Obama and Republicans bicker over doctors' Medicare pay

WASHINGTON – President Barack Obama is asking Republican lawmakers to approve billions of dollars in new spending to avert a scheduled 21 percent cut in payments to doctors who treat Medicare patients.

If GOP senators don't allow the stalled proposal to pass, some doctors will stop treating Medicare recipients, Obama said in his weekly radio and Internet address Saturday.
The Senate's top Republican, Mitch McConnell of Kentucky, said his party wants to avoid reducing physicians' fees, but do it without adding to the deficit — meaning spending cuts elsewhere.
The president noted that since 2003, Congresses led by Democrats and by Republicans alike have blocked similar proposed cuts in doctors' reimbursement rates. But now, he said, Republicans are "willing to walk away from the needs of our doctors and our seniors."
The "doc fix" is part of a large, Democratic-drafted bill that would extend several popular tax breaks while greatly increasing the tax that oil companies pay into a spill liability fund. Republican senators have focused their objections on the bill's tax increases, not the doctors' pay matter.
"Even in the face of public outrage, Democrats are showing either that they just dont get it on this issue of the debt, or that they just dont care," McConnell said.
For years, lawmakers from both parties routinely have said that would trim Medicare reimbursement rates as a way to save money and make their budget plans appear more frugal. Later, in a move that watchdog groups call cynical, the lawmakers routinely undo the proposed cuts in doctor payments, which are considered politically unpalatable.
Obama acknowledged that a better plan is needed.
"I realize that simply kicking these cuts down the road another year is not a long-term solution," he said. "I am committed to permanently reforming this Medicare formula in a way that balances fiscal responsibility with the responsibility we have to doctors and seniors."
The president said he is "absolutely willing to take the difficult steps necessary to lower the cost of Medicare and put our budget on a more fiscally sustainable path. But I'm not willing to do that by punishing hardworking physicians or the millions of Americans who count on Medicare. That's just wrong. And that's why in the short-term, Congress must act to prevent this pay cut to doctors."
In the GOP weekly radio address, House Republican leader John Boehner of Ohio called on Obama to rein in government spending and accused the president of "refusing to make the tough choices" when it comes to budget cuts. While Boehner did not mention the dispute over Medicare doctor payments, he renewed his attack on the new health care law, saying its "burdensome mandates and tax increases" are stalling economic recovery.

Lockheed, Boeing and Others See Health Reform Charges

Reuters is reporting that Lockheed Martin Corp, Boeing Co, Goodrich Corp and Ingersoll-Rand Plc on Wednesday joined a growing list of companies that plan to book charges related to U.S. healthcare reform.

The federal government pays subsidies to large companies, including AT&T Inc, Caterpillar Inc and Deere & Co, to help pay for prescription drug benefits for retirees.
The U.S. healthcare overhaul signed into law last week by President Barack Obama would eliminate tax deductions that have been available to companies that provide such benefits.
Some corporate leaders have complained that the change amounts to a tax increase. White House officials have countered that it essentially closes a tax loophole.
Although the change does not take effect until 2013, accounting rules require that the charges be recorded in the period the legislation was enacted.
On Wednesday, the list of corporations expecting to take charges related to healthcare reform grew.
Lockheed Martin, the world's largest defense contractor, said it expected to record a $96 million, or about 25 cents a share, after-tax charge in the first quarter.
Boeing said it would take a charge of around $150 million, or 20 cents per share, against first-quarter results.
Aircraft parts supplier Goodrich expected the charge to be about $10 million, or 8 cents per share, in the first quarter, while air compressor and cooling systems maker Ingersoll-Rand forecast a charge of $41 million, or 12 cents per share.
Conversely, General Electric Co has said that it does not expect health care reform to have a "significant material impact" on its results.

Obama signs law finalizing health care, loan redo

Associated Press Writer Philip Elliott, Associated Press Writer – 4 mins ago


WASHINGTON – President Barack Obama has signed a law that finalizes his health care overhaul and makes the government the issuer of all federal college loans.
The president completed the measure at Northern Virginia Community College, where he emphasized new help for college students.
The legislation was the second of two steps needed for the Democratic-led House and Senate to approve a health care package affecting virtually all Americans. The new law makes a series of fixes to the one Obama approved last week. It removes some unpopular provisions among other changes.
In the same swoop, Democrats added in a rewriting of college aid.
The new law strips banks of their ability to issue federal student loans in favor of direct government lending.

Coverage Now for Sick Children?

WASHINGTON — Just days after President Obama signed the new health care law, insurance companies are already arguing that, at least for now, they do not have to provide one of the benefits that the president calls a centerpiece of the law: coverage for certain children with pre-existing conditions.
Senator John D. Rockefeller IV criticized insurance companies that say they do not yet have to cover pre-existing conditions.
A blog from The New York Times that tracks the health care debate as it unfolds.
How the Health Care Overhaul Could Affect You
Mr. Obama, speaking at a health care rally in northern Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”
The authors of the law say they meant to ban all forms of discrimination against children with pre-existing conditions like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they say, was to provide those youngsters with access to insurance and to a full range of benefits once they are in a health plan.
To insurance companies, the language of the law is not so clear.
Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the “availability of coverage” for all until 2014.
William G. Schiffbauer, a lawyer whose clients include employers and insurance companies, said: “The fine print differs from the larger political message. If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.”
Congressional Democrats were furious when they learned that some insurers disagreed with their interpretation of the law.
“The concept that insurance companies would even seek to deny children coverage exemplifies why we fought for this reform,” said Representative Henry A. Waxman, Democrat of California and chairman of the Energy and Commerce Committee.
Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”
The issue is one of many that federal officials are tackling as they prepare to carry out the law, with a huge stream of new rules, official guidance and brochures to educate the public. Their decisions will have major practical implications.
Insurers say they often limit coverage of pre-existing conditions under policies sold in the individual insurance market. Thus, for example, an insurer might cover a family of four, including a child with a heart defect, but exclude treatment of that condition from the policy.
The new law says that health plans and insurers offering individual or group coverage “may not impose any pre-existing condition exclusion with respect to such plan or coverage” for children under 19, starting in “plan years” that begin on or after Sept. 23, 2010.
But, insurers say, until 2014, the law does not require them to write insurance at all for the child or the family. In the language of insurance, the law does not include a “guaranteed issue” requirement before then.
Consumer advocates worry that instead of refusing to cover treatment for a specific pre-existing condition, an insurer might simply deny coverage for the child or the family.
“If you have a sick kid, the individual insurance market will continue to be a scary place,” said Karen L. Pollitz, a research professor at the Health Policy Institute at Georgetown University.
Experts at the National Association of Insurance Commissioners share that concern.
“I would like to see the kids covered,” said Sandy Praeger, the insurance commissioner of Kansas. “But without guaranteed issue of insurance, I am not sure companies will be required to take children under 19.”
A White House spokesman said the administration planned to issue regulations setting forth its view that “the term ‘pre-existing’ applies to both a child’s access to a plan and his or her benefits once he or she is in a plan.” But lawyers said the rules could be challenged in court if they went beyond the law or were inconsistent with it.
Starting in January 2014, health plans will be required to accept everyone who applies for coverage.
Until then, people with pre-existing conditions could seek coverage in high-risk insurance pools run by states or by the secretary of health and human services. The new law provides $5 billion to help pay claims filed by people in those pools.
Federal officials will need to write rules or guidance to address a number of concerns. The issues to be resolved include defining the “essential health benefits” that must be offered by all insurers; deciding which dependents are entitled to stay on their parents’ insurance; determining who qualifies for a “hardship exemption” from the requirement to have insurance; and deciding who is eligible for a new long-term care insurance program.
As originally conceived, most of the new federal requirements would have taken effect at the same time, in three or four years. The requirements for people to carry insurance, for employers to offer it and for insurers to accept all applicants were tied together.
But as criticism of their proposal grew, Democrats wanted to show that the legislation would produce immediate, tangible benefits. So they accelerated the ban on “pre-existing condition exclusions” for children.
Consumers will soon gain several other protections. By July 1, the health secretary must establish a Web site where people can identify “affordable health insurance coverage options.” The site is supposed to provide information about premiums, co-payments and the share of premium revenue that goes to administrative costs and profits, rather than medical care.
In addition, within six months, health plans must have “an effective appeals process,” so consumers can challenge decisions on coverage and claims.

