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White House budget chief hits back at skeptics of health reform measure
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12/02/09 11:43 AM ET
President Barack Obama's budget chief issued a strong defense of the cost-containment measures in the Senate healthcare reform bill Wednesday, arguing that the legislation does more than any in history to tackle inflating spending.
Peter Orszag, the director of the White House Office of Management and Budget, said naysayers are giving the Obama administration and Senate Democratic leaders insufficient credit for the reforms actually contained in the bill and are slow to offer alternatives.
"People can always complain and question but judging by results we are further along … than has ever been the case before," he said. "There are always things that could be strengthened and as this process moves forward, perhaps we will be paying attention to further tweaking."
Orszag emphasized two proposals in the bill that face resistance from a large number of Democrats: Creating an independent commission to establish Medicare payment policies and enacting an excise tax on high-cost insurance plans designed to encourage employers and individuals to choose less expensive insurance and consume fewer healthcare resources.
Although Senate Majority Leader Harry Reid (D-Nev.) retained both policies, originally included in the Senate Finance Committee's version of the bill, the Medicare commission and the excise tax are scaled back from their original forms and could be further diminished as the healthcare debate advances.
Labor unions and numerous Democrats in the Senate oppose the excise tax, which they maintain would hurt union workers who negotiated generous health benefit packages in lieu of higher wages. They also say the tax would apply to ever-greater numbers of people in future years. On the commission, lawmakers have expressed unease with granting an independent body the authority to present Congress with an up-or-down slate of Medicare pay rates each year, a notion that also creates high anxiety among medical providers.
The House-passed healthcare reform bill contains neither the Medicare commission nor the excise tax and resistance to both proposals, long touted by Orszag and other administration officials, is stronger in the lower chamber, setting up a clash during House-Senate conference negotiations if the Senate passes its legislation. Though Obama and his aides have been careful not to be seen as choosing sides on issues that divide Democrats — to the consternation of some on Capitol Hill who want the president to take the reins more firmly — Orszag's emphasis on the Medicare panel and the excise tax strongly suggest the White House will favor the Senate on those points.
Despite the political obstacles ahead for the cost-containment provisions in the healthcare bill, Orszag urged reporters to look at the legislative process in a historical context.
"From a cost-containment perspective if, a year ago — November or December of last year — someone told you that a bill would be actively debated on the floor of the United States Senate that expands coverage by more than 30 million, reduces the deficit, had a Medicare commission in it and had an excise tax on high-cost insurance plans contained in it, I think most of you would have been — to say you would have been skeptical would’ve been an understatement," he said.
Republicans, along with deficit-hawk groups, have expressed skepticism that the cost-containment provisions in the Senate healthcare bill, especially the more than $400 billion in Medicare cuts, would inevitably be reversed by lawmakers in the future fearful of a backlash from senior citizens and medical provider lobbies. Orszag rejected that argument, noting that while Congress has undone some of the Medicare cuts enacted in the late 1990s, the "vast bulk" were allowed to take effect. Moreover, he said, the implementation of pay-as-you-go budget rules in Congress has made the task of increasing spending more difficult.
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