250,000 a year.

As party leaders lurch toward a compromise, House Democrats are unifying around a few core priorities, and affordability tops that list.

On the conference call, Rep. Mike Doyle (D-Pa.) said insurance needs to be affordable if Congress requires almost every American to secure coverage through the so-called individual mandate.

And Education and Labor Committee Chairman George Miller (D-Calif.) explained that the subsidy levels differ drastically in the area of caps for out-of-pocket expenses. The House sets a cap of $500 for individuals and $1,000 for families at the lower end of the income scale. In the Senate bill, those caps are $2,050 and $4,100 respectively. The president has suggested he is leaning in the House’s direction on this one.

But these changes all cost money, and raising the final price tag from $871 billion runs the risk of alienating senators, including Nelson.

“Every dollar above $900 billion is pushing people’s tolerance level,” the Senate aide said. “It can be something rounded down and called $900 billion, but it can’t be something that when rounded up is called $1 trillion.”

Most Democrats seem to accept the predictable loss of the public option. In the absence of government-sponsored health coverage, liberals now want negotiators to waive the anti-trust exemptions for insurance companies –another sticking point for Nelson.

Oregon Rep. Peter DeFazio told his fellow Democrats on Thursday that it needs to be in the final package to keep insurance companies accountable. The speaker agreed wholeheartedly, telling her members that any bill that lacks a public option must also include a national insurance exchange and require companies to spend a higher proportion of premiums on actual health care costs for their customers.

And a push to change the Medicaid funding formula – a flashpoint for Nelson – seems to be gaining momentum and is likely to change during the conference negotiations, according to Democratic aides.

Nelson’s spokesman confirmed this week that the senator was engaged in “serious discussions” with Reid to extend the special deal he secured for Nebraska – that the federal government forever picks up the state’s share of the Medicaid expansion – to all 50 states. A commitment of that size would cost tens of billions of dollars, making it unlikely. Nelson is also pushing an alternative, allowing states to opt-out of the Medicaid expansion in 2017, when the federal government stops picking up the full cost.

Reid spokesman Jim Manley said the discussions were still in their earliest phase.

"We are just starting to work with the house and the administration to reconcile the differences between the two bills," Manley said.

With the White House pushing for a speedy resolution, the speaker isn’t giving her members any more insights on the deadline than she gives the members of the media who hound her in the hallways. Appropriations Committee Chairman Dave Obey asked Pelosi on Thursday what her timeline is for a vote, and the speaker replied, “When we’re ready” – a refrain familiar to every reporter covering the issue.



View Larger Map


Sources: Politico, Google Maps

Chinese Lobbyists Yield Influence In Congress...They Own U.S.

China's Lobbying Efforts Yield New Influence, Openness On Capitol Hill


Ten years ago, U.S. lawmakers publicly accused the China Ocean Shipping Co. of being a front for espionage and blocked plans to expand its Long Beach, Calif., port terminal over fears that Chinese spies would use it to snoop on the United States.

By last year, Congress was seeing the state-owned Chinese behemoth in a far kinder light. Sen. John F. Kerry (D-Mass.) authored a resolution applauding the company for employing thousands of Americans and helping keep the waters of Alaska clean. Rep. Stephen F. Lynch (D-Mass.) hailed the firm on the House floor, calling its chief executive "a people's ambassador" to the United States after it rescued Boston's port -- and thousands of jobs -- when a European shipping line moved out.

The congressional about-face illustrates a dramatic increase in China's influence on Capitol Hill, where for years its lobbying muscle never matched its ballooning importance in world affairs. Members of Congress, lobbyists and other observers said China's new prominence is largely the result of Beijing's increasingly sophisticated efforts to influence events at the center of U.S. power -- and a growing realization among U.S. lawmakers that China has become a critical economic player across America.

Although many Americans still view China with deep suspicion because of its communist system and human rights record, the results of Beijing's image-and-influence campaign are clear. Members of Congress "are starting to understand that the Chinese are not communist but that the Chinese are Chinese," said Rep. Earl Blumenauer (D-Ore.). China is Oregon's biggest export market after Canada.

"China is an overarching backdrop to almost everything that I am involved with," said the seven-term congressman, adding that on matters as diverse as the U.S. economy, climate change and energy policy, "China is something that no one can ignore."

For years, as China steadily rose to global economic and political heights, it all but ignored the U.S. Congress, with outreach to American lawmakers left to friends in the business community. But now China has launched a multimillion-dollar lobbying effort so effective that it is challenging the heralded efforts of nemesis Taiwan.

A decade ago, U.S. politicians of all stripes routinely subjected China to attacks. Now acts of benevolence are more likely -- such as a resolution commemorating the 2,560th birthday of Chinese philosopher Confucius, which the House overwhelmingly approved in October.

"There was originally this kind of anti-communist view of China," said Sen. Dianne Feinstein (D-Calif.), who in 1979 became the first U.S. mayor to visit China when she ran San Francisco. "That's changing. . . . China is a socialist country but one that is increasingly becoming capitalistic."

The new openness toward China is often subtle and not shared by all. But an undeniable evolution is taking place, congressional staffers and analysts said, as members of Congress, many with increasing numbers of large and small businesses in their districts that depend on trade with China, are now far more likely to kill or water down measures opposed by Beijing.

While China maintains a huge trade surplus with the United States, U.S. exports to China have surged in recent years. In 2008, according to the U.S.-China Business Council, exports to China grew in 85 percent of congressional districts. China is now the third-biggest market for U.S. goods, after Canada and Mexico.

"People in Congress are not stupid," said Minxin Pei, a professor of politics at Claremont McKenna College. "A few years ago, China-bashing was costless. Now they will get phone calls from worried CEOs. China is creating jobs in their congressional districts."

Zhou Wenzhong, China's avuncular ambassador, has visited about 100 senators and representatives in their districts during his four-year-old tenure in Washington. But he said it wasn't simply lobbying and shoe-leather efforts that have helped China's image in Congress.

"It's because of our common interests that more and more members have seen the importance of this relationship," he said. "I think their understanding of China is much deeper."

An Evolving Outreach

Until the late 1990s, the Chinese Embassy employed only one diplomat focused on congressional affairs. It was a dead-end job for functionaries who rarely left the embassy, then located in a dour former hotel on Connecticut Avenue.

China counted on U.S. business groups, such as the American Chamber of Commerce, to lobby on its behalf. But with China's accession to the World Trade Organization in 2001, those U.S. groups became reluctant to work on behalf of an increasingly potent competitor.

That spurred China to up its game on Capitol Hill, as did other events.

In the mid-1990s, Taiwan's success in lobbying for a visa for then-President Lee Teng-hui to attend a reunion at Cornell University and give a speech infuriated China and helped precipitate a crisis in the Taiwan Strait.