Breaking News - Congress clears historic health care bill

WASHINGTON – Summoned to success by President Barack Obama, the Democratic-controlled Congress approved historic legislation Sunday night extending health care to tens of millions of uninsured Americans and cracking down on insurance company abuses, a climactic chapter in the century-long quest for near universal coverage.

Widely viewed as dead two months ago, the Senate-passed bill cleared the House on a 219-212 vote. Republicans were unanimous in opposition, joined by 34 dissident Democrats.

Obama watched the vote in the White House's Roosevelt Room with Vice President Joe Biden and about 40 staff aides. When the long sought 216th vote came in — the magic number needed for passage — the room burst into applause and hugs. An exultant president exchanged a high-five with his chief of staff, Rahm Emanuel.

A second, smaller measure — making changes in the first — was lined up for passage later in the evening. It would then go to the Senate, where Democratic leaders said they had the votes to pass it.

The nonpartisan Congressional Budget Office said the legislation awaiting the president's approval would extend coverage to 32 million Americans who lack it, ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade. If realized, the expansion of coverage would include 95 percent of all eligible individuals under age 65.

For the first time, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.

Far beyond the political ramifications — a concern the president repeatedly insisted he paid no mind — were the sweeping changes the bill held in store for millions of individuals, the insurance companies that would come under tougher control and the health care providers, many of whom would face higher taxes.

Crowds of protesters outside the Capitol shouted "just vote no" in a futile attempt to stop the inevitable taking place inside a House packed with lawmakers and ringed with spectators in the galleries above.

Across hours of debate, House Democrats predicted the larger of the two bills, costing $940 billion over a decade, would rank with other great social legislation of recent decades.

"We will be joining those who established Social Security, Medicare and now, tonight, health care for all Americans, said Speaker Nancy Pelosi, partner to Obama and Senate Majority Leader Harry Reid, D-Nev., in the grueling campaign to pass the legislation.

"This is the civil rights act of the 21st century," added Rep. Jim Clyburn of South Carolina, the top-ranking black member of the House.

Republicans readily agreed the bill would affect everyone in America, but warned repeatedly of the burden imposed by more than $900 billion in tax increases and Medicare cuts combined.

"We have failed to listen to America," said Rep. John Boehner of Ohio, leader of a party that has vowed to carry the fight into the fall's midterm elections for control of Congress.

The final obstacle to the bill's passage was cleared at mid-afternoon when Obama and Democratic leaders reached a compromise with anti-abortion lawmakers whose rebellion had left the outcome in doubt. The White House announced he would issue an executive order pledging that no federal funds would be used for elective abortion, satisfying Rep. Bart Stupak of Michigan and a handful of like-minded lawmakers.

A spokesman for the U.S. Conference of Catholic Bishops expressed skepticism that the presidential order would satisfy the church's objections.

Republican abortion foes also said Obama's proposed order was insufficient, and when Stupak sought to counter them, a shout of "baby killer" could be heard coming from the Republican side of the chamber.

The measure would also usher in a significant expansion of Medicaid, the federal-state health care program for the poor. Coverage would be required for incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014.

The insurance industry, which spent millions on advertising trying to block the bill, would come under new federal regulation. They would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions and from canceling policies when a policyholder becomes ill.

Parents would be able to keep children up to age 26 on their family insurance plans, three years longer than is now the case.

A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion would go into high gear.

For the president, the events capped an 18-day stretch in which he traveled to four states and lobbied more than 60 wavering lawmakers in person or by phone to secure passage of his signature domestic issue. According to some who met with him, he warned that the bill's demise could cripple his still-young presidency.

After more than a year of political combat, Democrats piled superlative upon superlative across several hours of House debate.

Rep. Louise Slaughter of New York read a message President Franklin Roosevelt sent Congress in 1939 urging lawmakers to address the needs of those without health care, and said Democrat Harry Truman and Republican Richard Nixon had also sought to broaden insurance coverage.

Republicans attacked the bill without let-up, warning it would harm the economy while mandating a government takeover of the health care system.

"The American people know you can't reduce health care costs by spending $1 trillion or raising taxes by more than one-half trillion dollars. The American people know that you cannot cut Medicare by over one-half trillion dollars without hurting seniors," said Rep. Dave Camp, R-Mich.

"And, the American people know that you can't create an entirely new government entitlement program without exploding spending and the deficit."

Obama has said often that presidents of both parties have tried without success to achieve national health insurance, beginning with Theodore Roosevelt early in the 20th century.

The 44th president's quest to succeed where others have failed seemed at a dead end two months ago, when Republicans won a special election for a Massachusetts Senate seat, and with it, the votes to prevent a final vote.

But the White House, Pelosi and Reid soon came up with a rescue plan that required the House to approve the Senate-passed measure despite opposition to many of its provisions, then have both houses pass a fix-it measure incorporating numerous changes.

To pay for the changes, the legislation includes more than $400 billion in higher taxes over a decade, roughly half of it from a new Medicare payroll tax on individuals with incomes over $200,000 and couples over $250,000. A new excise tax on high-cost insurance policies was significantly scaled back in deference to complaints from organized labor.

In addition, the bills cut more than $500 billion from planned payments to hospitals, nursing homes, hospices and other providers that treat Medicare patients. An estimated $200 billion would reduce planned subsidies to insurance companies that offer a private alternative to traditional Medicare.

The insurance industry warned that seniors would face sharply higher premiums as a result, and the Congressional Budget Office said many would return to traditional Medicare as a result.

The subsidies are higher than those for seniors on traditional Medicare, a difference that critics complain is wasteful, but insurance industry officials argue goes into expanded benefits.

Breaking News - House passes second historic health care vote

The aftermath of the great Washington health care debate has held true to form, breaking down strictly down partisan lines. House Democrats hailed their final vote on health care reform tonight as a historic breakthrough, ending more than 70 years of efforts to put all Americans under some form of health care coverage. Republicans just as forcefully denounced today's vote - which approved both the original Senate bill and some key "fixes" to it - as an irresponsible and needless expansion of big government amid ballooning federal deficits.


The bill passed 220 to 211.

