Obama to stress common ground in health speech
September 4, 2009
WASHINGTON - As President Obama prepares to deliver a make-or-break address on health care to a joint session of Congress next week, he is expected to turn the focus away from controversial issues such as the “public option’’ plan and toward key areas of bipartisan agreement, including enabling anyone to buy insurance regardless of preexisting conditions, according to White House and congressional officials. Nancy-Ann DeParle, Obama’s health care adviser, said that outrage over insurance company practices has grown so great that Congress could quickly pass legislation to fix the problem, with or without broader proposals such as requiring people to ob tain coverage.
"I think the insurance market reforms are so deeply thought to be needed that I think the Congress would be willing to enact those apart from the increases in coverage,'' DeParle said in a recent interview. DeParle stressed that Obama wants much more in his health care overhaul, including federal subsidies for lower-income people who can't afford to buy insurance. But if some parts of the reform effort fail to gain enough support, Obama could deploy a backup plan that includes measures such as ending the denial of coverage - and give him an interim victory. At the least, the potential for passing such a plan could give the president leverage to win concessions from Congress. Amid all the angry discussion at town hall meetings, relatively little attention has been paid to the fact that many Republicans agree broadly with Obama - though not necessarily on the details - on ideas such as making it easier for small businesses to band together to buy insurance for their employees and for workers to take their insurance with them from one company to another, keeping the plan deficit-neutral, and imposing new regulations on the insurance industry to make it easier for anyone to get coverage.
DeParle, director of the White House Office of Health Reform, said there is consensus on as much as 85 percent of the issues in the health care debate, a theme that Obama is likely to stress in his address. “I was amazed at how much agreement there was,’’ she said. “That is something that a year ago I could not have imagined, that Republicans and Democrats would say we all need to have health insurance.’’ Some advocates of the health care overhaul are also urging that more attention be paid to the areas of likely agreement to help rebuild wavering public support. “I don’t think there’s an appreciable portion of the American public that understands there are so many other things that are really important and for which there is a close to consensus,’’ said Ron Pollack, executive director of Families USA. “But people don’t understand it because all they are hearing about are the controversial provisions like the public plan option.
Senator Lamar Alexander, a Tennessee Republican who is one of his party's leaders on health care, said in a conference call with reporters this week that "we all favor'' making it possible for people with preexisting conditions to buy insurance "rather than be denied insurance.'' Even Senator Mike Enzi, the Wyoming Republican who has all but walked away from a round of bipartisan negotiations and blasted Obama's original proposal, has left room for a scaled-down deal. Enzi's spokesman, Michael Mahaffey, said such a compromise could include enabling people with preexisting conditions to buy private insurance. The big difference is over how to pay for such increased coverage. Enzi has suggested paying for expanded coverage, in part, by lowering malpractice costs and changing tax rules. Obama has said he prefers raising taxes on the wealthiest Americans to help pay for coverage.
For years, the insurance industry has fought efforts to require them to insure anyone who seeks coverage, saying that it has the right to refuse coverage to a relatively small number of people with preexisting conditions that are expensive to treat. But in a landmark move in December 2008, the group that represents most of the nation’s health insurance companies said it would give up that right in exchange for assurance that the government would require and subsidize universal coverage, which would greatly expand the number of customers. The organization opposes a public option plan, which it views as unfair competition. “There is widespread agreement that we need to reform the insurance markets so that nobody falls through the cracks,’’ said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, which represents 1,300 companies that insure 200 million Americans. “We have proposed guaranteed coverage, no preexisting condition exclusion, and no longer basing premiums on a person’s health status or gender.’’
The White House has also been trying to make some progress toward a possible compromise on the public option - a government plan to compete with private insurers. Obama said earlier this year that there must be a public option. More recently, he said that it is only a “sliver’’ of his plan. A number of House liberals have said they won’t support a plan without the public alternative. The president and White House aides have been talking with Senator Olympia Snowe, a Maine Republican who has proposed to use the threat of a government plan to force private insurers to become more competitive and lower costs. If the insurance industry does not make changes within a certain amount of time, the government-run plan would be created. Obama’s strategy of deferring to Congress in drafting details of the health care bill has frustrated some lawmakers, who are urging him to provide specifics instead of outlines in his primetime speech on Wednesday night.
Don Stewart, a spokesman for Senate Republican Leader Mitch McConnell of Kentucky, said yesterday that Obama should use his speech to drop some of his costliest demands and search for compromise. “If you start at the agreeable goals and the agreeable approaches, you have a pretty solid bill,’’ Stewart said, citing bipartisan agreement on insurance industry reforms, wellness and prevention programs, and enabling companies to provide cheaper insurance to those who quit smoking and keep their weight under control. White House officials declined to provide details about Obama’s address, but Vice President Joe Biden said yesterday that the president will lay out the main options for a health care overhaul and “what he thinks those pieces have to be and will be.’’ “We’re going to get something substantial,’’ Biden told a gathering at the Brookings Institution. “It’s going to be an awful lot of screaming and hollering before we get there. But I believe we’re going to get there.’’
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