Then, in 2005, the state-owned China National Offshore Oil Corp. tried to buy the U.S. oil conglomerate Unocal but ran into a lobbying operation backed by the American giant Chevron, which had the competing bid. The Chinese spent $4 million on lobbying. But it lost to Chevron as Congress passed a resolution opposing the Chinese-led takeover on security grounds.
ad_icon

Last year, China opened a $200 million citadel of an embassy overlooking Van Ness Street -- showcasing its rising fortunes and its focus on Washington. There, the beefed-up congressional affairs office now numbers at least 10 diplomats, most of whom have studied in U.S. universities, speak perfect English and are familiar with American ways.

"The Chinese have for years been wielding a lot of influence," said Rep. J. Randy Forbes (R-Va.), who heads the Congressional China Caucus, which has taken a tough line on Beijing. "They've liked to do it under the radar. But as there's been more light shed on it, they've had to change their ways."

China's handling of troublesome U.S. politicians has evolved, too. When Sens. Charles E. Schumer (D-N.Y.) and Lindsey O. Graham (R-S.C.) proposed legislation in 2005 that would slap a 27.5 percent tariff on Chinese goods unless China revalued its currency, Beijing took a new tack. Instead of denouncing the pair on the front page of the People's Daily, as it might have in the past, the Foreign Ministry in Beijing welcomed them on a visit to China. At the end of his trip, Schumer told reporters that he was no longer sure he would push for a vote on the bill and that he was "more optimistic that this can be worked out than we were in the past."

From 2005 to 2009, China for the first time hosted more U.S. politicians and congressional staff members than Taiwan, according to LegiStorm.com, a congressional watchdog. China has also tripled the amount it spends on lobbying firms, including such powerhouses as Patton Boggs and Hogan & Hartson, since 2006 -- although it continues to be outspent by Taiwan.

Feinstein said the views of her colleagues have become more sophisticated with time. They know that China holds a massive amount of U.S. debt and that it imports a lot of goods -- $11 billion worth from her state alone last year. "I have never seen a country change as fast in 30 years as China has done," she said.

Neutralizing Taiwan

Washington used to be home to two types of "China people," known to insiders as the Red team, which supported China, and the Blue team, which backed Taiwan. These days China's rising influence has succeeded in bolstering the Reds.

In 1991, Rep. Nancy Pelosi traveled to China and unfurled a banner on Tiananmen Square in remembrance of those who died during the 1989 crackdown on pro-democracy demonstrators. Last year, as speaker of the House, Pelosi returned to China, and although she continued to raise human rights issues, she focused far more on climate change and, as a congressional staffer said, "minded her P's and Q's."

Some legislators who used to be considered firmly in Taiwan's camp now lean toward China.

Del. Eni F.H. Faleomavaega, a nonvoting, 11-term member from American Samoa, is the influential chairman of the House Foreign Affairs subcommittee on Asia, the Pacific and the Global Environment and for years was considered a solid backer of Taiwan. But over the past year, the Democrat has watered down or killed pro-Taiwan legislation and resolutions.

Faleomavaega partly credited China's improved lobbying for the shift. "Our friendliest allies -- Germany, Great Britain, France and Japan -- know how to work the system," he said. "China is just trying to catch up."

China's strongest backers in Congress are also becoming more vocal, especially the 60-member U.S.-China Working Group, led by Reps. Rick Larsen (D-Wa.) and Mark Steven Kirk (R-Ill.), who represent districts that do considerable trade with China.

"We bought China when it was low," Larsen quipped. "There was nowhere for it to go but up."



View Larger Map

Sources: Washington Post, Politico, MSNBC

13 Attorney Generals Threaten Lawsuit Over Nelson's Medicaid Bribe...Repeal

13 Attorneys General Threaten Lawsuit Over Health Care Reform



Republican attorneys general in 13 states say Congressional leaders must remove Nebraska's political deal from the federal health care reform bill or face legal action, according to a letter provided to The Associated Press Wednesday.

"We believe this provision is constitutionally flawed," South Carolina Attorney General Henry McMaster and the 12 other attorneys general wrote in the letter to be sent Wednesday night to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid.

"As chief legal officers of our states we are contemplating a legal challenge to this provision and we ask you to take action to render this challenge unnecessary by striking that provision," they wrote.

In a rare Christmas Eve vote, Senate Democrats pushed sweeping health care legislation to the brink of Senate passage, crushing a year-end Republican filibuster against President Barack Obama's call to remake the nation's health care system. The 60-39 vote marked the third time in as many days Democrats posted a supermajority needed to advance the legislation.

The letter was signed by top prosecutors in Alabama, Colorado, Florida, Idaho, Michigan, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Virginia and Washington state. All are Republicans, and McMaster and the attorneys general of Florida, Michigan and Pennsylvania are running for governor in their respective states.

Last week, McMaster said he was leading several other attorneys general in an inquiry into the constitutionality of the estimated $100 million deal he has dubbed the "Cornhusker Kickback."

Republican U.S. Sens. Lindsey Graham and Jim DeMint of South Carolina raised questions about the legislation, which they said was amended to win Nebraska Sen. Ben Nelson's support.

"Because this provision has serious implications for the country and the future of our nation's legislative process, we urge you to take appropriate steps to protect the Constitution and the rights of the citizens of our nation," the attorneys general wrote.

A conference committee begins meeting next year to work out a compromise between House and Senate versions of the bill. Experts expect those talks will likely last into February, and a spokeswoman for U.S. House Majority Whip Jim Clyburn, D-S.C., did not immediately comment on the letter.

McMaster says if the bill goes through to final approval with the benefit to Nebraska, taxpayers in the other 49 states will have to pay for it.

Meanwhile, Nelson is taking his message on health care reform directly to his constituents. In a television ad beginning during Wednesday night's Nebraska-Arizona Holiday Bowl football game, the Democrat says he stuck by his principles throughout the debate and doesn't want Nebraskans to be confused on his position.

While it's not uncommon for states to challenge federal laws in court, one legal expert said political bluster was likely behind the letter.

"I do think that it is some combination of the losers just complaining about the officiating, or complaining about how the game was played, in combination with trying to make the bill look as seedy and inappropriate as possible, for political purposes," says Andy Siegel, a former University of South Carolina School of Law professor now teaching at Seattle University School of Law.

"It is smart politics to try to tarnish it and make it look less like an achievement and more like some sort of corrupted bargain," he said.



View Larger Map


Sources: AP, Huffington Post, MSNBC, TPM, Youtube, Google Maps

Health Care Lobbyists Now Wooing House Dems...Public Option Is Dead!

Watch CBS News Videos Online




Health Lobby Takes Fight To The States


Like about a dozen other states, Florida is debating a proposed amendment to its state constitution that would try to block, at least symbolically, much of the proposed federal health care overhaul on the grounds that it tramples individual liberty.

But what unites the proposal’s legislative backers is more than ideology. Its 42 co-sponsors, all Republicans, were almost all recipients of outsized campaign contributions from major health care interests, a total of about $765,000 in 2008, according to a new study by the National Institute on Money in State Politics, a nonpartisan group based in Helena, Mont.