Tonight's second vote was designed to rid the final legislation of some of the more-controversial provisions in the Senate version of the bill, such as the special multimillion-dollar increases in Medicaid for the states of Nebraska and Louisiana, which were instrumental to winning the support of wavering Sens. Mary Landrieu (D-LA) and Ben Nelson (D-NE). The vote also closes up the "doughnut hole" in the Medicare prescription drug benefit, which leaves seniors without drug subsidies for several months - which has likewise proved critical in winning the backing of the pharmaceutical industry and has been blanketing the airwaves with ads urging passage of the bill.

While the Senate still has to weigh in on the amended bill, most observers think that shouldn't be much more than a formality, especially at this late stage of the process. At the very least, the House vote ensures that there will be a health care bill on President Obama's desk, perhaps as early as the end of this week. And the president's signature will set into motion the most dramatic change to American health care since Lyndon Johnson signed Medicare into law in 1965.

The bill, which the Congressional Budget Office says will cost $940-billion over ten years, is expected to cover an estimated 32 million Americans who are presently uninsured. Among its major provisions:

-An "individual mandate" will require all Americans to purchase some form of health care coverage, with government subsidies provided to those needing financial assistance to do so. People who don't obtain coverage of some sort will be subject to federal fines, which would begin to take effect in 2015.

-All employers with 50 or more employees will be legally obliged to offer coverage - or else they will be assessed a stiff fine of $2,000 per uninsured employee.

-Insurance exchanges - that is, purchasing pools for individuals not covered by employer-provided or federal plans such as Medicare - will be able to obtain coverage.

-Private insurers will no longer be permitted to deny coverage or raise premiums on the basis of pre-existing medical conditions or illness.

-Cost controls will be phased in via expanded coverage plans, resulting in a $1.3 trillion reduction in the federal deficit during the next 20 years, against $940 billion in costs associated with the bill, according to estimates from the Congressional Budget Office.

A Look At The Health Care Bill

By The Associated Press The Associated Press –
Congressional Democrats have released a final version of President Barack Obama's health care overhaul bill in advance of a House vote planned for Sunday. Some features of the legislation, which makes changes to the bill the Senate passed on Christmas Eve:
COST: $940 billion over 10 years, according to the Congressional Budget Office.
HOW MANY COVERED: 32 million uninsured. Major coverage expansion begins in 2014. When fully phased in, 95 percent of eligible Americans would have coverage, compared with 83 percent today.
INSURANCE MANDATE: Almost everyone is required to be insured or else pay a fine. There is an exemption for low-income people. Mandate takes effect in 2014.
INSURANCE MARKET REFORMS: Starting this year, insurers would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions, and from canceling policies because someone gets sick. Parents would be able to keep older kids on their coverage up to age 26. A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion goes into high gear. Major consumer safeguards would also take effect in 2014. Insurers would be prohibited from denying coverage to people with medical problems or charging them more. Insurers could not charge women more.
MEDICAID: Expands the federal-state Medicaid insurance program for the poor to cover people with incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014. The federal government would pay 100 percent of costs for covering newly eligible individuals through 2016. A special deal that would have given Nebraska 100 percent federal financing for newly eligible Medicaid recipients in perpetuity is eliminated. A different, one-time deal negotiated by Democratic Sen. Mary Landrieu for her state, Louisiana, worth as much as $300 million, remains.
TAXES: Dramatically scales back a Senate-passed tax on high-cost insurance plans that was opposed by House Democrats and labor unions. The tax would be delayed until 2018, and the thresholds at which it is imposed would be $10,200 for individuals and $27,500 for families. To make up for the lost revenue, the bill applies an increased Medicare payroll tax to investment income as well as wages for individuals making more than $200,000, or married couples above $250,000. The tax on investment income would be 3.8 percent.
PRESCRIPTION DRUGS: Gradually closes the "doughnut hole" coverage gap in the Medicare prescription drug benefit that seniors fall into once they have spent $2,830. Seniors who hit the gap this year will receive a $250 rebate. Beginning in 2011, seniors in the gap receive a discount on brand name drugs, initially 50 percent off. When the gap is completely eliminated in 2020, seniors will still be responsible for 25 percent of the cost of their medications until Medicare's catastrophic coverage kicks in.
EMPLOYER RESPONSIBILITY: As in the Senate bill, businesses are not required to offer coverage. Instead, employers are hit with a fee if the government subsidizes their workers' coverage. The $2,000-per-employee fee would be assessed on the company's entire work force, minus an allowance. Companies with 50 or fewer workers are exempt from the requirement. Part-time workers are included in the calculations, counting two part-timers as one full-time worker.
SUBSIDIES: The proposal provides more generous tax credits for purchasing insurance than the original Senate bill did. The aid is available on a sliding scale for households making up to four times the federal poverty level, $88,200 for a family of four. Premiums for a family of four making $44,000 would be capped at around 6 percent of income.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Small businesses, the self-employed and the uninsured could pick a plan offered through new state-based purchasing pools called exchanges, opening for business in 2014. The exchanges would offer the same kind of purchasing power that employees of big companies benefit from. People working for medium-to-large firms would not see major changes. But if they lose their jobs or strike out on their own, they may be eligible for subsidized coverage through the exchange.
GOVERNMENT-RUN PLAN: No government-run insurance plan. People purchasing coverage through the new insurance exchanges would have the option of signing up for national plans overseen by the federal office that manages the health plans available to members of Congress. Those plans would be private, but one would have to be nonprofit.
ABORTION: The proposal keeps the abortion provision in the Senate bill. Abortion opponents disagree on whether restrictions on taxpayer funding go far enough. The bill tries to maintain a strict separation between taxpayer dollars and private premiums that would pay for abortion coverage. No health plan would be required to offer coverage for abortion. In plans that do cover abortion, policyholders would have to pay for it separately, and that money would have to be kept in a separate account from taxpayer money. States could ban abortion coverage in plans offered through the exchange. Exceptions would be made for cases of rape, incest and danger to the life of the mother.

GOP HEALTH CARE SUMMIT IDEAS: Following a bipartisan health care summit last month, Obama announced he was open to incorporating several Republican ideas into his legislation. But two of the principle ones — hiring investigators to pose as patients and search for fraud at hospitals and increasing spending for medical malpractice reform initiatives — did not make it into the legislation released Thursday. The legislation incorporates only one, an increase in payments to primary care physicians under Medicaid, an idea mentioned by Sen. Charles Grassley, R-Iowa.

