Republicans were skeptical, and undoubtedly a little annoyed, when healthcare industry representatives stood behind President Obama last month as he touted their pledge to find ways to reduce national healthcare spending by as much as $2 trillion over 10 years.
The promise wasn't enforceable, they said. The promise didn't come with any details on just where players in the healthcare market planned to find this money, they said. And anyway, what the White House and some spooked lobbying groups saying in the midst of a political battle on healthcare reform doesn't mean a thing when it comes to dollars and cents because the Congressional Budget Office (CBO) is the only true arbiter on Capitol Hill. All fair points.
So when those same healthcare groups--hospitals, doctors, device makers, drug makers, insurance companies and workers--met Obama's deadline Monday by offering some specifics about their plans, did it make Republican lawmakers any less dubious?
No. No, it did not.
"I'm skeptical that these proposals will add up to anywhere near $2 trillion. In the legislative process, proposals rise or fall based on what CBO says about them, and the same will be true here," Senate Finance Committee ranking member Chuck Grassley (R-Iowa), who has hardly been a partisan bomb-thrower on healthcare reform as he and Finance Committee Chairman Max Baucus (D-Mont.) continue to hold out hope of getting a deal, said in a statement.
House Ways and Means Committee ranking member Dave Camp (R-Mich.) wins the directness prize, though. Pretty much as soon as the industry groups released their recommendations Monday, Camp fired off a letter to the CBO asking for a cost analysis.
"Perhaps the most difficult issue in the health reform debate is deciding how to pay for it. Hopefully, the CBO can tell us whether these proposals save enough money to help offset the high cost of health reform," Camp said in statement that is not at all sarcastic.
Senate Finance Committee Chairman Max Baucus (D-Mont.) will meet with liberal Sen. Bernie Sanders (I-Vt.) and other supporters of creating a single-payer national healthcare system--just about the only option for reform Baucus has openly rejected--on Wednesday.
Single-payer advocates have been hopping mad at Democrats, especially since last November's election swept President Obama into the White House and increased the Democratic majorities in the House and Senate. Despite past support of single-payer healthcare on the part of Obama and other prominent Democrats, such as Sen. Edward Kennedy (Mass.), the party in power has dismissed the political viability of a total federal takeover of the the healthcare system.
Baucus surely hopes the private meeting will include less shouting and fewer insults than he endured during the protests some of these same activists organized at several public Finance Committee meetings this
year. At those same meetings--in between calls for the cops to show up--Baucus promised protesters he'd sit down with them. Looks like it's going to happen.
Baucus has become infamous in Washington's healthcare circles for answering nearly every question about what will be in his health reform bill with the statement "Everything's on the table" but he hasn't been at all shy about blowing off the idea of a single-payer system.
"Everything's on the table, nothing's off the table. Nothing. Nothing, with the possible exception of single-pay," he said recently, for example. "I'm not going to waste my time pushing on something that
isn't going to happen," Baucus has said.
Sanders is an independent who caucuses with Democrats and is the only member of the Senate who currently sponsors legislation to create a European-style government program that could provide healthcare to everyone in America.
Baucus and Sanders will be be joined by several prominent single-payer activists: Rose Ann DeMoro and Geri Jenkins of the California Nurses Association/National Nurses Organizing Committee (Jenkins is also a vice president of the AFL-CIO); Cornell's Oliver Fein and Harvard's David Himmelstein of Physicians for a National Health Program; and Marcia Angell of Harvard, an author and former editor-in-chief of the New England Journal of Medicine, according to a press release issued by Sanders's office Monday.
Contrary to the claims of the business lobby, the Employee Free Choice Act (EFCA) would actually preserve the right to a secret ballot in union organizing, says Rep. Don Young (R-Alaska).
Young, one of the few Republicans who favors EFCA, said a secret ballot was still an option under the controversial legislation.
Under the legislation, the National Labor Relations Board (NLRB) would certify a union if a majority of employees sign a card. The law would take away employers' right to demand a secret ballot election after such cards are presented, as they can do under current law. Employees could still choose to hold an election instead of using the card-check process.