It is just one example of how insurance companies, hospitals and other health care interests have been positioning themselves in statehouses around the country to influence the outcome of the proposed health care overhaul. Around the 2008 election, the groups that provide health care contributed about $102 million to state political campaigns across the country, surpassing the $89 million the same donors spent at the federal level, according to the institute.

Any federal legislation is likely to supersede state constitutional amendments. But backers of the state measures say they want to send a message to Congress and also lay groundwork for fights about elements of the health care package that are expected to be left up to the states.

Some proposals floated around Capitol Hill, for example, would allow individual states to “opt in” or “opt out” of regional health insurance markets or government-sponsored insurers.

“We would be essentially telegraphing our intentions,” said State Senator Carey Baker, a Florida Republican and lead sponsor of the state’s proposal. “If there was an opt-in, we are essentially stating now that we are not going to opt in.”

Advocates of a sweeping overhaul by the federal government, on the other hand, say the magnitude of the health care industry’s contributions shows the dangers of leaving such a question up to individual states, where campaign finance and ethics rules vary from strict to negligible.

“The states are the next battle,” said Richard Kirsch, national campaign manager for the liberal advocacy group Health Care for America Now, “and the insurers and health care industry are primed up and ready to go. The industry has enormous power at the state level, and very few states have state-level consumer groups that are able to lobby effectively against them.”

Last year, for example, the drug industry poured more than $20 million into political contributions in states around the country. In California alone, the industry spent an additional $80 million on advertising to beat back a California ballot measure intended to push down drug prices.

Now, speaking on condition of anonymity because the pharmaceutical trade group is officially backing the federal overhaul, industry lobbyists say they are eyeing Congressional proposals that would expand a state’s Medicaid obligations, and are preparing to fight efforts to make some of it up by paying less for drugs. (A spokeswoman for the National Conference of State Legislatures said many states were contemplating just that.)

The idea of amending state constitutions to block the core of the federal health care legislation, including the requirement that individuals and businesses buy insurance, began at the conservative Goldwater Institute in Arizona, the state where the first such measure will appear on the ballot next year.

“The measures are an opportunity for people to make their views known in a tangible way, to generate some rumble at the grass roots,” said Clint Bolick, a lawyer at the Goldwater Institute who helped devise the idea.

From there, though, the concept was picked up by the American Legislative Exchange Council, a business-friendly conservative group that coordinates activity among statehouses. Five of the 24 members of its “free enterprise board” are executives of drug companies and its health care “task force” is overseen in part by a four-member panel composed of government-relations officials for the Blue Cross and Blue Shield Association of insurers, the medical company Johnson & Johnson and the drug makers Bayer and Hoffmann-La Roche.

The group adopted Arizona’s proposed amendment as a model, and it was introduced in 14 state legislatures around the country. Lawmakers in several others are reportedly considering it as well.

“We are trying to prepare, and trying to send a message that there is no reason for those decisions to get made at the federal level,” said Representative Linda L. Upmeyer, a Republican who is leading the council’s efforts in Iowa.

The states where the amendment has been introduced are also places where the health care industry has spent heavily on political contributions in recent years, according to figures from the National Institute on Money in State Politics. Over the last six years, health care interests have spent $394 million on contributions in states around the country; about $73 million of that went to those 14 states. Of that, health insurance companies spent $18.2 million, according to the institute.

In Florida, where health interests have given a total of about $32 million over the last six years, the state medical association has become an especially important backer of the proposed amendment. In contrast to the national American Medical Association, the state chapter has come out firmly against the current Congressional proposals, and a spokeswoman said the Florida group had embraced the proposed state amendment “to protect Florida from being forced into a federal government mandate that would hurt patients.”

Dr. Madelyn E. Butler, president elect of the Florida Medical Association, said, “We are trying to ameliorate the effects of national health care reform on the State of Florida.”

James Greer, chairman of the Florida Republican Party, said he too supported the proposal, which could be on the ballot in 2010 or more likely in 2012. Whatever its legal weight, Mr. Greer said, its mere presence on the ballot would give it political force.

“It will energize Republicans and independents who want to vote against Democrats and the policies of the Democratic Congress,” Mr. Greer said.


Sources: NY Times, CBS News, Face The Nation

Obama, Congressional Dems Finally Switch Focus To Job Creation...Too Late!

Visit msnbc.com for breaking news, world news, and news about the economy

Obama Plans For Health Care Delay, New Jobs Bill


The White House privately anticipates Health Care talks to slip into February — past President Barack Obama’s first State of the Union address — and then plans to make a “very hard pivot” to a new jobs bill, according to senior administration officials.

Pres. Obama has been told that disputes over abortion and the tight schedule are highly likely to delay a final deal, a blow to the president, who had hoped to trumpet a health care victory in his big speech to the nation. But he has also been told that House Democratic leaders seem inclined, at least for now, to largely accept the compromise worked out in the Senate, virtually ensuring he will eventually get a deal.

Internally, White House aides are plunging into a 2010 plan calling for an early focus on creating jobs, especially in the energy sector, along with starting a conversation about deficit reduction measures, the administration officials said.

Both will be major themes for his first State of the Union speech, which will most likely take place on Jan. 26 or Feb. 2. White House aides are in the early stages of planning for the national address, but Obama will not only trumpet what he has described as his “B-plus” performance in 2009 but also set the stage for the 2010 congressional campaigns.

Obama and Democrats seem in agreement that they want to minimize the number of tough votes moderates in their party must take in the aftermath of the health care debate. They also seem in agreement that a jobs bill is a must — and that they need to show a serious commitment to reducing the deficit, a very difficult task after racking up record spending in Obama’s first year.

The first order of business will be getting a health care deal, which Obama and Democrats see as inevitable. The White House is working closely with House Speaker Nancy Pelosi and other leading liberals to make sure the House does not push for significant changes to the compromise worked out in the Senate. This will force House Democrats, who often feel slighted by all the attention and influence the Senate gets, to swallow a compromise it did not write or advocate.

Logistically, it’s hard to see how this gets done before early to mid-February. The House comes back into session on Jan. 12 and then goes on a Democratic retreat. The Senate doesn’t come back until Jan. 18. And once a final health deal is worked out, it could take seven to 10 days for the Congressional Budget Office to deliver a final report on cost.

“I think we should be in a place by the State of the Union where the issues are being resolved and it’s just a matter of time,” a senior administration official said.

White House aides are planning an intense focus on the economy and jobs at the beginning of the year. And an aide said Obama will be “very prescriptive” about measures he wants from Congress.

The plans were telegraphed in a speech the president delivered at the Brookings Institution on Dec. 8, with an emphasis on infrastructure improvements, green jobs and small-business incentives for hiring and investment.

All that will fit into a middle-class agenda that the White House hopes will give the country a psychological lift, even before jobs numbers rebound.