Pelosi Predicts a Health Bill Within 10 Days

WASHINGTON — Speaker Nancy Pelosi mobilized House Democrats on Friday for a final effort to pass an overhaul of health care, predicting approval in the next 10 days with help from President Obama, who delayed a trip abroad to try to win over wavering Democrats.
Speaker Nancy Pelosi said a proposed overhaul of the student loan program would be included in the final health care bill.
The White House said Mr. Obama would begin his trip to Indonesia and Australia a week from Sunday, three days later than scheduled, allowing him to be on hand for what is shaping up as the pivotal period for his top domestic initiative. Mr. Obama will travel to Ohio on Monday to push for passage.
But even as the yearlong battle hurtled toward a conclusion, approval of the bill was hardly certain, so lawmakers were preparing for a week of arm-twisting and high drama. Although they have been debating the issue for a year, some House Democrats said Friday that they could not say how they would vote because they had not seen the final text of the legislation or an official estimate of its cost.
Some issues that could swing blocs of votes, like insurance coverage for abortions, remain unresolved. House Democratic leaders said they had suspended their efforts to reach a compromise with party members who oppose abortion and the use of federal money to subsidize insurance that includes coverage of the procedure. That could cost them the votes of some House Democrats who supported the health care bill in the fall after it was amended to impose tight restrictions on abortion coverage.
The Capitol, normally quiet on a Friday, was abuzz as Democrats and Republicans readied for what is likely to be a frenetic push, leading to a series of climactic votes.
At the same time, members of both parties struggled to decipher a ruling by the Senate parliamentarian about how they would have to navigate through the complex rules governing the legislative technique being used by Democrats to win final approval of the bill. While their interpretations differed, Democrats said they believed they could meet its requirements with this sequence of events:
As soon as Thursday or Friday, the House would pass the health care bill approved by the Senate in December. The House would immediately approve a package of changes in a separate bill, using a procedure known as budget reconciliation, to avoid the threat of a Republican filibuster in the Senate.
Mr. Obama would sign the Senate health care bill, making it the law of the land. The budget reconciliation bill would go to the Senate, where Republicans intend to offer dozens of amendments and points of order in an effort to alter or stop it. Assuming they are able to fend off the Republican blocking efforts, Democrats could pass the reconciliation package with a simple majority vote, amending the health bill in a way that makes it acceptable to Democrats in the House and the Senate and to Mr. Obama. The president would then sign the reconciliation bill, completing the process.
The Senate Republican leader, Mitch McConnell of Kentucky, said Democrats were “twisting themselves into pretzels trying to figure some way to get this health care bill passed.”
“The reason all of this arm-twisting and deal-making and parliamentary maneuvering is going on is that people hate this bill,” Mr. McConnell said. “They are trying to convince their members, within eight months of an election, to ignore their constituents and do something that the public is opposed to.”
Ms. Pelosi said a proposed overhaul of the student loan program would be included in the reconciliation bill, a decision that cheered many Democrats. The education bill is popular in the House, and some Democrats said it could help win support for the overall package, in part because it cuts off subsidies to big banks at a time of populist anger against Wall Street.
“This is a controversial, difficult vote for a lot of people, me included,” said Representative Robert E. Andrews, Democrat of New Jersey. “The more things that you can go home and say are in the bill that are sort of universally popular, yeah, it helps.”
He noted, for example, that the bill would provide additional money for community colleges and Pell grant scholarships.
But another New Jersey Democrat, Representative Bill Pascrell Jr., criticized packaging the health care and education bills together. “We will be confusing the American people more than we already have,” said Mr. Pascrell, who supports both bills.
Ms. Pelosi welcomed Mr. Obama’s decision to delay his trip.
“I’m delighted that the president will be here for passage of the bill,” she said. “It’s going to be historic. And it would not be possible without his tremendous, tremendous leadership, his persistence, his concern for the American people, always guided by his statement that we will measure our success by the progress being made by America’s working families.”
The bill would provide coverage to more than 30 million people who are uninsured, would require most Americans to carry insurance and would prohibit insurers from denying coverage to people who are sick. In both houses, Republicans strenuously oppose the legislation, saying it would raise taxes, cut Medicare and lead to higher premiums for many people who are relatively young and healthy.
Though Democrats said the bill could come to a vote by the end of the week, they have missed many self-imposed deadlines on health care, and when pressed on the schedule, Ms. Pelosi said she could not guarantee final House action by March 21, when Mr. Obama is to leave on his trip.
“I’m hoping that it will be in that time frame,” she said, adding, “We stand ready to stay as long as it takes to pass the bill.”
Representative Anthony D. Weiner, Democrat of New York, expressed the optimism of many in his party after the House Democratic Caucus met Friday.
“There’s been a tidal change, I think, in the last 72 hours or so,” Mr. Weiner said. “People have become more confident that we’re going to get this done.”
Abortion is perhaps the most contentious outstanding issue. Representative Steny H. Hoyer of Maryland, the Democratic leader, said he had discussed the issue with Representative Bart Stupak of Michigan, a leader of the anti-abortion Democrats. But Mr. Hoyer said, “I made it clear I was not negotiating.”
House Democrats dislike the Senate health bill and do not want to vote for it without an assurance that the Senate will pass the budget reconciliation bill to eliminate politically unpopular provisions, like one giving Nebraska extra Medicaid money.

Obama Using 'Bounty Hunters' for Health Care Fraud

WASHINGTON (AP) — President Barack Obama said Tuesday he'll bring in high-tech bounty hunters to help root out health care fraud, grabbing a populist idea with bipartisan backing in his final push to overhaul the system.

The White House announcement came as Obama prepared to travel to Missouri on Wednesday, taking his closing argument to the nation's heartland. The trip will be his second public appearance this week to rally support and fire up nervous Democrats.
The White House released details of the anti-fraud plan hours after a fresh challenge to the administration from major business groups that unveiled a multimillion-dollar ad campaign arguing that under Obama's plan "health care costs will go even higher, making a bad economy worse."

Obama Targets Insurers, Sells Reform Plan

WASHINGTON (Reuters) - President Barack Obama launched a sharp attack on health insurers on Monday and called on his fellow Democrats to rise above politics and pass a healthcare overhaul in the next few weeks.

Hitting the road to rally support in the final push for healthcare reform, Obama used a campaign-style speech to urge Democrats to approve a bill and quickly end the political wrangling that has consumed Washington since July.
"There have been plenty of folks in Washington who have said that the politics is just too hard. They've argued now is not the time for reform," Obama said at Arcadia University in Glenside, Pennsylvania.
"My question to them is: When is the right time? If not now, when?" he asked, shrugging off warnings of a political backlash in November for Democrats who back the overhaul.
"I don't know how passing healthcare will play politically, but I do know that it's the right thing to do," he said.
Obama also offered his toughest criticism yet of a health insurance industry that he said placed profits ahead of patients. "Every year, they raise premiums higher and higher," Obama said "They will keep doing this for as long as they can get away with it."
Turning up the heat, Health Secretary Kathleen Sebelius sent a letter to top companies such as Aetna Inc and Wellpoint Inc asking them to justify rate increases by making public information about costs, enrollment changes and other details.
"It's time for these insurance company CEOs to do their part to make the system more transparent for the American people," Sebelius said. "If insurance companies are going to raise rates, the least they can do is tell us why."
The Obama administration has targeted health insurers in its final push for an overhaul designed to rein in costs, regulate insurers and expand coverage to tens of millions of Americans.
Obama said failure to pass a healthcare overhaul this year would leave intact a broken $2.5 trillion healthcare system that is ravaged by greedy health insurers.

