Yesterday, President Obama finally set a course for health care reform and announced a “televised meeting with Republican and Democratic congressional leaders” to find a bipartisan solution to controlling health care costs and extending coverage to the uninsured. White House aides stressed that the President was not scraping the existing health care bills and promised that Obama would move forward with reform with or without Republican support. “This is not starting over,” one White House official said. “Don’t make any mistake about that. We are coming with our plan. They can bring their plan.”
The summit will allow Democrats to scrub clean the process of reform and give Republicans what they’ve been demanding all along — another seat at the health care negotiating table. Here is my prediction: Republicans will repackage their existing health care plans and present them to the President with a TV salesman’s pitch: a common sense approach to fixing the nation’s health care ills, at half the cost of all previous reform efforts. Act now and they’ll throw in a free copy of Going Rogue.
The plan will allow healthier Americans to purchase porous coverage across state lines with government tax credits and push the millions of Americans with chronic conditions into high-cost high-risk pools. Republicans will proclaim that owning one’s own health care policy is the silver bullet to solving the country’s health care crisis and promise to slow Medicare and Medicaid spending by privatizing both programs. With step by step improvements, everyone will have some kind of health insurance, they’ll argue. Eventually.
The President will insist that any health care reform must build on the current employer-based system and rely large risk pools to spread the risks and costs of health care insurance across a large group. He will remind Republicans that the House and Senate health care bills already include many Republican health care ideas like high risk pools, selling policies across state lines (in the form of more regulated compacts), high deductible policies for younger Americans, employer-sponsored wellness programs, tax credits for small businesses, and allowing younger Americans to stay on their parents’ health care plans as dependents.
Republicans will insist that their plan is an all-or-nothing deal; carving out little bits and incorporating it into a larger plan is not their flavor of bipartisanship. The only way they’ll jump on board is if Democrats accept their plan. As Rep. Eric Cantor (R-VA) has already explained, “unless the President and Speaker Pelosi are willing to scrap their government take over and hit the reset button, there’s not much to talk about.” Republicans took a similar approach to Obama’s first health care conference in March 2009, demanding that Democrats abandon the public option before convening any real negotiations.
The President will explain that the House and Senate health care bills regulate insurer competition without eliminating private companies or expanding government control, much like the Massachusetts health care reform. This will trigger Sen. Scott Brown’s (R-MA) effort to awkwardly distance himself from the plan he ran on and still supports. He’ll say that he’s an independent who doesn’t think that Massachusetts should have to pay for other states’ reform efforts. He may even highlight the state’s success in achieving a 98% insurance rate and the popularity of reform, although that would run the risk of suggesting that reform could work without resorting to death panels. Before sitting down, he’ll explain that Massachusetts’ success in expanding health insurance coverage should not be used as a template for the nation because even if it worked there, there is no guarantee that it will work everywhere. He’ll throw his support behind the Republican’s untested health care ownership scheme.
The summit will close with some inspiring remarks from the President, but at the end of the day, it will be up to the Republicans to meet the Democrats half way. Obama would have taken his steps towards bipartisanship, he may even make some concessions on tort reform. But this will be the Republicans’ final opportunity to embrace the rather moderate package of reforms. If they still insist on starting over, they’re effectively taking themselves out of the process and giving the reins to the Democrats. From there, Reid and Pelosi can either build momentum for passing the Senate health care bill alongside a package of fixes, pass a smaller package “around those elements in the package that people agree on” or (less likely) adopt a compromise that resembles Sen. Ron Wyden’s (D-OR) health care bill.
The summit will give both sides the opportunity to publicly rehash their health care rhetoric. It’s what Obama chooses to do after February 25th that’s important.