Key elements of the plans outlined at Brookings:

— Help small businesses by building on tax cuts in the stimulus bill, including the "complete elimination" of the capital gains taxes on small-business investment. Obama also wants to extend write-offs to encourage small businesses to expand. And he wants to help small businesses get loans by waiving fees and increasing guarantees for Small Business Administration-backed loans as well as continuing to mobilize bailout funds to facilitate lending to small businesses.

— Boost Infrastructure by Modernizing Transportation and Communications networks.

— Create Environment-Oriented Jobs by pressuring Congress to start a program with incentives for consumers to retrofit their homes and expanding select Stimulus initiatives to promote Energy Efficiency and Clean Energy Jobs.

Also in the State of the Union address, Obama will discuss his views about the deficit and some of the things he’s going to do to address it over the midterm and long term.



View Larger Map


Sources: Politico, MSNBC, Morning Joe Show, Google Maps

Dems Angry Over Parker Griffith's Defection To GOP

Alabama Slammer: Democrats Fret Over Parker Griffith


The outlook for the 2010 elections just grew dimmer for Democrats, with the abrupt announcement Tuesday that Rep. Parker Griffith, an Alabama freshman, was jumping to the Republican Party.

While Griffith’s departure from the now 257-member Democratic Caucus will have almost no impact on the balance of power in the House, his party switch highlighted the growing unease among the Democratic Party’s most vulnerable members about the party’s ambitious national agenda and its role in contributing to the deteriorating political environment in which they must run for reelection.

Publicly, congressional Democrats mostly remained silent, a reflection of the unexpected timing—Griffith blindsided House leadership with the news and had even attended Speaker Nancy Pelosi’s pre-recess holiday party—and a desire to downplay the significance of his exit.

In the only statement issued by a top Democrat, Democratic Congressional Campaign Committee Chairman Chris Van Hollen simply asked for the party’s money back after devoting considerable resources to his 2008 election and reelection campaign.

"We were committed to helping Mr. Griffith deliver for his constituents and successfully helped Mr. Griffith fend off the personal attacks against him from the far right,” said Van Hollen in a statement. “Mr. Griffith, failing to honor our commitment to him, has a duty and responsibility to return to Democratic Members and the DCCC the financial resources that were invested in him. His constituents will hold him accountable for failing to keep his commitments.”

A Griffith spokesman confirmed to POLITICO Tuesday that DCCC money would be returned.

During last year’s election, the DCCC poured over $1 million into Alabama’s 5th Congressional District in an effort to fend off attacks on Griffith from the National Republican Congressional Committee and other conservative groups. Pelosi herself recently donated $2,000 to Griffith’s campaign coffers.

Martin Frost, a former DCCC chair who dealt with a handful of Democrat-to-Republican party switches during his late 1990s tenure, dismissed the significance of a single party-switching member.

“I don’t think one party switch means much of anything, quite frankly,” said Frost. “I’m sure the DCCC would rather no one switch, but one switch is not a big deal.”

“This is one guy in the south who’s made a political calculation. He could have won as Democrat and he felt it would be easier as a Republican,” said John Anzalone, an Alabama-based Democratic pollster.

Still, privately Democrats acknowledged the announcement came as a serious blow to a party that, over the last several election cycles, had made significant inroads in conservative southern districts like Griffith’s, which delivered 61 percent of the vote to John McCain in 2008 but nevertheless managed to elect a Democrat to an open House seat.

The situation is compounded by the worrisome recent uptick in retirements in politically competitive districts—among them veteran Southern Democrats like Tennessee Reps. John Tanner and Bart Gordon—and comes amidst troubling polling data for various Democratic incumbents.

“There’s a real backlash in the conservative districts against Washington and the president,” said one senior Democratic operative. “In any right-leaning district…you’re going to see the incumbent looking at numbers they’ve never seen before.”

“I just think it really shows the moderates feel they don’t have a voice in the party, they don’t like where we are going as a party, and that should be troubling for Democrats,” said another senior Democratic strategist. “Less than a year into a Washington that is controlled by Democrats, they’ve lost hope, they feel disillusioned, and they don’t think there’s anything to stick around for.”

On Tuesday morning, House Democratic leadership aides made rushed calls to at least two first-term members who frequently vote with Republicans—Reps. Walt Minnick of Idaho and Bobby Bright of Alabama—to gauge whether they were also planning to switch parties.

In a statement to POLITICO later in the day, Minnick said he had no plans to leave the Democratic caucus.

“Nothing should be read into or inferred about Congressman Bright’s future based on an individual decision by another member,” said Bright spokesman Lewis Lowe.

Griffith framed his announcement as a rebuke of Democratic leaders and the agenda they put forward during his first 10 months in office.

“Unfortunately there are those in the Democratic Leadership that continue to push an agenda focused on massive new spending, tax increases, bailouts and a health care bill that is bad for our healthcare system,” Griffith said in a statement. “I have always considered myself to be an independent voice and I have tried to be that voice in Congress—but after watching this agenda firsthand I now believe that the differences in the two parties could not be more clear and that for me to be true to my core beliefs and values I must align myself with the Republican party and speak out clearly on these issues.”

For Republicans, Griffith’s announcement was the culmination of a months-long, behind-the-scenes courtship effort. GOP sources said Griffith reached out to House Minority Leader John Boehner and met with NRCC Chairman Pete Sessions after first approaching an Alabama delegation colleague, GOP Rep. Jo Bonner. On Sunday, Griffith notified Boehner that he was prepared to make the switch official. GOP sources insisted that no deal was struck between Griffith and the House Republican leadership over his move.

Democratic aides said Griffith had actually approached House leaders after the August recess—a time in which he faced raucous town halls—to discuss a party switch. But aides said today’s announcement caught them off guard, and that Griffith gave them no indication that he was planning to bolt.

Democrats said in hindsight Griffith telegraphed his intentions in August when he told a local newspaper that he wouldn’t vote for Pelosi as Speaker again because she was too divisive.

“For people who have been working with his office and watching him, it wasn’t a big surprise,” remarked one senior Democratic leadership aide. “You connect the dots and it’s not a big surprise.”

Still, on the eve of an historic congressional health care vote, the announcement was an unwelcome reminder of the resistance to the measure—Griffith referred to it in his statement as “a major threat to our nation”—and of the increasingly stormy midterm election environment.

“Just about every signal we’ve had so far indicates that 2010 is going to be a tough year for Democrats, and this is another flashing red light,” said Larry Sabato, a University of Virginia political scientist. “The Democrats telling us Griffith’s switch doesn’t matter remind me of the Republicans who insisted that Arlen Specter’s party flip made no real difference. No, these things matter considerably, and they are indicators of which way the wind is blowing in a political season.”


Sources: Politico

Final Congressional Health Care Reform Negotiations Still In Progress

Health Care Bill Plans On Collision Course



Despite a last-minute weekend deal that put the Senate on the brink of passing health care reform this week, liberal and moderate Democrats remain on a collision course over the bill, as both sides dug in Sunday for the next phase of negotiations.

