This morning, C-SPAN’s Washington Journal invited Rep. John Shadegg (R-AZ) — a 25-year veteran of Congress who is retiring from Congress at the end of this term — to discuss the prospects of health care reform passing the Congress. Asked to explain his reason for retiring, Shadegg said he was frustrated with Democrats’ reluctance to include Republican ideas in the health care reform bill and cited one “stunning” example in which Democrats didn’t even understand the Republican proposal:

SHADEGG: One of the big issues that I find stunning. Republicans proposed to deal with pre-existing conditions through what are called high-risk pools. As a week before the House bill passed, I was in a meeting where Democrats said, “well, what’s a high risk pool?,” and didn’t understand it. And then, two weeks ago at the summit, both Secretary Sebelius and President Obama revealed they don’t understand a high-risk pool and yet it’s not all that complicated. So I think Republicans were left out and that becomes frustrating. That contributed to my decision to say, “it’s time to move on.”

Watch it:

If Shadegg is leaving Congress because Democrats didn’t include high-risk pools in health care reform or failed to understand the idea, he should reconsider. Both the House and Senate health care bills would establish a federal high-risk pool that would allow Americans with pre-existing conditions to find affordable coverage in the period before the exchanges become available.

In fact, President Obama has long embraced the high-risk pool concept — which was part of Sen. John McCain’s (R-AZ) health care reform plan. “For those Americans who can’t get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. This was a good idea when Senator John McCain proposed it in the campaign, it’s a good idea now, and we should embrace it,” Obama said in September of 2009.

It’s worth noting that Shadegg would probably argue that Obama didn’t adopt McCain’s exact proposal, which called for funding state-based high risk pools. But Shadegg can’t expect Democrats to simply swallow Republican ideas; modifying and improving provisions is the very definition of compromise. As ABC News’ Teddy Davis points out, “by doing the risk pool at the federal level, it eliminates the risk that the program will become an unfunded mandate on the states. Currently, over 30 states have high-risk pools” and they “have struggled, however, to provide affordable insurance due to underfunding.

Compared to President Obama’s fiery condemnations of the health insurance industry, Kathleen Sebelius’s speech before the insurance industry’s annual conference struck a more conciliatory note. Dressed in a gray suit that made her look almost identical to AHIP President and CEO Karen Ignagni, Sebelius steered clear of criticizing insurers for funding efforts to undermine reform and asked just two things of the industry. The secretary reiterated the administration’s request that insurers publicize their rate hike requests and asked the industry “to work with us” and “help us pass comprehensive health reform.”

But listening to Ignagni’s introduction of Sebelius, one would think that the insurance industry had been cooperating with Congress all along:

IGNAGNI: We entered 2009 with a major commitment to do something that was unexpected by various communities in the stakeholder arena, which is to commit to massive change in the way we do business. So we are on the page and fully committed to insurance reforms, not half steps, but massive change….we have proposed dramatic comprehensive solutions to get to the issue of affordable and predictability projection into the health care system…. We’re working very hard. We do not have all the problems solved, but you have our commitment, Madam Secretary, to continue this work with physicians and hospitals, to free them up to practice medicine.

Despite its public support for health care reform, however, the insurance industry has engaged in a “duplicitous” campaign to undermine the effort (and openly engaging in practices that undermine Ignagni’s rehtoric.) In January, the National Journal revealed that from September to December 2009, “six of the nation’s biggest health insurers began quietly pumping big money into third-party television ads aimed at killing or significantly modifying the major health reform bills moving through Congress.” The companies used AHIP “as a conduit to avoid a repeat of the political flack that hit the insurance industry after it famously ran its multi-million dollar ‘Harry and Louise’ ads to help kill health care reforms during the Clinton administration.”

Earlier, the industry had sponsored several reports criticizing the Senate legislation, and funded state efforts to challenge the constitutionality of health reform. Several insurers — including Aetna and UnitedHealth — have long been dues-paying members of the Chamber, which has just unveiled another round of health care reform ads.

Rep. Alan Grayson (D-FL) has provided the White House with a real opportunity to win back its disillusioned Democratic base and take the next logical step to reforming the health care system. Last night, Grayson introduced the “Public Option Act,” also known as the “Medicare You Can Buy Into Act,” which would give all citizens and permanent residents under the age of 65 an opportunity to buy unsubsidized coverage in the Medicare program. The bill instructs the Secretary of Health And Human Services to “establish enrollment periods and coverage” guidelines and requires the newly insured to pay premiums that reflect the “costs incurred for individuals within each age.”

