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Did C-SPAN Cameras Improve The Health Bill Or Change The Debate?

Last month, Republican leaders seized on C-SPAN’s request for full access into the Democrats’ health care talks to argue that capturing policy negotiations on camera would inform the public and improve the underlying legislation. Sen. John McCain (R-AZ) accused Obama of breaking his campaign pledge and House Minority Leader John Boehner (R-OH) announced that “all House Republicans strongly endorse your proposal and stand ready to work with you to make it a reality.” “Hard-working families won’t stand for having the future of their health care decided behind closed doors,” Boehner wrote in a response letter.

The actual summit, however, turned out to be something less than substantive. Republicans used the existing reform legislation as props, Senate Minority Leader Mitch McConnell (R-KY) criticized Obama for “allowing Democrats to run on” (saying Republicans had spoken for 24 minutes while Democrats had had 52), and McCain seemed to resort to his old campaign rhetoric. Both sides used familiar talking points and memorized phrases and at least five different Republicans asked Obama to “scrap the bill ” and “start over” with a “clean sheet of paper.”

In the days leading up to the forum (and in the hours following it), lawmakers expressed doubts about the usefulness of a 6-hour televised debate session and most concluded that the chances of a a new bipartisan agreement were remote. Suddenly, the very same Republicans who argued that televised meetings would cleanse the process or produce a more bipartisan bill quickly recognized that C-SPAN gave lawmakers just another opportunity to score political points without advancing the debate:

- “This week’s summit clearly has all the makings of a Democratic infomercial for continuing on a partisan course that relies on more backroom deals and parliamentary tricks to circumvent the will of the American people and jam through a massive government takeover of health care.” [Rep. John Boehner (R-OH), 2/22/2010]

- “This whole dog and pony show that we’re about to witness today is something that should have taken place a year ago when the administration first came in last February and laid out its agenda for health care.” [Michael Steele, 2/25/2010]

- “Unfortunately, my fears about this summit were realized: rather than a substantive discussion about health care reform, the President’s summit was just for show.” [Rep. Mike Simpson (R-ID), 2/26/2010]

- “I was discouraged by the outcome…I do not believe there will be any Republican support for this 2,700 page bill.” [Sen. Mitch McConnell (R-KY), 2/25/2010]

The ultimate verdict on the bipartisan health care summit is still out, but yesterday’s forum didn’t alter the debate or meet the expectations of C-SPAN advocates. It’s why I argued back in January that “the public should have ample opportunity to review the final product before the vote, but when it comes to legislating, transparency is overrated. Changing Washington’s political culture requires far deeper systematic reforms than C-SPAN television. The hard politics isn’t pretty enough for TV.”

At Health Summit, Cranky McCain Complains About Nonexistent ‘Special Deal’ For Florida

At yesterday’s health care summit and again this morning on Good Morning America, Sen. John McCain (R-AZ) proved that he was yesterday’s man as he rehashed old grievances and complained that Obama’s health care bill was full of special interest deals and carve outs. McCain signaled out an amendment offered by Sen. Bill Nelson (D-FL) during the Senate Finance Committee’s mark-up process, characterizing the provision as “unsavory”:

MCCAIN: The American people don’t like these unsavory deals. The issue came up twice about Florida and the 800,000 people. Because where they live in Florida they will not be subject to Medicare Advantage cuts. Now, you know, Medicare Advantage is a very popular program with seniors. Now, you can argue — I don’t agree with the argument that it might have to be cut. Although, I don’t agree with that. But to say carve out 1 group of 800,000. And there’s 300,000, 30,000, in my state, who have Medicare Advantage that are going to be cut with this plan. That’s unsavory. That’s unsavory.

Watch it:

In effort to reduce waste and lower spending, the Senate and House health care bills eliminate the government’s overpayments to plans that participate in the Medicare Advantage program. The legislation establishes a competitive bidding program under which private insurers in each geographical area would bid to provide coverage to Medicare beneficiaries in a particular geographic area.