President Barack Obama’s liberal base and powerful union leaders once hoped the expected House-Senate conference would partly undo a year of retreats and compromises, with Obama weighing in to nudge the moderate Senate bill to the left.

But the titanic struggle to lock in Sen. Ben Nelson (D-Neb.) as the 60th senator for the first key test vote early Monday morning has changed all that. The need to hold Nelson and other moderates in line means major changes on the public option, abortion, taxes, Medicare and Medicaid are unlikely — and that the Senate’s vision of health reform is likely to prevail over the House’s in the final talks.

“It is very clear that the bill — the final bill — to pass in the United States Senate is going to have to be very close to the bill that has been negotiated here,” Sen. Kent Conrad (D-N.D.) said on “Fox News Sunday.” “Otherwise, you will not get 60 votes in the United States Senate.”

Nelson, who received assurances of a “limited conference” to secure his vote for the Senate bill, has already laid down at least two deal breakers in the House bill that he can’t support: the inclusion of a government insurance plan and an income tax increase on wealthy individuals.

“That would break it,” Nelson said on CNN’s “State of the Union.”

House Democrats acknowledge that they will be limited in how far they can tweak the Senate compromise. But House leadership also knows that its rank and file need to force some changes, however small, before they will accept the final package — as a face-saving measure to be able to swallow late changes to the bill in the Senate, most notably the decision to eliminate a public option.

But on the left, the sentiments of a liberal base that revolted over concessions to moderates were channeled Sunday by Howard Dean, the former Democratic National Committee chairman, who last week repeatedly called on Democrats to scrap the bill.

“This can’t be the final version of the bill,” Dean said on NBC’s “Meet the Press.” “It simply sets us on a track in this country which is expensive and where we’re going to have lots more political fights.”

In a slight shift, however, Dean tempered his words, saying the bill is better than it was earlier in the week.

“I would certainly not vote for this bill if this were the final product,” Dean said. “I would let this thing go to conference committee, and let’s see if we can fix it some more.”

Andy Stern, president of the Service Employees International Union, identified areas beyond the public option in which Democrats in both chambers could agree, including boosting the federal insurance subsidies for middle-income Americans and strengthening insurance regulations.

“It is about progress, and we now have to fight for the changes in the conference committee and decide, when it is over,” whether to support it, Stern said on CNN’s “State of the Union.”

Senior administration officials contend the conference will not be as difficult as predicted because the differences between the two chambers have been known for months. “Once the Senate passes this bill, obviously there’s work to be done,” White House senior adviser David Axelrod said on “State of the Union.”

Two big voices in the health-reform debate came out with endorsements of the measure moving ahead in the Senate this week: the Federation of American Hospitals, which represents private community hospitals, and AARP, the nation’s largest seniors organization, which urged the Senate to move ahead with debate.

In addition, Democrats desperately tried to avoid an ugly public fight over abortion, but it looks as though the issue will haunt them right up until the end.

Abortion-rights supporters and foes alike blasted the compromise Senate Majority Leader Harry Reid (D-Nev.) cut with Nelson late Friday night. But it’s unclear whether their opposition will be enough to sink the broader bill.

“I have some deep reservations with this Nelson language on first examination,” Rep. Diana DeGette (D-Colo.), a co-chairwoman of the Congressional Pro-Choice Caucus, told POLITICO on Sunday.

Rep. Bart Stupak (D-Mich.), a leading abortion opponent, said during the weekend, “While I and many other pro-life Democratic House members wish to see health care coverage for all Americans, the proposed Senate language is unacceptable.”

The final Senate bill grants state legislatures the right to prevent insurance plans that operate in the proposed health insurance exchange from covering elective abortions. The changes also require people who seek abortion coverage through the exchange to pay two separate checks each month to their insurance company to “segregate” federal funds from private funds that pay for abortion.

Reproductive-rights advocates argue the new system would create a more onerous burden for women seeking coverage for the procedure, while abortion opponents have argued throughout the debate that segregating payments still violates the existing prohibition on federal funds being used to pay for abortion.

Douglas Johnson, the legislative director of the National Right to Life Committee, called the changes “book-keeping contortions” and said that his group plans to put pressure on any senator who votes to consider the changes Reid unveiled.

But the real fight will occur in negotiations between House and Senate leaders over a final bill.

House Speaker Nancy Pelosi of California can’t afford to lose any Democrats. And with Stupak threatening to vote against the Senate compromise, she’ll need to offset his vote with other Democrats who voted against it the first time. She might be able to pick up some moderate-to-conservative Democrats who favor the Senate approach, but many of these lawmakers will need to be OK with the final abortion restrictions.

On the other side, a bloc of abortion-rights backers, led by DeGette, has already promised to vote against any bill that includes Stupak’s amendment, which would prevent people who receive government subsidies from purchasing coverage for elective abortions through the exchange. DeGette believes many of the 41 Democrats who voted for Stupak and “yes” on the House health care bill are willing to work with party leaders to find a middle ground.

The opposing camps are similarly entrenched on the public option and the method for financing the health care expansion. The House would create a government-sponsored insurance plan, but the Senate bill is silent on this point. After several attempts at compromise, Reid nixed the public option altogether.

The taxes could prove difficult to bridge. The House relies on a so-called millionaires’ tax, and has refused to consider the tax on expensive insurance plans. The Senate has taken the exact opposite posture. But because the White House has weighed in several times in favor of the tax on “Cadillac” plans, as a key component to slow the growth rate in health care spending, the Senate is likely to win this round.

Meanwhile, Republicans increaed their attacks on the bill Sunday, criticizing a variety of deals cut to win the votes of Democratic senators, such as Nelson, who got the federal government to pick up the cost of any Medicaid expansion under the health reform bill in the state of Nebraska forever. Republicans said Democrats have refused to say which state would get about $100 million inserted into the bill on behalf of a still unidentified university hospital.

“This process is not legislation. This process is corruption,” said Sen. Tom Coburn (R-Okla.). “And it’s a shame that that’s the only way we can come to consensus in this country is to buy votes.”

But Nelson defended his efforts. “I always put Nebraska first,” he told POLITICO in an interview Saturday. “But I looked at this through the standpoint of Nebraskans and the country. ... There is a difference between holding out for something and holding up. I was holding out for something to make it better.”


Sources: Politico, Washington Post, AP

Harry Reid Steps Up!...Promises Public Option Will Be In Final Bill

Reid Says Public Plan Will Be In Final Bill

Senate Majority Leader Harry Reid, who will have wide control over reconciling two versions of health care legislation in the Senate, told local constituents on Thursday that the final bill will include a Public Option for insurance coverage.

The remarks, first reported by the Las Vegas Review-Journal are destined to bring a wide smile to the faces of progressives who view the melding of health care legislation by leadership in the Senate -- and the subsequent melding between the Senate and the House versions -- as the best chance of ensuring the public option's passage.

Reid had been skeptical of getting a government-run plan through Congress in recent days -- though aides say that the provision remains his personal preference. And after the defeat of two public option amendments in the Senate Finance Committee it seemed that the policy proposal was all but pronounced dead.