INSURERS MAKE 'A CALCULATION'
"These insurance companies have made a calculation," Obama said "They're OK with people being priced out of health insurance because they'll still make more by raising premiums on the customers they keep.
The House of Representatives is expected to vote by the end of March on the Senate's version of the healthcare bill, with Democratic House Speaker Nancy Pelosi searching for the 216 votes to pass it. The House approved its version with only three votes to spare in November.
Republican leaders say they will make healthcare reform a top issue in November's elections and urged Republican candidates to focus on the Democratic-crafted bills, which polls show are unpopular with the public.
"A vote for this bill opens an entirely new line of attack on House Democrats," Johnny Destefano, a House Republican campaign committee official, said in a memo to Republican House candidates.
"Now is the time to apply pressure and force your opponents into taking a stand on whether they will walk Speaker Pelosi's plank by supporting her last-ditch healthcare push," he said.
Republican Senate leader Mitch McConnell said the new push on healthcare would be a replay of the frantic maneuvering that marked Senate passage just before Christmas.
"Americans don't like this bill any more today than they did three months ago," he said.
But in Pennsylvania, Obama sought the public's help in rallying Congress to pass the overhaul. "It's time to make a decision," Obama said. "The time for talk is over."
The overhaul looked dead in January when Republicans deprived Democrats of their crucial 60th Senate vote by winning a Massachusetts special election, stopping negotiations to merge bills already passed by the House and Senate.
But changes to the Senate bill sought by Obama and House Democrats will be considered separately using a procedure that allows a majority vote in the 100-member Senate rather than the 60 votes needed to clear Republican procedural hurdles.
Obama proposed revisions to the Senate bill last week to ease the concerns of House Democrats, including watering down a tax on expensive insurance plans and boosting federal subsidies to make coverage more affordable.
"I think there's a lot more determination in the Congress now to get it passed," Democratic Senator Arlen Specter of Pennsylvania told reporters after Obama's speech.
"I really think there's sort of reaction on the Democratic side of getting a little angry over the duration and intensity of obstruction and a lot more determination to see it through."
In her letter to insurers, Sebelius asked executives to post on their websites the justification for any individual or small group rate increases they implemented or proposed in 2010, and continue to do so in the future.
The heads of Cigna Corp, UnitedHealth Group Inc and privately held Health Care Service Corp also received the letter.
Health insurer shares were down for the day. The Morgan Stanley Healthcare Payor index was down about 0.4 percent and the S&P Managed Health Care index was off 1 percent.
The CEO of Manpower, a global employment services company that provides temporary workers, said the uncertainty of the healthcare debate in Washington was keeping U.S. employers from hiring.
"The concern is that we have a political system that is too broken to fix systemic issues," CEO Jeff Joerres told Reuters.

Obama's Health Care Pitch to Democrats: Trust Me

WASHINGTON (AP) --
 In private pitches to Democrats, President Barack Obama says he will persuade Congress to pass his health care overhaul even if it kills him and even if he has to ask deeply distrustful lawmakers to trust him on a promise the White House doesn't have the power to keep.
That, in a sometimes darkly joking way, is what the president is telling Democratic House members as he begins an all-out push to coax Congress into passing his proposals despite voters' misgivings and Republicans' dire warnings.
''He made the case, 'Listen, we put in a very hard year working on health care reform and the time for action is now,''' said Rep. Ron Kind, D-Wis., one of several Democrats who met with Obama at the White House on Thursday.
Obama joked that the political battle has contributed to the recent rise in his cholesterol, Kind said, and the president noted how ironic it would be if health care drove him to his grave.

Unwelcome Spotlight Falls on Obama Chief of Staff

The Associated Press reports -  No-drama Obama was bound to get fireworks when he chose the expletive-spewing, hotheaded, never-at-rest Rahm Emanuel to be his White House chief of staff. The only questions were when -- and how big.
The answers are now -- and pretty large, by inside-the-Beltway standards, anyway.
And they're happening at a particularly unpleasant time in Barack Obama's presidency, which is struggling with problems in terrorist policy, health care reform and other matters that have the president in political hot water and down in the polls.
The strange, only-in-Washington story began unfolding about two weeks ago when a column in The Washington Post asserted that Obama's ''first year fell apart in large part because he didn't follow his chief of staff's advice on crucial matters.''
The piece advised a 180-degree turn from the recent trend of blaming Emanuel for Obama's woes and of calling for the former congressman from Illinois to go. Instead, it said, blame others in Obama's orbit who are too ''in love with the president'' to advise him wisely on such things as health care strategy, the closing of the U.S. military prison at Guantanamo Bay, Cuba, and how and where to try accused Sept. 11 terrorists. Blame Obama himself for not listening more to Emanuel, columnist Dana Milbank wrote.
Then this week came another Post story saying basically the same thing, based largely on interviews with Democrats on Capitol Hill. This was harder for the White House to shrug off, because it was not an opinion piece but in the news section -- on the front page, no less.
Suddenly, the Obama White House had to deal with a narrative that some (though it's still unclear who) think Obama's chief of staff is smarter than the president, an awkward development in Washington's deeply ingrained tradition of aides staying behind the scenes and not upstaging the boss.
At the least, it creates an embarrassment and a distraction at a perilous time. And it belies Obama's own prized no-drama culture, where neither dirty laundry nor disagreements are aired and theatrics aren't tolerated. At worst, it sets in motion a dynamic that could lead to shakeups and further doubts about Obama's leadership.
So some angst behind the scenes at the White House was no surprise.
Publicly, however, the White House stood firmly behind Emanuel. White House press secretary Robert Gibbs on Tuesday dismissed as ''parlor games'' the talk of a White House divided into camps or of Emanuel facing the prospect of being ousted.
''Knowing most of what goes on here, I don't subscribe to all of it or a lot of it,'' he said. ''He absolutely has the president's confidence.''
Several current and former White House aides said Emanuel, despite his often passionately delivered opinions, is, once a decision is made, among the most loyal and energetic about making it happen. The president was said to view the spate of stories with a long view, that he and his team would rise -- or fall -- together and that Emanuel is too valued to cut loose.
Emanuel has been open about harboring political ambitions beyond the White House, specifically to run for Chicago mayor. But Gibbs deemed it unlikely that the chief of staff is feeding the stories himself to protect his reputation from its recent battering, particularly from the Democratic Party's liberal wing, which feels abandoned by Obama on many issues.
''We all give advice to the president on a daily basis,'' Gibbs said. ''The president makes decisions and we move forward. When we move forward, nobody moves forward with more determination than the chief of staff.''
Some indications point to the stories being driven by Emanuel loyalists, becoming increasingly upset at the criticism aimed at him lately over Obama's sputtering agenda, say those inside and outside the White House. A large number of Democratic lawmakers, particularly centrists and conservatives, feel a huge debt to Emanuel from his days as chairman of the Democratic campaign committee in 2006, when he played an instrumental role in restoring his party to power after 12 years in the minority.
Many of those same Democrats now fear for their chances in November's midterm congressional elections. As is common at this stage in an election cycle, they are looking for more help from Obama and someone to blame if they lose.
And yet, there is no doubt that Emanuel's own pugnacious, loquacious style is to blame, at least indirectly if not more.
Emanuel is known as a fierce competitor, who strikes back -- hard -- when hit.
He also fairly openly shares where he stands on issues, and where that has differed with the president.
For instance, it's well-documented that Emanuel argued internally against trying accused Sept. 11 mastermind Khalid Sheikh Mohammed and four of his alleged henchmen in civilian court in New York. That decision, by Attorney General Eric Holder, invited a firestorm of criticism for Obama, has now been put on hold and may be reconsidered.
Back when the cool-tempered Obama first offered him the job, Emanuel surprised many by publicly and repeatedly sharing his reluctance to do so -- because it would require him to give up his goal of becoming House speaker and would cost him time with his wife and three children. Such admissions of doubt when a president comes calling, which Emanuel still talks about, are almost unheard of.
The man nicknamed ''Rahmbo'' has been no stranger to controversy, either. Recently, he apologized for using the word ''retarded'' to describe liberal activists whose tactics on health care he questioned.
Obama has not been shy about getting rid of aides; he doesn't employ loyalty just for the sake of it.
But Obama has welcomed disagreement within his staff and has shown he is willing to tolerate a lot to get the benefit of Emanuel's considerable legislative and political talents. So the word is that Emanuel isn't going anywhere. For one thing, he is regarded as essential to shepherd health care reform to a conclusion.
And that, said those close to the White House, is the way out of this mess.
If health care is passed, the bad stories and the finger-pointing stop and Obama moves on to other issues.
If health care fails, there will be more bad stories and finger-pointing -- common in times of trouble for any president. And they're likely to be not just about Emanuel, but others in the White House as well.