“What it does is it takes this enormously valuable public resource called the Medicare provider network and makes it available to all Americans,” Grayson said on the floor, remarking that the government “spends billions” on putting together a provider network that benefits “only 1/8 of the population.” “It’s like saying only senior citizens can drive on federal highways. That is how important the network is and we have to open it to everybody”:

GRAYSON: We’re going to be seeing a Senate bill that doesn’t have a public option. We’re going to be seeing reconciliation that doesn’t have a public option. But Americans need a public option. That’s why I’ve introduced this bill….This is not a plan for subsidies. Everyone would have to pay their own costs. This is not a plan that is not meant to help everybody except for the people who can’t otherwise get insurance…I’m asking the speaker and the leadership, if we have to vote on this senate bill, if we have to vote on this reconciliation amendment that doesn’t have a public option on it, isn’t it time we did something good for America?

Watch it:

As Grayson himself admits, in of itself, the unsubsidized Medicare buy-in would wouldn’t provide an affordable option for most Americans. Clinton era reformers sought to expand the Medicare program but were never able to provide enrollees with affordable premiums on an unsubsidized basis. According to a CBO analysis of a Medicare buy-in for uninsured Americans between 62 and 64 — that group would have to pay a premium plus an administrative fee of 5 percent — “the annual premium for single coverage in 2011 would be about $7,600 (that figure includes the cost of Part D coverage).”

The significance of this amendment lies in its political implications. After all, most progressives lost faith in the Senate health care bill after Reid’s deal to replace the opt-out public option with a Medicare buy in for 55 to 64 year olds fell apart. Running on a platform that calls for a Medicare buy in could rally the base, get out the vote, and provide Democrats with an offensive campaign strategy in response to the GOP’s anticipated ‘repeal it’ campaign. Most importantly, it would allow Democrats to rally behind a very popular element of health care reform and help offset the public’s reaction to the Senate bill. It’s a win-win for Democrats. The White House would be keen to pursue it.

The White House is pushing the House to pass the Senate’s health care bill by the end of next week, but Democratic leaders have rebuffed the administration’s deadlines. “He was certainly informed that we don’t feel we want any deadlines assigned to us,” House Energy and Commerce Committee Chairman Henry Waxman (D-CA) said after a healthcare strategy meeting between House and Senate Democratic leaders and Rahm Emanuel. Democrats appear to be about 10 votes short of securing the 216 votes necessary to pass the Senate reform bill and Republicans are fanning the flames of discontent. Over the last few weeks Republicans have promised to hold Democrats accountable for their original vote on the Senate package and tried to scare House members by arguing that there’s no guarantee that the Senate will approve a reconciliation package.

This morning, during an appearance on The Today Show, House Majority Leader Steny Hoyer (D-MD) — who yesterday morning said that “None of us has mentioned the 18th other than Mr. Gibbs” — initially suggested that the administration’s March 18 deadline was doable, before pushing it back to March 26, the beginning of Easter recess:

VIEIRA: Quickly, Congressman Hoyer and also Congressman Cantor, yes or no, will this bill be voted on before the president leaves for Asia on March 18th? Congressman Hoyer, yes or no?

HOYER: That’s our objective.

VIEIRA: And congressman Cantor?

CANTOR: Meredith, all I can say…

HOYER: Meredith, let me recall that ….

CANTOR: Is if it was a good bill, we’d be voting on it now, wouldn’t have to be talking about circumventing the rules….

HOYER: There is no circumventing of the rules and Mr. Cantor knows there’s no circumventing of the rules. And when I said the 18th, we hope to have this vote before we break for the Easter Break.

Watch the somewhat awkward exchange:

It’s certainly frustrating to hear Hoyer say that he’s merely “hoping” to pass something before Easter break, since a vote after the break would probably fail. Convincing ‘no’ votes to switch to ‘yes’ is a heavy lift in Washington, but it will be almost impossible after lawmakers attend August-style town halls in their districts.

But then again, the White House really set itself up for failure by enforcing an unrealistic (if past experience is any indicator) deadline. The reality is, we won’t have final action until the reconciliation instructions expire in April (once Congress passes a new budget) and lawmakers are literally pressed into action.