But on Thursday Reid reportedly told a conference call of Nevadans that: "We are going to have a public option before this bill goes to the president's desk."

"I believe the public option is so vitally important to create a level playing field and prevent the insurance companies from taking advantage of us," Reid added.

UPDATE: Reid's office clarifies his remarks in a statement sent over from an aide to the Senator.

"Sen. Reid believes that health insurance reform must include a mechanism to keep insurers honest, create competition and keep costs down," the statement reads. "He feels that the public option is the best way to do that. While we don't know exactly what that option will look like, Sen. Reid, working with President Obama, will ensure that whatever is included in the final bill does just that."

This seemed somewhat inevitable as Reid has largely resisted going out on a limb when it comes to the public option.



View Larger Map


Sources: Huffington Post, Las Vegas Review Journal, Google Maps

Congressional Progressive Caucus Pressuring Pelosi For Public Option...So Are Voters

(Speaker Nancy Pelsoi calls the proposal of a "trigger" for a Public Health Care Option, an excuse for not doing anything, and stands by the Public Option as the best cost-saving plan for Americans.)




Progressives Push Pelosi On Public Option

Members of the Congressional Progressive Caucus met with House Democratic leaders Thursday afternoon to reiterate their commitment to a strong public option tied to Medicare reimbursement rates.

In her weekly press briefing Thursday morning, Speaker Nancy Pelosi (D-Calif.) said she still personally supports the "robust" option but did not commit to its inclusion in the final bill. "We don't intend to move forward without a public option in our bill," Pelosi said. "What form that will take, I don't know."

The progressive caucus has been whipping its members to find out how committed the bloc is to oppose any bill without a public option tied to Medicare reimbursement rates. CPC leaders delivered the tally, which co-chair Raul Grijalva (D-Ariz.) described as "significant," to leadership at the meeting. Co-chair Lynn Woolsey (D-Calif.) said "the great majority of our caucus" stands behind a public plan that would reimburse at a rate 5 percent above Medicare, rather than a public option that must negotiate with insurers on its own. "We're not on negotiated rates," Woolsey said.

Progressives said they believe their position is pretty clear. "We're just reaffirming what we say over and over again," Grijalva said. "We plan on Medicare plus five. There's a great deal of caucus support for it. They asked us to do this count, and we provided it."

The discussion didn't end there, however. "No decision's been made," said Rep. Henry Waxman (D-Calif.), a CPC member himself and chairman of the Energy and Commerce Committee, who had to bargain with conservative Blue Dog Democrats on his committee for a weaker public option with negotiated rates. Woolsey said she hopes to see a draft of the final House bill coalesce next week, but Progressive Reps. Maxine Waters (D-Calif.) and Rosa DeLauro (D-Conn.), the latter of whom co-chairs the leadership steering committee, said no dates are certain. "They're not at that point," Waters said.

In the meantime, some members are looking at a proposal from Majority Whip Jim Clyburn (D-S.C.) for state-run public plans. Given that the federal health reforms on the table wouldn't take effect until 2013, "I've just been saying that I think we ought to be doing some pilots in that three-year period in order to see what best practices can be developed," Clyburn said, claiming that he's heard "a lot of receptivity" among Congressional Democrats.

Progressives told the Huffington Post they were somewhat skeptical of Clyburn's proposal -- and a similar one offered by Sen. Tom Carper (D-Del.) -- but many said they'd reserve judgment until they saw more details. "People are going to try to ferret out how it could work," DeLauro said. Single-payer crusader Dennis Kucinich (D-Ohio) said he'd consider supporting any amendment that strengthens the ability of states to create a single-payer system, but he was unsure whether or not state-run public options would do so.

Clyburn said he has not asked the White House to opine on a state-run public option proposal. "That's not my job," he said.

Rep. Jan Schakowsky (D-Ill.) said she expects President Obama to join Pelosi in pushing for cost reduction. "I feel confident that the White House will weigh in on a bill that makes health care affordable for the middle class," she said. "That's the Speaker's litmus test, I think that'll be his litmus test, and he will weigh in."



Pelosi shoots down Public Option "trigger"

House Speaker Nancy Pelosi on Thursday shot down a healthcare compromise that has been viewed as the best chance for getting a bipartisan bill through the Senate.

Pelosi (D-Calif.) rejected the idea of a “trigger” for a public option. That means that the government-run healthcare plan would be a fallback option, enacted only if other reforms didn’t make healthcare more accessible.

Sen. Olympia Snowe (R-Maine), who is being courted by the Obama administration as their best hope for getting a Republican to sign on to President Barack Obama’s healthcare initiative, supports a trigger. But Pelosi does not.

“I don't even want to talk about a trigger,” Pelosi said at her weekly press conference. She said the “attitude” of her fellow Democrats is that “a trigger is an excuse for not doing anything.”

By dismissing a trigger, she also risks further alienating Blue Dog Democrats, who are angry at Pelosi's handling of the bill, particularly her push to include a public option supported by the liberal wing of the caucus. Blue Dogs at times have threatened to block the bill.

Pelosi spoke after a caucus meeting Thursday morning at which outside experts talked to members about the public option, and health “co-operatives.”

Co-operatives, which would be run by members, not the government, are a popular idea in the Senate, and with some centrist Blue Dog Democrats.

Pelosi told her fellow leaders last week that she planned to write a bill that includes a public option tied to Medicare rates, pulling back from a deal she and other leaders had cut with a group of Blue Dog Democrats in July. She also said she wanted the bill to include an income surtax on the wealthy to help pay the cost.

But she backed off that position in meetings this week, saying she will leave those decisions to the caucus.


Sources: Huffington Post, The Hill, House.gov, Youtube

Pelosi On Grayson: "He Doesn't Need To Apologize"...I Agree

(Rep. Grayson says he will only apologize to the dead and their families.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

(Rep. Alan Grayson (D-FL): Republicans Want Sick People To Die Quickly.)





Pelosi: Grayson Shouldn't Apologize

Republicans are calling on freshman Rep. Alan Grayson (D-Fla.) to apologize for denigrating their party's health care plan on the House floor, but Speaker Nancy Pelosi (D-Calif.) thinks they ought to look in the mirror instead.

"Apparently Republicans hold Democrats to a higher standard than they hold members of their own party," Pelosi told reporters at her weekly press conference on Thursday. "There's no reason for Mr. Grayson to apologize. If anyone should apologize, everyone should apologize."

Grayson has taken fire from Republicans since he said on the House floor Tuesday night that the opposition party's proposed health care reform amounts to "don't get sick" or, failing that, "die quickly." The Florida Democrat did not back down Wednesday, calling Republicans "knuckle-dragging Neanderthals" and expressing sorrow only that delays to reform cost more American lives every day.

"I think we should be on the offense, not the defense, and that's where I plan to stay," Grayson told reporters.

Pelosi said she holds everyone in Congress to a high standard of discourse, but she argued that health reform is too important to be "distracted" by Republican efforts to force an apology from Grayson.

