At last. President Barack Obama has unveiled his own version of health care reform. No longer subjecting themselves to blame or praise for what members of Congress put forward, the Administration now has a plan to call it’s own. Copies of President Obama’s health care reform plan, as well as copious supporting material, are available on the White House web site.
And it looks a lot like what we’ve seen from Congress. In fact, it’s pretty much the bill passed by the Senate last December with some several tweaks – some significant; some less so. For example, the “sweeteners” benefitting specific states (think Nebraska and Louisiana) have been removed. Not a big surprise. Seizing on the recent outrage over large rate increases in the individual health insurance market the President has added a provision that would provide for “rate review” of premiums charged by health insurers by creating a Health Insurance Rate Authority “to provide needed oversight at the Federal level and help States determine how rate review will be enforced and monitor insurance market behavior.” The Associated Press describes this provision as seeking to “regulate the health insurance industry much like a public utility.”
Once there’s been time to analyze his proposal I’ll address specific elements of President Obama’s health care reform proposal. What’s of immediate interest is the strategy behind the proposal.
In advance of the bi-partisan health care reform summit he is convening this Thursday, President Obama had a choice concerning the nature of the health care reform proposal he put forward today. He could repackage comprehensive health care reform along the lines of those approved by the House and Senate. Or he could introduce a new, less comprehensive package. Whatever approach he chose would change the dynamics of the summit.
Moving forward comprehensive, complicated reforms based on what had already passed a chamber in Congress (which is what he did) would reassure Democratic members of Congress – many of whom risked their political careers supporting controversial reforms. This approach also gives him more negotiating room. The President can go to allies later and say “I fought for this provision, but if we want any health care reform we have to compromise.” This approach also allows him to offer the Republicans concessions that otherwise might never have been on the table. This seems to be the thinking of the White House. The Associated Press quotes Administration spokesman Dan Pfeiffer as saying the health care reform plan the President introduced today “is an ‘opening bid’ going into Thursday’s summit.” Mr. Pfeiffer then reiterated that “The president is coming into the meeting with an open mind. If the Republicans do, too, our hope is that we can find some areas of agreement.”
The problem with this approach is that it is more confrontational than the alternative. And it opens the Administration to charges that it has failed to understand the public’s concern with a dramatic increase in the government’s involvement in America’s health care system. In fact, that’s what’s happened with House Minority Leader John Boehner saying “the president has crippled the credibility of this week’s summit by proposing the same massive government takeover of health are based on a partisan bill the American people have already rejected,” according to the AP.
Yet if President Obama had taken the second option – putting forward a more modest health care reform package that already incorporated elements of Republican proposals – he would have taken flack from his Democratic allies and had left bargaining room. However, he also would have made it more difficult for Republicans to declare the summit political theater.
President Obama is not the only summit participant who will have to find a way to simultaneously appealing to his base while showing the flexibility independents demand. Republicans face the same challenge. The conservative base wants no compromise with the Democratic president. Independents, however, want lawmakers to solve problems.
My guess is that the president has decided to approach this political quandary in two-steps. First, demonstrate to the base that he wants what they want (although he did abandon the public option as an absolute non-starter and left it out of his proposal). The cost: a barrage of criticism from opponents that he’s arrogantly ignoring the public’s rejection of these plans (as indicated by various polls). The second step, however, will be to embrace proposals put forward by Republicans during the summit, claiming that the result is a bi-partisan bill. He’ll then work with Democratic lawmakers to introduce the refined legislation and challenge the GOP to reject a bill that includes several of their ideas. If this legislation fails President Obama still has the option of bringing forward a greatly scaled down bill blaming Republicans for failing to support more comprehensive reform.
Whether this strategy works or not remains to be seen. But the first moves have been made. It now falls to the Republicans to respond. Will they simply attack President Obama’s health care plan or offer alternatives of their own prior to the summit? And will those alternatives be presented as a single health care reform package or as a assorted, separate proposals? Will the GOP play solely to its base or seek to seize centrist ground? The President has given Republicans an opportunity to capture independents. Now we get to see what the GOP does with this opening.