WASHINGTON — The Obama administration delivered to Congress its first detailed proposal for a piece of the healthcare overhaul Friday, suggesting that a new independent board make the decisions on how Medicare pays hospitals and doctors.
Until now, the president has carefully deferred to lawmakers developing healthcare legislation, in part because many believe that the Clinton administration's decision to write its own healthcare bill 15 years ago alienated Congress and contributed to that initiative's failure.
But pressure has been growing on the administration and its congressional allies to do more to restrain the nation's $2.5-trillion healthcare tab. And many specialists believe one key to curbing costs is to remove reimbursement decisions, which are now made by Congress, from the political process.
In addition, a growing number of Democratic lawmakers want President Obama to get more directly involved in the legislative process, in part to offer them the protection of his popularity. Many are concerned about the direction of the legislation rapidly moving through Congress. Two House committees and one Senate panel approved bills this week that would greatly expand coverage, and pay for it with higher taxes on the wealthy and cuts in Medicare and Medicaid reimbursements.
Obama offered encouragement Friday. "I realize that the last few miles of any race are the hardest to run," he said. "But I have to say: Now is not the time to slow down, and now is certainly not the time to lose heart.
"Make no mistake: If we step back from this challenge at this moment, we are consigning our children to a future of skyrocketing premiums and crushing deficits," he added. "There's no argument about that."
On Friday, a group of freshman House Democrats traveled to the White House to talk with Obama about their opposition to provisions in the House bill to raise taxes on wealthy Americans.
"The way we are paying for health reform would put a lot of strain on small business, which is particularly dangerous during a recession," said Rep. Jared Polis (D-Colo.), a leader of the group.
The House bill would impose a surtax on individuals who make more than $280,000 a year and couples who make more than $350,000. (Senate lawmakers have shown little interest in such an approach).
At the same time, a group of moderate "Blue Dog" Democrats in the House have been stepping up their demands that the legislation do more to increase the healthcare system's efficiency.