"Points have been made. Now it's time to take the debate to health care," Pelosi said. "This is urgent and we won't be distracted from our course of action."

GOP Rep. Tom Price of Georgia filed a resolution Wednesday that would censure Grayson for his comments, but Republican leadership has yet to decide whether to pursue that course of action, according to a Republican Study Committee aide. If House leadership opposes the measure, it is unlikely to pass.



View Larger Map


Sources: Huffington Post, MSNBC, C-Span, House.gov, TPM, Youtube, Google Maps

Pres. Obama's New HC Reform Speech To Congress... A Return To Strong Leadership

NY Times, MSNBC----

Aim of Pres. Obama's Health Speech: Reigniting a Presidency

(Addressing a joint session of Congress, President Barack Obama calls for action on health care reform. "Our collective failure to meet this challenge ... has led us to a breaking point," said President Obama.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

President Barack Obama’s Health Care proposal would:

• Allow Americans to keep their current coverage if they wish.

• Create an “insurance exchange” that would allow individuals and small businesses to bargain for insurance collectively.

• Bar insurance companies from denying coverage because of a pre-existing condition.

• Prohibit annual and lifetime caps on the coverage recipients can receive.

• Impose limits on out-of-pocket expenses.

• Require free coverage for routine checkups and preventive care.


On one level, President Obama’s address to a joint session of Congress on Wednesday night was what it seemed: an attempt to corral lawmakers into approving the signature initiative of his presidency, the health care overhaul that has eluded Washington, as Pres. Obama said, for 65 years.

But the speech was about more than health care.

It was an attempt by this still new president to display his authority to a Congress that had begun to question his fortitude, to show that he was as strong a political leader as he was a political candidate and to show that he was not — to use the shorthand of the day — another Jimmy Carter: professorial, aloof, a micromanager who perhaps was not ready to be the nation’s chief executive.

It is one thing to create and surf a political movement, as Pres. Obama did in capturing the White House. It is quite another to lead an uneasy country and a politically divided Congress toward tough decisions that create winners and losers.

“That’s what this is about,” said Joe Trippi, a Democratic consultant. “We know he can be a candidate; he may even have the right ideas. Now he has to reach down there and make something big happen in the country — either a lot of Americans changing their minds, or members of Congress backing his agenda even if it puts their own political hides at risk. Can he get people to do these things?”

For nearly an hour, Pres. Obama spoke strongly and passionately, pausing only to acknowledge the repeated cheers from his audience as he made what appeared to be his clearest and most concise case yet on a complicated issue that had repeatedly defied his communications skills.

He managed to invest his case with both economic and emotional urgency — particularly when he invoked the memory of Senator Edward M. Kennedy, whose widow, Victoria, was in the audience — without getting bogged down in too many details.

Pres. Obama had clearly decided to speak more to the American people watching on television than to the lawmakers arrayed in front of him in the House chamber. On this evening, at least, Congress was part of the political theater, both in the form of the constant applause from fellow Democrats and in the person of the Republican congressman who yelled out “lie” when Pres. Obama asserted that nothing in his plan would provide coverage for illegal immigrants.

It will take time to see if this works. Bill Clinton gave a similarly well-received address on this very subject in the chamber 16 years ago, to an audience that included many of the same people, among them his wife, Hillary Rodham Clinton, then an author of an ambitious health care plan, now secretary of state.

But there was a key difference between former Pres. Clinton in 1993 and Pres. Obama today. For former Pres. Clinton, it was the beginning of the process; Pres. Obama was ushering in what he hopes to be an endgame, at a moment, as he noted, when four Congressional committees have already reported out bills.

In a recognition of the current political atmosphere, Pres. Obama used his speech to ease away from what had been another defining aspect of his candidacy: the promise to transcend the partisanship in Washington.

He did offer gestures across the aisle, embracing an idea from Senator John McCain of Arizona that would insure the poor against catastrophic medical expenses and endorsing some sort of medical malpractice limits that Republicans have long championed.

But in a climate where at this point he might be lucky to get more than one or two Republican votes from Congress, those were seen by Republicans and Democrats alike mostly as an effort by the White House to get credit for trying and so insulate the administration from criticism that it was trying to jam a bill through on its terms. For the White House, one of the more worrisome events of this summer has been an erosion of independent voters’ support for this president and his health care plan.

Though Pres. Obama spoke of a plan that “incorporates ideas from many people in this room tonight, Democrats and Republicans,” he used the kind of tough, confrontational language that suggested the extent to which the White House would seek to portray Republicans as recalcitrant and standing in the face of a historical tide.

“Know this,” he said: “I will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it.”

Matthew Dowd, a onetime adviser to former President George W. Bush, argued in an interview that Pres. Obama would not succeed unless he trimmed back on his plan, defying liberal Democrats and appealing to Republicans.

“You cannot sell the country on something it doesn’t want,” Mr. Dowd said.

Pres. Obama is most engaged when his back is to the wall, typically after a period of drift. Again and again throughout his career, he has risen to the occasion: The November 2007 speech at a dinner of Democrats in Iowa that put him on the road to victory there, his speech that defused the controversy over racially charged remarks by his onetime pastor, the Rev. Jeremiah A. Wright Jr., even the speech he gave to Democrats at the 2004 convention in Boston that elevated him to fame.

But as he struggles with the adjustment from campaigning to governing, the battle he is trying to bring to a successful close may prove the toughest test of all.

For his first six months in Washington, Pres. Obama was carried by the momentum of the excitement of his election, by the adrenaline of dealing with the financial crisis that greeted him and by his own popularity. Now, with polls suggesting that all that is beginning to fade, and with Republicans regrouping, he is faced with a need to show that the leadership strengths he displayed as a candidate can be transferred to the office of the Presidency.



Pres. Obama projects $900 billion to fix Health Care

Declaring that he is determined to be the last president confronted with reshaping health care in America, President Barack Obama proposed a 10-year, $900 billion plan Wednesday night to overhaul a system that he said had left the country at “a breaking point.”

In a prime-time address to a joint session of Congress, Obama laid out the specifics of his proposal to change the way Americans’ medical care is paid for, responding to critics who have complained that he has not set forth precisely what he thinks the new program should be.

Obama outlined what he called the favored proposals of extremes on both sides of the health care debate: a single-payer system like Canada’s, in which the government provides coverage for everyone, and a dismantling of the employer-based system, leaving individuals to buy insurance on their own.

The president rejected both options, saying they would represent “a radical shift that would disrupt the health care most people currently have” — something that he said could not be allowed to happen. Instead, he charted a middle course on the most contentious issue of the entire debate — whether the government should directly pay for some Americans’ health insurance beyond the current Medicare and Medicaid programs.

While Obama strongly endorsed what has come to be known as the “public option,” he offered it as only a small component of a larger “insurance exchange” in which individual Americans and small businesses could pool their negotiating power to wrest better coverage and lower rates from private insurance companies.

