sexta-feira, 19 de fevereiro de 2010

Obama to get specific on healthcare legislation


The president will detail his ideas days before the televised congressional talks planned next week. It marks a change in tack from his approach to let congressional leaders take the lead

By Noam N. Levey

Reporting from Washington - President Obama, after sustaining months of criticism for not being clear about what he wanted in healthcare legislation, will post specific proposals for a comprehensive plan on the Internet by Monday, according to the White House.



The posting would come three days before a televised meeting that Obama plans to convene with congressional Democratic and Republican leaders in hopes of restarting his stalled bid to overhaul the nation's healthcare system.



"There will be one proposal. It is the president's," Secretary of Health and Human Services Kathleen Sebelius said Thursday while unveiling a report highlighting large premium increases by insurance companies nationwide, including California-based Anthem Blue Cross.

"I think the idea is that it will take some of the best of the ideas [from the House and Senate bills] and put them into a framework moving forward," Sebelius said.

Sebelius and other Democratic officials have been stepping up their attacks on the insurance industry as they work to convince Americans of the need for a comprehensive healthcare bill.

Obama, in a letter inviting congressional leaders to next week's meeting, indicated that his legislative proposal would "put a stop to insurance company abuses, extend coverage to millions of Americans, get control of skyrocketing premiums and out-of-pocket costs and reduce the deficit".

His plan will probably offer the most detailed vision yet of where the president stands on a number of contentious healthcare issues that have divided Democrats, including how to pay for a major expansion of medical coverage. Administration officials and congressional Democrats are nearing such a compromise, according to Democratic officials.

It is still unclear what, if any, concessions the president will make to Republicans, who have steadfastly opposed Obama's push for an overhaul.

Obama's proposal may represent the last, best hope for reviving his top domestic priority. After a year during which the president looked to congressional Democrats to develop health legislation, many are now looking to him to push it over the finish line after his party lost its Senate supermajority following last month's special election in Massachusetts.

Obama has challenged congressional Republicans to come forward with their own alternative.

House Republicans have proposed a more limited healthcare bill that the nonpartisan Congressional Budget Office estimated would control premiums, but would do almost nothing to expand coverage over the next decade.

Senate Republican leaders have not developed an alternative. "We will not be offering a comprehensive bill," said Don Stewart, a spokesman for Senate Minority Leader Mitch McConnell (R-Ky.), citing public anxiety about sweeping healthcare legislation.

Michael Franc, who oversees government relations for the conservative Heritage Foundation, said Republicans would be wise to steer clear of any public negotiating over healthcare legislation with the president, suggesting instead that they stick to their demand that the Democratic bills be scrapped.

"The last thing Republican leadership wants is to get drawn into something that upsets their base," Franc said.

House Minority Leader John A. Boehner (R-Ohio) and the minority whip, Rep. Eric Cantor (R-Va.), have asked the White House for an assurance that Obama is prepared to "start over". Administration officials have firmly rejected that.

Instead, senior Democrats plan to outline a proposal that hews closely to the legislation that Democrats developed last year that would expand coverage to about 30 million Americans over the next decade, dramatically increase regulation of the insurance industry and cost about $900 billion.

To get the proposal through Congress, Democrats in the House would probably have to approve the bill that the Senate approved last year on a party-line vote. Then both the House and Senate would vote on a package of changes to the bill using a process known as budget reconciliation that requires only a simple majority in the Senate.

That package of changes, which has been the subject of intense negotiations for more than a month, are almost finalized, according to Democratic officials.

Senior Democrats have largely agreed to eliminate a controversial provision in the Senate bill providing special federal aid to Nebraska to help that state expand its Medicaid program, which had been included to secure the vote of that state's Democratic senator.

They plan to boost federal subsidies to help low- and moderate-income Americans buy health insurance in new insurance exchanges. And they want to close the gap in Medicare's drug coverage for seniors, known as the "doughnut hole".

Discussions about how to scale back a new tax in the Senate bill on high-end "Cadillac" health plans are still underway.

Next week, the White House and senior Democrats could also add more changes to the package to reflect Republican priorities or to satisfy additional requests from rank-and-file Democrats, who will return to Washington after their Presidents Day recess.

Times staff writer Duke Helfand in Los Angeles contributed to this report

Los Angeles Times