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Obama lays out goals on healthcare

His $950-billion blueprint would raise some taxes and cut Medicare spending, and it challenges GOP leaders to offer an alternative.

February 23, 2010|By Noam N. Levey

Reporting from Washington — In an 11th-hour bid to rally Democrats behind a sweeping healthcare overhaul, President Obama offered his own detailed plan Monday that would expand coverage, tighten regulation of the insurance industry and seek greater efficiencies in the nation's medical system.

Healthcare plan: An article in Tuesday's Section A about President Obama's healthcare plan quoted Democratic strategist Paul Begala as saying, "The Republican leadership is more likely to perform in a gay marriage than they are to work with Democrats on healthcare." The quote should have read, "The Republican leadership is more likely to perform a gay marriage than they are to work with Democrats on healthcare." —

The 10-year $950-billion blueprint -- released by the White House three days before a healthcare summit with congressional Democrats and Republicans -- would also raise a variety of taxes and cut Medicare spending while reducing the federal deficit by $100 billion.

In unveiling the plan, the White House also challenged GOP leaders to offer an alternative. But with Republicans firmly against any major healthcare legislation, the president's primary task is unifying House and Senate Democrats.

After Democrats recently lost their filibuster-proof majority in the Senate, Democratic leaders and the White House hope the House will approve the bill that has already passed the Senate -- along with separate legislation incorporating changes suggested by Obama on Monday to address concerns by House Democrats.

"The real goal here has to be to resolve differences among Democrats," said veteran Democratic strategist Paul Begala. "The Republican leadership is more likely to perform a gay marriage than they are to work with Democrats on healthcare."

GOP leaders swiftly condemned the president's latest proposal, which House Minority Leader John A. Boehner (R-Ohio) called a "new Democrats-only backroom deal" that "doubles down on the same failed approach."

Republicans have called on Obama to scrap the current bill and pursue more limited legislation.

House Speaker Nancy Pelosi (D-San Francisco) met with rank-and-file House Democrats on Monday evening to discuss the president's proposal.

Among other issues, she faces the challenge of winning over representatives who want tighter restrictions on abortion funding than those in the Senate bill.

Senate Democrats are slated to discuss healthcare when they meet for their weekly luncheon Tuesday.

White House officials and Democratic congressional leaders have been working on the two-stage strategy in which the House would vote on the Senate bill and both chambers would separately pass a package of changes.

The package could also include traditional Republican healthcare priorities, including new efforts to clamp down on waste and fraud in government healthcare programs.

The extent to which GOP ideas are incorporated could depend on the outcome of Thursday's summit.

Even without GOP support, Democrats believe that the package could be advanced through a process known as budget reconciliation, which requires only 51 votes in the Senate, rather than the 60-vote supermajority necessary to squash a filibuster.

White House communications director Dan Pfeiffer said Monday that no decision had been made about using budget reconciliation. But he said the president's proposal was developed with that option in mind.

"The president expects, and believes the American people deserve, an up or down vote on health reform," Pfeiffer said. "The package is designed to provide us the flexibility to achieve that if the Republican party decides to filibuster health reform."

Both parties have used budget reconciliation over the last 25 years to advance major domestic initiatives, including the 1996 overhaul of the nation's welfare system and the major tax cuts enacted by the Bush administration in 2001 and 2003. But it remains controversial, even with some Democrats.

Like the Senate bill, the centerpiece of the president’s plan to expand coverage are new state insurance exchanges in which people who do not get coverage through work would be able to shop for plans. The federal government would oversee the plans, as it now does for members of Congress and other federal employees.

Additionally, the president would give the federal government new authority to regulate premiums charged by private insurers, a new proposal that the White House unveiled over the weekend in response to steep rate hikes in California and elsewhere in recent months.

Under Obama's proposal, the secretary of Health and Human Services would be able to block premium hikes deemed excessive under standards to be developed by a panel of experts.

That idea drew fire Monday from insurance industry officials, who said rate hikes nationally are being driven primarily by rising medical costs.

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