According to the Anchorage Daily News, the constituent who asked Young the question was none too happy about the response he got.
"What you just said is almost enough to make me vote against you," the constituent responded.
24% of Alaska's workforce is represneted by unions, according to the Bureau of Labor Statistics. That's the third highest rate in the nation.
The chief criticisms are that the healthcare groups weren't very specific about just how they plan to achieve those staggering savings and that there's no way to hold them accountable if they don't.
Obama sought to answer those criticisms Tuesday in a thank-you note he sent to the leaders of the organizations that made the promise.
"I will hold you to your pledge to get this one," Obama wrote. "I would like you to update my administration by early June on the progress you have made toward fulfilling this important commitment."
The president sent the letter to the heads of the Advanced Medical Technology Association, the American Hospital Association, the American Medical Association, America's Health Insurance Plans, the Pharmaceutical Research and Manufacturers of America and the Service Employees International Union's healthcare division.
Don't know whether they're trying to piggyback on President Obama's big announcement on healthcare or whether they're trying to hide it, but the Senate Finance Committee issued a report Monday outlining the options of the table to expand healthcare coverage to the uninsured.
There's an awful lot in the 63-page document: Ideas for expanding Medicaid, offering tax credits to individuals and small businesses for private coverage and enacting health insurance market reforms, to name a few. But the biggie has got to be the outline of several different ways to create a new public plan people could choose instead of private insurance.
Basically, the Finance Committee -- which is set to mark up a comprehensive healthcare reform bill in about a month -- is looking at creating up a government-run program that looks like Medicare, creating regional plans administered by private insurers or having the public plan run by the states.
Though Finance Committee Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) jointly issued the report, they're on opposite sides about whether to create a public plan option at all. The committee held a public roundtable discussion last week to debate coverage options.
Baucus and Grassley released a similar report last month detailing the committee's set of proposals on reforming the healthcare delivery system. On Tuesday, the panel will convene for the last of three "roundtables," during which they will discuss how to finance the $1 trillion-plus the healthcare bill is expected to cost.
President Obama formally announced an agreement with healthcare industry groups Monday under which national healthcare spending could be reduced by $2 trillion over 10 years.
"What's brought us all together today is a recognition that we can't continue down the same dangerous road we've been traveling for so many years; that costs are out of control; and that reform is not a luxury that can be postponed, but a necessity that cannot wait," Obama said.
The White House previewed the announcement Sunday and issued the letter from America's Health Insurance Plans, the American Medical Association, the Pharmaceutical Research and Manufacturers of America, the American Hospital Association, the Advanced Medical Technology Association and the Service Employees International Union outlining their plans on Monday.
- Jeffrey Young
Below is a transcript of the president's full speech:
A new Rasmussen poll released today indicates the public debate over cap-and-trade is still undefined. In fact, people have no idea what it is.
Well, not NO idea.
Rasmussen asked voters what issue "cap and trade" dealt with, presenting three options: healthcare, Wall Street, or the environment.
Just 24% correctly chose "the environment." 29% chose Wall Street, and 17% chose healthcare. A plurality--30%--said they didn't know.
In the same poll, 69% of respondents said healthcare is a bigger priority than global warming (15% chose the latter.) That question is not arbitrary. Congressional negotiations over cap-and-trade are making progress, but many Democrats are nervous that the legislation will take a back seat to healthcare. From today's NY Times:
[T]here is also a hint of nervousness that Waxman, who took over this year as the new chairman, may still stumble and be forced to drop the climate issue altogether -- to begin work on health care -- because of a lack of votes from some of his own moderate party members. Few dispute that would be a huge blow to President Obama's domestic agenda.
The wonkosphere is abuzz today with news that five healthcare industry groups and at least one major union will meet with Obama at the White House today to announce a new cost-savings initiative.
The plan aims to cut the rate of growth in healthcare costs by 1.5 percent each year for 10 years--a total of $2 trillion.
