Agreement Remains Out of Reach at Bipartisan Health Reform Summit

Democrats and Republicans engaged in debate at the health reform summit on Thursday, but they emerged without a bipartisan agreement or even a clear strategy for securing one, the Chicago Tribune reports.

The differences between the two parties' preferred reform approaches were reinforced during the discussion, which was broadcast live through several media outlets. Senate Minority Whip Jon Kyl (R-Ariz.) said, "There are some fundamental differences that we cannot paper over."

The disagreement centers on the two parties' differing views of government's role in health care reform. Democrats want comprehensive reform driven by government regulation, while Republicans prefer a more incremental approach that emphasizes the role of small businesses and individuals.

Rep. Paul Ryan (R-Wis.) said, "We don't want to sit in Washington and mandate these things," adding that Republicans want to "decentralize" the health system (Levey/Hook, Chicago Tribune, 2/25).

House Minority Leader John Boehner (R-Ohio) reiterated the GOP's position that Democrats should "scrap" their current reform bills (Meckler/Adamy, Wall Street Journal, 2/26).

Democrats maintained that the incremental approach promoted by Republicans would be inadequate.

Senate Health, Education, Labor and Pensions Committee Chair Tom Harkin (D-Iowa) said, "We're drowning, in this country, on health care," adding, "An incremental approach is like a swimmer who's 50 feet offshore drowning, and you throw him a 10-foot rope."

However, Obama and other senior Democrats outlined a few overhaul proposals on which they share common ground with Republicans. They said both parties endorse initiatives to combat Medicare fraud, permit the sale of health insurance across state lines and aid small businesses in providing health benefits to their workers (Chicago Tribune, 2/25).

Obama also said Democrats and Republicans agree on the need to curb rising health care costs. He said if a reform strategy consists of only "adding more people to a broken system, then costs will continue to skyrocket, and eventually somebody's going to be bankrupt, whether it's the federal government, state governments, businesses or individual families." He continued, "So we have to deal with costs. ... I haven't heard anybody disagree with that" (Tapper et al., ABC News, 2/25).

Both Dems and GOP Score Political Points

According to the New York Times, it is unclear if either party had stronger arguments at the summit (Herszenhorn, New York Times, 2/26).

The Christian Science Monitor reports that Republicans fared better than when they met with Obama in January at an annual retreat. According to the Monitor, GOP attendees were more willing to voice their opinions to the president and illustrated their points to Democrats more effectively (Feldmann, Christian Science Monitor, 2/25).

The Los Angeles Times, however, reports that Obama led Democrats with a "mastery of the nuances of health care." According to the Los Angeles Times, Obama might have gained favor with U.S. residents by engaging in what seems to be an irresolvable debate with the GOP (Nicholas, Los Angeles Times, 2/25).

 What's Next?

Obama closed the summit after about seven-and-a-half hours by saying that he does not know if Democrats and Republicans can close the ideological gap between them regarding reform efforts. He said, however, that they "cannot have another yearlong debate" (Chicago Tribune, 2/25).

Obama then said he would allow four to six more weeks of discussion to secure a bipartisan agreement before Democrats would move forward with other options (Hunter/Wayne, CQ Today, 2/25).

An administration official later said that Obama was not providing an official timetable. According to the official, Obama "was just saying that we are going to continue moving forward over the next few weeks as we take the final steps necessary for passage" (Bendery, Roll Call, 2/25).

Barring an agreement with Republicans, Democrats likely would use budget reconciliation to pass an overhaul package. Although criticized by Republicans, the strategy is garnering more support from Democrats and has been endorsed publicly by Obama as a viable option for reform.

White House officials have confirmed that Obama's own reform proposal -- separate from the House and Senate overhaul packages (HR 3962, HR 3590) and posted online on Monday -- was designed to be approved through budget reconciliation, which would result from a two-bill process.

The most likely use of the two-bill process would involve convincing House Democrats to pass the more moderate Senate reform bill unchanged and sending it directly to Obama for his signature. The Senate then could pass a separate package of reform measures through the budget reconciliation process to pacify more liberal House Democrats, which requires only a simple majority for passage (California Healthline, 2/25).

Rep. Rob Andrews (D-N.J.) thinks that, in the aftermath of the summit stalemate, Obama will work faster than the weeks he allotted for further discussion of a bipartisan solution. According to Andrews, the president likely will send a modified version of his own bill to the House by next week (Frates/O'Connor, "Live Pulse," Politico, 2/25).

Another option for Democrats is to pass a series of smaller bills while they work out the details of a large overhaul package, CongressDaily reports. For example, House Democrats on Wednesday passed legislation that strips health and medical malpractice insurers of an antitrust exemption that allows them to collectively set prices.