“It would only be an option for those who don’t have insurance,” Obama said. “No one would be forced to choose it, and it would not impact those of you who already have insurance.”

And even then, he said that he would be open to alternatives as long as they accomplished the “ultimate goal” — ensuring coverage for uninsured Americans and promising “security and stability” for those who already have coverage.

That was not sufficient for Rep. Charles Boustany, R-La., who delivered the official Republican response.

“The president had a chance tonight to take government-run health care off the table. Unfortunately, he didn’t do it,” said Boustany, a cardiothoracic surgeon.

Pres. Obama: "Time for games has passed"

Obama’s address came against the background of harsh back and forth between proponents of competing health care proposals.

The president went out of his way to denounce the “scare tactics” of his opponents, which have included false claims that the government would convene panels to decide whether ill, elderly Americans should be forced to die.

In blunt language rarely heard from a president from the halls of Congress, Obama used words like “bogus,” “demagoguery” and “distortion.” He dismissed the death-panels claim as “a lie, plain and simple.”

And even as he declared that “the time for bickering is over” and that “the time for games has passed,” Obama took a strong swipe at his predecessor, President George W. Bush, in arguing that his proposal — whose price tag he himself put at $900 billion — would actually save money.

That bill would still be “less than we have spent on the Iraq and Afghanistan wars and less than the tax cuts for the wealthiest few Americans that Congress passed at the beginning of the previous administration,” he said.

Without naming Bush, Obama blamed his administration for bequeathing him “a trillion-dollar deficit when I walked in the door of the White House ... because too many initiatives over the last decade were not paid for — from the Iraq war to tax breaks for the wealthy.”

“I will not make that same mistake with health care,” he said.

The remarks contributed to a palpable sense of tension in the room. When Obama promised that his plan would not cover illegal immigrants, Rep. Joe Wilson, R-S.C., shouted, “You lie!” — an outburst for which he quickly issued an apology.

“While I disagree with the president’s statement, my comments were inappropriate and regrettable,” Wilson said in a statement. “I extend sincere apologies to the president for this lack of civility.”

Wilson also called the White House and apologized to Chief of Staff Rahm Emanuel after fellow Republicans criticized the episode.

“I think we ought to treat the president with respect,” said Senate Republican leader Mitch McConnell of Kentucky. “Anything other than that is not appropriate.”

Sen. Bob Corker, R-Tenn., likewise said Wilson’s eruption was “not the kind of thing that to me is appropriate in that kind of setting.”

“My sense was that most people there didn’t think it was a good idea that it occurred, and I happen to be one of those.”

Individuals would join for group rates

Obama took pains to spell out that he was rejecting “a government takeover of the entire health care system.” Instead, he laid out a proposal to create a “marketplace” where individual Americans and small businesses could shop among a variety of private plans.

The idea is to clump individual Americans not already covered by their employers into one big group with “greater leverage to bargain with the insurance companies.” The exchange would take effect within four years, he said, “which will give us time to do it right.”

The collective bargaining of group rates “is how large companies and government employees get affordable insurance,” he said. “It’s how everyone in this Congress gets affordable insurance. And it’s time to give every American the same opportunity that we’ve given ourselves.”

While the insurance exchange is the centerpiece of Obama’s plan, the White House told Democrats that the details would also include at least some ideas from Republicans because “he believes reform should be bipartisan.” But it said Obama was firm that it was now or never.

“The Republicans will have to decide whether they are genuine in their wish to work in a bipartisan manner, or whether they will continue to vote against proposals they have said are key to reform,” the White House message said.

If they choose the latter, it said, opponents “will need to either propose their own plan or explain why they think it is best to do nothing.”

In an interview with Joe Scarborough and Mika Brzezinski of MSNBC TV, White House press secretary Robert Gibbs said Wednesday that Obama still hoped Republicans would sign on to his efforts but that it might not be possible.

Referring to three Republican senators crucial to the debate, Gibbs said: “We’ve worked with Olympia Snowe, with Mike Enzi, with Chuck Grassley. What we’re trying to do is bring Republicans together. ... But some people don’t want to come together.”

From the beginning of his administration, Obama has labored to craft a bipartisan solution, but the White House message and the tone of Obama’s speech Wednesday appeared to be a prelude to an agreement to go ahead without Republican support.

Obama’s proposal tracks closely with legislation offered by Sen. Max Baucus, D-Mont., who as chairman of the Finance Committee has been one of the main negotiators among the differing factions on Capitol Hill.

Baucus signaled Wednesday that he, too, had finally abandoned seeking a bipartisan agreement. He said his committee would take up action on health care legislation he has put forth within two weeks whether or not Republicans agreed.

“I very much hope and do expect Republicans will be on board,” Baucus told reporters. But he acknowledged that “I moved forward anyway,” saying, “The time has come for action, and we will act.”

“We’re going to get this bill done by the end of the year,” said Baucus, one of the centrist lawmakers known as “the Gang of Six” who are considered the dealmakers and dealbreakers on health care.

Baucus: No chance for public option
That legislation is sure to disappoint proponents of a public option, which Baucus said did not have enough support in the Senate.

Liberal health care activists and lawmakers — including House Speaker Nancy Pelosi, D-Calif. — have insisted that some form of government-run insurance system is necessary, both to provide coverage for Americans with no other option and to drive down costs by creating a large competitor to private insurance companies.

But opponents mounted a fast-moving, blunt-force campaign to kill the idea during the summer congressional recess, leading to vivid scenes of raucous objection at lawmakers’ meetings with constituents throughout August.

“I think, with increasing conviction, the public option cannot pass the Senate,” Baucus said.

Snowe, of Maine, another of the Gang of Six, agreed that Obama should give up on the idea of a government-run system.

“I hope that this public option will be taken off the table,” Snowe said in interview Wednesday with MSNBC TV. “Hopefully, he will indicate that he will consider alternatives to the public option so we can move the debate forward.”

White House on board with Baucus plan
The White House message to Democrats said Baucus’ plan, which does not include a public option, was “in line with the principles the president has laid out.” It would require Americans to have health insurance, either through their employers or individually through the insurance exchange, while prohibiting insurance companies from refusing to cover anyone with a pre-existing condition.

To make that happen, the plan would make all families with incomes below a certain point eligible for Medicaid, while tax credits would be offered to help everyone else buy private insurance. In Baucus’ plan, that level would be 133 percent of the federal poverty level, or about $29,300 for a family of four.

Obama welcomed the general principles of that proposal at the close of his address.

“There is agreement in this chamber on about 80 percent of what needs to be done, putting us closer to the goal of reform than we have ever been,” he said. While he will remain open to new proposals, “know this,” he said:

“I will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it. I will not stand by while the special interests use the same old tactics to keep things exactly the way they are.

“If you misrepresent what’s in the plan, we will call you out. And I will not accept the status quo as a solution. Not this time. Not now.”



View Larger Map

Sources: NY Times, MSNBC, Google Maps