The stakeholders: Pharmaceutical Manufacturers of America (PhRMA); Advanced Medical Technology Association (AdvaMed); America's Health Insurance Plans (AHIP); the American Hospital Association (AHA); the American Medical Association (AMA); and the Service Employees International Union (SEIU).
What does this mean? All of the groups (except SEIU) have been major opponents of healthcare reform in recent years, and continue to oppose a public insurance plan to compete with private insurers.
Regardless, the consensus is that this is unequivocally good news for Obama's hopes of pushing through big, comprehensive healthcare reform this year.
The mere sight of these groups standing shoulder-to-shoulder with Obama will give reform additional political momentum, driving an even bigger wedge between health industry groups and their erstwhile allies in the conservative movement--where dismay over the behavior of AHIP and other groups is becoming louder by the day.
The event will also give lawmakers in Congress political cover for proposing bolder changes to the payment and delivery systems--the kind that might make reform seem more affordable, at least in the eyes of the all-important Congressional Budget Office.
This is big -- and I'm not talking about the news. I'm talking about the dealmaking between unions, corporations, the health insurance companies and hospitals. And there all going to be at the White House tomorrow. What's the bottom line political significance of all of this: it means that the White House is gonna get health care reform, this year.
The fact that the medical-industrial complex is trying to shape health care reform rather than block it is a tremendously good omen. It looks as if America may finally get what every other advanced country already has: a system that guarantees essential health care to all its citizens.
And serious cost control would change everything, not just for health care, but for America's fiscal future. As Mr. Orszag has emphasized, rising health care costs are the main reason long-run budget projections look so grim. Slow the rate at which those costs rise, and the future will look far brighter.
I still won't count my health care chickens until they're hatched. But this is some of the best policy news I've heard in a long time.
So there you have it. Politically, this is nothing but good news for the administration. It will be infinitely harder for Republicans to oppose a reform package when the major industry groups--these are the Harry and Louise people--are on board, at least in principle.
House Republicans released a new video today showing footage of 9/11 and attacking President Obama's decision to close Guantanamo Bay.
The video is part of a Republican offensive against the prospect of transferring or releasing Guantanamo detainees into the United States.
Yesterday, Republicans introduced the Keep Terrorists Out of America Act, which would require consent of the governor and legislature of a state before detainees could be transferred there. It would also require the administration to certify that the detainees would not threaten U.S. safety.
Attorney General Eric Holder said yesterday that no one considered a terrorist would be released into the United States.
Labor Secretary Hilda Solis neglected Thursday to mention the Employee Free Choice Act (EFCA) in remarks to the National Association of Manufacturers (NAM), one of the contentious union bill's biggest opponents.
Instead, the former California congresswoman, speaking before a breakfast meeting of the trade group's members, concentrated on what both the business association and the Obama administration agreed upon: the $787 billion stimulus package.
"This is just one down-payment. It won't last long but we have to produce something," Solis said.
Thanking NAM for their support of the recovery effort, which was key to its passage on Capitol Hill, Solis said there are a number of areas for the trade association and the administration can work together in to help right the tough economy, whether it was creating jobs in the renewable energy industry, more workforce training or expanding college education.
"The long and the short of it is there are good opportunities for us in the future," Solis said.
Solis is the first Obama administration official to speak at a NAM event, according to the trade group's president and CEO, former Michigan Gov. John Engler (R). The business group is known for its Republican ties but has reached across the aisle in the past, most recently in its support of the stimulus package.
One area where NAM and the administration will not find agreement is on EFCA, which would make union organizing much easier if passed. Business groups have lobbied heavily against the bill, believing it will lead to more strikes and work stoppages. Unions have supported it though, arguing it would give workers better wages and benefits by extending collective bargaining rights.
The White House is behind EFCA as well. Though not involved in the battle over the bill as much as some unions have wanted so far, both President Obama and Vice President Joe Biden have called for Congress to pass the legislation in public speeches.
Solis herself was a vocal supporter of EFCA while in Congress. The Democrat co-sponsored the legislation in the House and her backing of the bill served as a point of attack for Senate Republicans during her lengthy confirmation process for Labor Secretary.
-- Kevin Bogardus
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