Snowmageddon Can Still Kill Health Care Reform

February 26, 2010, 1:51 pm

Washington’s “Snowmageddon” may have already passed. But the storm still has the power to kill Washington’s health care reform talks, perhaps for good.
Take a look at where the health care reform process is now. Despite high hopes, Thursday’s much anticipated summit meeting did not seem to move the needle much. And yet, even with cannons to the left of them and cannons to the right of them, Democratic leadership vowed to charge forward.
“If nothing comes of this we’re going to press forward,” The Times quoted Senator Richard J. Durbin of Illinois, the No. 2 Democrat, as saying. “We just can’t quit. This is a once-in-a-political-lifetime opportunity to deal with a health care system that is really unsustainable.”
The implication is that Democrats regard the impasse as an extension; health care reform is, after all, a long-term question, and not one that had to be resolved by Thursday, per se. But how long will this “once-in-a-political-lifetime opportunity” to address the long-term issue last?
My guess: The deadline is probably one week from today, when the February jobs report comes out.
That report will probably be very, very ugly. I have seen some forecasters project job losses as high as 100,000.
The main culprit behind the expected jobs plunge is the blizzard, which closed businesses and kept people from going to work or even seeking work for days and sometimes weeks. These work stoppages probably occurred precisely when the government was collecting data for its February jobs report.
The Labor Department is of course very aware that the blizzard will distort its numbers. In fact, labor officials will probably try to isolate the effects of the storm from all the other data so economists can get a better sense of what’s going on in the economy. Offcials did this after previous major weather events like the 1996 East Coast blizzard and Hurricane Katrina.
But even though everyone will know that “snowmageddon,” and not President Obama, is really at fault for the poor report, the headline number may still be shocking enough to sufficiently discredit economic policy of Democrats. And all other economic policy debates, including health care which will be set against this backdrop of the Democrats’ failed stewardship of the economy.
Worsening economic dysfunction, at least when it comes to Main Streeters, sends a powerful message to Americans who believe that Democrats want a “government takeover of 17 percent of the United States economy.”
After all, if you were a Republican hell-bent on derailing health care reform, that's what I'd do.

Our Own Health Care Clash of the Titans - Just My Perspective

The underlying premise, as I see it, from the President's perspective was simply that we agree on many things, so why don't we modify the finer points on the things upon which we agree and negotiate by adding and subtracting on the points on which we do not agree. The Republican response was that we do not wish to participate; if you can pass the bill, pass it; if you can't, we will let the people decide in November. At one point the President actually conceded on that point. I believe that the President's motives were sincere in the sense that he would take an agreement that achieved less than he wanted, if he could have gained traction in the "process." Ramming the bill through Congress using reconciliation will give added ammunition to the Republicans in November. The size of the bill, the length of the debate and the endless bickering has drained the American psyche at a time when the majority have more pressing concerns such as the economy, unemployment and the next wave of property foreclosures.   In the final analysis the argument has been reduced to this one point: can government administer this massive legislation in an efficient manner.  I don't think so.... they've never done so before.  The unfortunate reality is that both sides are right and a bridge across the philosophical divide constructed by men of good will serve as the best path forward.

Obama to GOP on health care: `Let's get this done'

Associated Press -
WASHINGTON – President Barack Obama said Saturday he is ready to compromise with Republicans on health care if they are serious about it, but that an overhaul must go forward. "Let's get this done," he said.
Obama's comments in his weekly Internet and radio address, two days after an all-day bipartisan summit across from the White House, were the latest sign that Democrats are getting set to try to pass health care legislation without any Republicans on board.
Success will require colossal efforts on the part of Obama and Democratic leaders to round up votes after a year of corrosive debate and a Senate special-election upset that threw the overhaul effort into limbo last month. But Obama and the Democrats reject the piecemeal approach sought by Republicans and have no intention of scrapping their 10-year, $1 trillion bill and starting over, as the GOP demands.
"I am eager and willing to move forward with members of both parties on health care if the other side is serious about coming together to resolve our differences and get this done. But I also believe that we cannot lose the opportunity to meet this challenge," Obama said.

"The tens of millions of men and women who cannot afford their health insurance cannot wait another generation for us to act. Small businesses cannot wait. Americans with pre-existing conditions cannot wait. State and federal budgets cannot sustain these rising costs.
"It is time for those of us in Washington to live up to our responsibilities to the American people and to future generations," Obama said.
Obama's legislation would insure some 30 million more Americans over 10 years with a new requirement for nearly everyone to carry insurance and would end insurance company practices such as denying coverage to people with medical problems. Republicans generally oppose mandates that make everyone get insurance, and although they want people with health conditions to be able to buy insurance, they would try to address the problem without new requirements on insurers.
Obama plans to release an updated proposal in the week ahead, likely on Wednesday, according to press secretary Robert Gibbs. Gibbs suggested it would include concepts put forward by Republicans at the summit. One attendee, Sen. Tom Coburn, R-Okla., was contacted Friday by the White House and asked to submit details of suggestions he made to tackle waste and fraud in the medical system, Coburn's spokesman said.
John Hart said Coburn views Obama's legislation as a government takeover and would not be able to support it even if it includes some of his proposals.
Adding Republican ideas is not likely to win Republican votes because the GOP insists Democrats should start from scratch. But Obama would be able to say that he'd listened to Republicans and attempted to meet them part way. Moving ahead may mean using Senate rules that would let Democrats pass legislation with a simple majority instead of the 60 vote they no longer command.
The approach infuriates Republicans and is opposed by some Democratic moderates because of its partisan nature.
Coburn, in the GOP's weekly address, argued against a Democrats-only bill.
"Unfortunately, even before the summit took place the majority in Congress signaled its intent to reject our offers to work together," Coburn said. "Instead they want to use procedural tricks and back-room deals to ram through a new bill that combines the worst aspects of the bills the Senate and House passed last year."
"The American people are telling us to scrap the current bills, which will lead to a government takeover of health care, and we should start over," Coburn said.

White House: Announcement next week on health care

WASHINGTON – The White House says President Barack Obama will announce his plans next week for a "way forward" on long-stalled health care legislation.