Nelson’s proposal (on pg. 129) rewards any plan that provide services at rates that are below “the average per capita fee-for-service expenditure” with a bonus on top of their competitive bid. These extra bonuses are meant to encourage insurers to stay in a particular geographic area and continue providing benefits. So while it’s certainly not a coincidence that Florida (and other high cost states like New York and California) benefits from Nelson’s amendment, the provision is not exclusive to Florida and one could argue that encouraging efficient insurers to stay in certain markets is good policy. (Although, judging from Obama’s response at the Summit, it’s not clear that the administration agrees).

McCain claims that he’s now against cutting overpayments, but during the presidential campaign, he endorsed competitive bidding for Medicare Advantage. “We see no reason why the Medicare Advantage plans should continue to get a $15-billion-a-year subsidy,” McCain campaign adviser Douglas Holtz-Eakin said, “we’ll put them on a level playing field and save some money there.”

Republicans ‘Agree On About 80% Of The Issues,’ But Want To ‘Start Over’ On Health Reform

In May of 2009, GOP wordsmith Frank Luntz released a messaging memo instructing Republicans how to derail Democratic efforts to pass health care reform. The memo instructed Republicans to “acknowledge the crisis” and need for reform and argue that health care reform would lead to “the government setting standards of care,” government “rationing care,” and would “put the Washington bureaucrats in charge of health care.” “This plays into more favorable Republican territory by protecting individual care while downplays the need for a comprehensive national plan,” the memo states.

Republicans have been successfully deploying Luntz’s strategy for most last year and even used his tactics at yesterday’s health care summit. The Republican leadership acknowledged the crisis and agreed with some of the Democrats’ reforms, but demanded that the President abandon the existing legislation and “start over” on reform:

Watch a compilation:

Throughout the summer of 2009, Republicans claimed that they actually agreed with 80 percent of the Democrats’ bill. In September 2009, for instance, Rep. Eric Cantor (R-VA) told a town hall meeting that “Republicans and Democrats agree on 80 percent of fixing the nation’s healthcare system.” Rep.Charles Boustany (R-LA), who delivered the Republican response to the President’s congressional address in September, also said, “I would venture to say that we agree on about 80% of the issues right now. It’s just a matter of hashing out those few areas where we disagree, but there’s really not been that kind of real discussion, and it needs to happen.”

Unfortunately, even after yesterday’s “real discussion” and a drawn out negotiating process that only moved the President’s health care principles further to the right, Republicans are still more interested in deploying poll-tested catch phrases and strategies than genuinely addressing the health care crisis.

Democrats Indicate They Will Try To Pass Senate Health Care Bill In The House With Reconciliation Package

Education and Labor Committee Chairman George Miller (D-CA) suggested this morning that Democrats will move forward with health care reform using the reconciliation process. “I think the choreography gets a little complicated here,” Miller said, and explained that the House could pass the Senate bill before taking up a package of fixes through reconciliation:

MILLER: The House will present a reconciliation bill that’s going to be based upon many of the principles that the President put forth to correct some of the principles that the House has had with the Senate bill, that may require us to pass the Senate bill first and then send the reconciliation bill to the Senate for them to pass. I believe Senator Reid believes he can put together the votes for that and then we will have a new modern health care system in this country that can be signed by President Obama.

Watch it:

Media reports are suggesting that “congressional Democrats plan to begin making the case next week for a massive, Democrats-only health care plan,” but it’s still unclear if House Democrats — who have lost three votes and remain divided over federal funding for abortion — have enough votes to pass comprehensive reform.

At her weekly briefing today, House Speaker Nancy Pelosi (D-CA) rejected the GOP’s “itsy bitsy spider, teeny weeny” approach to reform and told reporters that the President’s bill bridged many of the differences between the House and Senate legislation. Still, she implied that the success of a vote in the House would depend on the reconciliation package put together by Majority Leader Harry Reid (D-NV). “I believe we have good prospects of passing legislation in light of the recognition the President gave to the House members,” Pelosi said. “Leader Reid will see what he can get the votes for and then we’ll go from there.”

Miller’s suggestion that the House would pass the Senate bill first also contradicts a previous assessment by top Pelosi aide Wendell Primus, who argued last week that the House would not pass the Senate bill until a reconciliation package is adopted.

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