White House press secretary Robert Gibbs told reporters on Friday that Obama officials and Democratic leaders in Congress will hold a few days of consultations before an announcement by the president on the next steps. Gibbs said the coming days will be a "fairly dynamic process."
Democratic leaders are also vowing to resurrect a comprehensive overhaul, with or without Republican suggestions or votes.

After healthcare summit: What's next?

Washington

After a day-long White House summit on healthcare, Republicans returning to the Senate said that President Obama and the Democrats appear ready to go it alone on this issue.
“They’re not interested in putting a 2,700-page bill on the shelf,” said Senate Republican leader Mitch McConnell of Kentucky, referring to GOP demands that the president start over with a step-by-step approach, focusing on issues on which there is broad agreement.
At the end of the summit, Mr. Obama said, “I did not propose something complicated just for the sake of being complicated.” He added, “The reason we didn’t do it is it turns out baby steps don’t get you to the place where people need to go.”
To get a bill without 41 Senate Republicans means resorting to a process called reconciliation. The process allows measures that meet certain budget criteria to pass by a simple majority, instead of the 60 votes now typical for major bills.
In the dictionary, “reconciliation” means bringing together, conciliation, or fence mending. But on the floor of the US Senate, it’s pure procedural warfare.
Liberal activists are urging Democrats to get back to the principle of majority rule in the Senate, now seen as the graveyard for much of the Obama agenda. But moderate Democrats are wary of a move that could further alienate the public from a comprehensive healthcare reform.
A new Gallup poll, released Thursday, reports that most Americans oppose using reconciliation, by a margin of 52 percent to 39 percent. Nine percent were unsure.
On Feb. 23, Sen. Robert Byrd (D) of West Virginia, the leading in-house defender of the Senate traditions, urged his colleagues to allow filibusters to run their course and not change rules to block them.
“The Senate is the only place in government where the rights of a numerical minority are so protected. Majorities change with elections. A minority can be right, and minority views can certainly improve legislation,” he wrote in a letter to his Senate colleagues.
“Extended deliberation and debate – when employed judiciously – protect every senator, and the interests of their constituency, and are essential to the protection of the liberties of a free people,” he added.
Sen. Kent Conrad (D) of North Dakota, who chairs the Senate Budget Committee, says that there could be a role for reconciliation in the healthcare debate, but only “in a very limited way”: First, the House must pass the Senate bill, then use reconciliation procedures to “fix” the bill. “You cannot do the whole healthcare bill through reconciliation. It will not work,” he adds.
If Democrats opt to push healthcare reform through the Senate using reconciliation, “the opposition to it would be bipartisan,” said Senator McConnell after the summit.

Democrats target insurers ahead of health summit

WASHINGTON (Reuters) – Democrats targeted health insurers and wary Republicans braced for a political showdown on Wednesday ahead of a White House summit that President Barack Obama hopes will spark momentum for a broad healthcare overhaul.
Republicans questioned the motive for Thursday's day-long summit and Democrats turned up the pressure on the health insurance industry with a hearing on a recent premium increase by insurer WellPoint Inc and a planned House of Representatives vote on repealing its antitrust exemption.
Democrats called the recent premium increases for some Anthem Blue Cross customers in California a function of greed rather than need and said they highlighted the importance of reform.
"Unless Congress and the administration act, Americans across the country will continue to experience large premium increases and will be priced out of the market," said Representative Bart Stupak, head of the House Energy and Commerce oversight panel.
The summit on Thursday brings together leaders of both parties in a last-gasp effort to revive a sweeping healthcare overhaul that has stalled in the U.S. Congress amid broad public dissatisfaction and unified Republican opposition.
The meeting follows Obama's release on Monday of a new healthcare plan amid signals he is prepared to try to jam the bill through Congress using a procedure that would bypass the need for Republican support.
"In light of all these behind-the-scenes efforts to get around the will of the people, it's hard to imagine what the purpose of Thursday's summit is," Senate Republican leader Mitch McConnell said.
Summit negotiations have touched on everything from the list of attendees to the shape of the table. The meeting will be broken into sections to discuss controlling costs, insurance reforms, deficit reduction and expanding coverage, the White House said.
Republicans said they will focus on a scaled-back approach that would boost competition across state lines and curtail medical malpractice lawsuits.

'NOTHING TO TALK ABOUT'
But if Republicans insist Democrats should scrap the existing bills and start over "then there is nothing to talk about," Democratic Senator Chris Dodd said.
The Democratic-controlled House and Senate passed sweeping bills last year designed to reshape the $2.5 trillion healthcare industry by cutting costs, regulating insurers and expanding coverage to tens of millions of Americans.
But efforts to merge them and send a final version to Obama collapsed in January after Democrats lost their crucial 60th vote in a special U.S. Senate election in Massachusetts.
McConnell and other Republicans condemned any Democratic effort to pass the bill through a process called reconciliation, which requires a simple majority in the 100-member Senate rather than the usual 60 votes needed to clear procedural hurdles.
McConnell called reconciliation "a last-ditch sleight of hand" and Eric Cantor, the No. 2 House Republican, published a memo casting doubt on whether House Democrats can still muster a simple majority to support healthcare.
Cantor noted the bill passed the House in November with three votes to spare, and the measure has lost at least four votes since then through retirement, death and a change of heart by the only Republican to support it in November.
"House Democrats are farther away from securing the votes to pass a government health care bill today than they have ever been," Cantor said.
Many Democrats fear reconciliation would spark a costly political backlash heading into congressional elections in November that could erase Democratic majorities in Congress.
The White House, which has not publicly endorsed the strategy, reiterated the summit was designed to elicit ideas and find areas of agreement with Republicans. It said Obama's new proposal was not meant to be the final word on the issue.
"At Thursday's bipartisan meeting, the president will continue to work with members of both parties to find common ground and look for the best ideas that will help American families and small business owners have greater control over their own health care," Nancy-Ann DeParle, director of the White House Office of Health Reform said in an e-mail.
Democrats on Wednesday focused on the health insurance industry, which has taken a pummeling from the White House and Democrats in recent weeks since the premium increases announced by Anthem Blue Cross in California.
Health insurer stocks stayed steady nevertheless, with the Morgan Stanley Healthcare Payor index up 0.5 percent in early afternoon trade.
WellPoint Chief Executive Officer Angela Braly defended the increases and said they reflected higher costs from hospitals and doctors. "Raising our premiums was not something we wanted to do -- but we believe this was the most prudent choice," Braly said.
The House also planned a vote on a measure that would remove the federal antitrust exemption for the insurance industry, a move Democrats said would increase competition and help shine a light on industry practices.

Democrats Cling to Reconciliation as Option to Pass Health Care Reform

Democrats increasingly have looked to reconciliation as viable option since Republican Scott Brown won a special election last month in Massachusetts to become the state's new U.S. senator, depriving Democrats of their 60-vote supermajority and sidelining the health care reform bills passed both the House and Senate late last year.
Faced with no other viable option, Democrats are vowing to use a parliamentary process called reconciliation, if necessary, to complete President Obama's yearlong effort to reform the U.S. health care system.
"Well, the avenue exists if one wants to pursue it," White House spokesman Robert Gibbs said Monday.
Rep. James Clyburn, the House majority whip, noted to Fox News that former President George W. Bush used the tactic to get his controversial tax cuts passed in 2001 and 2003.
Republicans acknowledge that reconciliation has a legitimate purpose but "it is not to pass a bill which is going to change 16 percent of the way our economy functions and everybody's health care delivery system," Sen. Judd Gregg of New Hampshire said.
Congress created reconciliation in 1974 to make it easier to raise taxes or cut spending to "reconcile" with a previously approved budget resolution.
For example, if Congress was running a higher budget deficit at the end of the year than projected, it could use reconciliation to quickly raise taxes or cut spending with just 51 votes in the Senate -- not the 60 votes it usually takes to avoid a filibuster.
Sen. Robert Byrd, D-W. Va., -- one of the original authors of the reconciliation rule created an additional hurdle in 1985 called the Byrd rule, preventing reconciliation's use for any "extraneous issue" that does not directly change revenue or expenditures.
But here's what would have to happen: The House would have to pass the Senate health care bill as it exists now -- with no changes. Then the House would simultaneously have to create a reconciliation vehicle -- a second bill -- that would make changes to send back to the Senate.
But this could only deal with taxes or budgetary changes. The following could not be changed by reconciliation:

 Creation of health insurance rate authorities

 Health care consumer protections

 Changing individual or employer mandates

 No social policy changes (i.e. abortion).

All are key elements in the new White House plan.
The Senate would have to then pass the additional bill with a simple majority of 51 votes.
But back to that first House vote on the existing Senate bill before any changes are made. The House passed health care reform by a vote of 220-215, and since then, Democrat John Murtha of Pennsylvania has died, Democrat Robert Wexler of Florida retired, Democrat Neil Abercrombie of Hawaii retired this week and Republican Joseph Cao of Louisiana has said despite a yes vote last time he will not vote for the bill this time.
That could make the vote 216-216, and ties fail in the House. Then there are 52 Bluedogs -- or fiscally conservative Democrats, 49 of them from districts won by John McCain in 2008. The numbers are not adding up yet for House passage.

Courtesy of FOXNews.com

LAST DITCH HEALTH CARE PLAN PUT FORTH BY OBAMA

WASHINGTON – Making a last-ditch effort to save his health care overhaul, President Barack Obama on Monday put forward a nearly $1 trillion, 10-year compromise that would allow the government to deny or roll back egregious insurance premium increases that infuriate consumers.
The White House immediately demanded an up-or-down vote in Congress on the plan, or something close to it. But it's highly uncertain that such sweeping legislation can pass. Republicans are virtually unanimous in opposing it, and some Democrats who previously supported a health care remake are having second thoughts in an election year. After a year in pursuit, Obama may have to settle for a modest fallback version of what once was his top domestic priority.
Release of the plan on the White House Web site comes just four days before Obama's one-of-a-kind, televised health care summit with Democrats and Republicans. The White House said the plan would provide coverage to more than 31 million Americans now uninsured without adding to the federal deficit.
On Capitol Hill, Democrats cautiously welcomed the plan, while Republicans gave a thumbs down.
House Speaker Nancy Pelosi, D-Calif., said in a statement she looks forward to reviewing the plan and discussing it at the summit. "We must pass comprehensive, affordable health insurance reform, and I am hopeful that Thursday's meeting will help us achieve this goal," she said, reaffirming her commitment.
House Republican Leader John Boehner of Ohio dismissed the proposal, saying, "the president has crippled the credibility of this week's summit by proposing the same massive government takeover of health care based on a partisan bill the American people have already rejected."
The plan is Obama's most detailed proposal since he took up the health care overhaul effort a year ago. At the time, he sought to avoid the problems former President Bill Clinton encountered when he issued Congress a detailed prescription in the 1990s. Now Obama is being criticized for having been too deferential to lawmakers.
White House spokesman Dan Pfeiffer said the plan is an "opening bid" going into Thursday's summit. It would cover more than 31 million Americans now uninsured — but also includes a new tax on investment income that Republicans object to.
"The president is coming into the meeting with an open mind," said Pfeiffer. "If the Republicans do, too, our hope is that we can find some areas of agreement. If the Republicans bring good ideas to the table we will find ways -- look for ways to incorporate those into our proposals."
Weeks ago, the president and congressional Democrats were on the verge of an historic step — a long-sought remake of the nation's health care system after a half-century of unsuccessful attempts by scores of politicians. Then Republican Scott Brown stunned Washington with an upset win in the Massachusetts Senate race, denying Democrats their 60-seat majority and reversing any political momentum.
Now, Obama may have to settle for a scaled-down plan that smooths some of the rough edges from the current health insurance system, but stops well short of providing coverage for all Americans. It could include ideas Democrats and Republicans have both supported, such as federal funding for high risk pools that would extend coverage to people denied because of medical problems, and a new insurance marketplace for small employers and individuals buying their own policies.
Determined not to abandon Democratic bills that took a year of arduous effort, Obama's plan builds on them. That's no guarantee that it won't run into problems.
The plan conspicuously omits a government insurance plan sought by liberals and viewed as a nonstarter by conservatives and some congressional moderates. It includes Senate-passed restrictions on federal funding for abortion that have been adamantly opposed by abortion foes as well as abortion rights supporters.
The new White House plan would give the federal government the power to regulate the health insurance industry much like a public utility. The Health and Human Services Department — in conjunction with state authorities — would be able to deny substantial premium increases, limit them or demand rebates for consumers.
Obama, who deferred to Congress on the specifics for more than a year, has finally put forward a detailed plan of his own. By and large, it follows the bill passed by Senate Democrats on Christmas Eve, with changes intended to make it acceptable to their House counterparts.
It would require most Americans to carry health insurance coverage, with federal subsidies to help many afford the premiums. Insurance companies would be barred from denying coverage to people with medical problems or charging them more.
The plan dramatically scales back a Senate tax on high-cost health insurance plans objected to by House Democrats — and labor unions. Instead of raising $150 billion over 10 years, it would bring in just $30 billion, the administration said. A Medicare payroll tax increase on upper-income earners would help plug the revenue gap. For the first time, Medicare taxes would be assessed on investment income, not just wages.
Like the Senate bill, the Obama plan would create competitive insurance markets in each state for small businesses and people buying their own coverage. But it would strip out special Medicaid deals the Senate bill granted to certain states, including Louisiana and Nebraska, that have drawn public scorn. It also would gradually close the Medicare prescription coverage gap, make newly available coverage for working families more affordable. Those changes move in the direction of the House bill.
Estimated to cost about $1 trillion over 10 years, Obama's plan would be paid for by a mix of Medicare cuts, tax increases and new fees on health care industries.
Oversight of insurance companies has traditionally been a state responsibility. Obama's proposal for a new federal role calls for setting up a seven-member Health Insurance Rate Authority to monitor insurance industry practices and issue an annual report. States that beef up their consumer protection programs would be eligible for a share of $250 million in federal grants.
House Majority Whip James Clyburn, D-S.C., declined to say that House leaders have the votes now to pass the new plan, but said some of the concerns of House members were addressed by the changes Obama is proposing.
"So I do believe that there is more fertile soil today than when we first took this up," Clyburn said.
Democrats, who now hold 255 of the House's 435 seats, drew only one GOP ally when the House passed its health care bill, 220-215, last November. Since then, one Democrat who voted for the bill has resigned, one has died and a third plans to leave office Feb. 28.