Obama seizes reins in daylong House-Senate healthcare meeting

President Barack Obama sought to muscle House and Senate Democrats to reach an accord on healthcare reform during a daylong White House meeting Wednesday.

With an eye toward sealing a deal on his signature domestic policy initiative before he delivers his first State of the Union address in a few short weeks, Obama sat down with the top Democratic leaders from Capitol Hill at the White House for a marathon negotiating session.

House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.), along with their top lieutenants and the five committee chairmen who were the bills’ chief authors, represented their respective bodies. Leaders from both chambers must strike a delicate balance that respects the political realities in the more liberal House Democratic Caucus and the more centrist Senate Democratic Caucus.

“Today we made significant progress in bridging the remaining gaps between the two health insurance reform bills," Obama, Pelosi and Reid said in a joint statement issued afterward. "We’re encouraged and energized, and we’re resolved to deliver reform legislation that provides more stability and security for those with insurance, extends coverage to those who don’t have coverage, and lowers costs for families, businesses, and governments.”

Though the president left the gathering periodically to conduct other business, such as leading the United States’s response to the massive earthquake in Haiti, Vice President Joe Biden attended a portion of the meeting and senior administration officials such as Health and Human Services Secretary Kathleen Sebelius, White House Office of Health Reform Director Nancy-Ann DeParle and Obama’s congressional liaison Phil Schiliro remained to help House and Senate leaders broker agreements on the outstanding issues standing in the way of passing final legislation.

The House and Senate took significantly different approaches in a number of key areas, such as how to pay for the bill, whether to establish health insurance exchanges at the national or state level and whether to require that employers provide health benefits.

“Nothing is agreed to until everything is agreed to but I think we are really moving toward a conclusion,” said Rep. Rob Andrews (D-N.J.), who chairs the health subcommittee of the Education and Labor Committee. “I think the progress here is that the principal decision-makers are talking with each other very specifically and directly.”

While aides shed no light on the substance of the discussions, a senior House aide said the appearance of the key participants working into the night left the impression that Obama was looking to “force some decisions and that takes a lot of time.”

Though there are numerous issues to be resolved, the chief difficulty appears to be coming to a compromise on the excise tax, which is strongly opposed by organized labor.

Underscoring the importance of securing union support for the final bill, White House officials staged a separate meeting Wednesday with the leaders of major unions at the same time congressional leaders sat down with Obama. Union leaders had met in person with the president on Monday and with Pelosi on Tuesday.

Since Congress began working on healthcare reform shortly after Obama’s inauguration last year, Obama mainly has taken a hands-off approach — at times to the consternation of Democrats seeking more leadership from the White House. Since the Senate passed its bill on Christmas Eve, however, the president has been playing a stronger hand and declaring his preferences for the final bill.

Direct pressure on Democratic leaders from the president, followed by a direct appeal to rank-and-file Democrats to support him on his goal of enacting healthcare reform, could be the difference-maker.

"One of the criticisms of him throughout this has been, ‘Oh, he’s been too disengaged,’” Andrews said. “I think he’s picking the right moment to be engaged — and this is it.

“A lot of Democrats in the House who have misgivings about particulars will support the whole thing,” Andrews said. “There’s a very mature understanding here that no one gets everything they want, that there are much larger questions here than any of these specifics.”

The pressure from the White House to quickly resolve the House’s differences with the Senate — and mostly in the Senate’s favor on issues like the public option, the excise tax and the employer mandate — is chafing some Democrats in the lower chamber, however.

“Getting it right is more important than just getting it passed. I have great respect for our president but I’m sorry if getting it right means we delay the State of the Union,” said Rep. Earl Blumenauer (D-Ore.).

House Democrats, particularly in the liberal wing of the caucus, continued to protest the legislation’s lurch toward the center. “We had a pretty good bill. It’s been watered down and watered down and we’re fighting to hold our heads above water,” said Rep. Eliot Engel (D-N.Y.).

Rep. Anthony Weiner (D-N.Y.) was characteristically blunt: “I am tired of hearing how hard it was to get 60 votes in the Senate — getting 218 votes to pass our healthcare bill in the House wasn’t easy,” he said in a statement. “We don’t like negotiating with a gun to our head.”

Not all liberals want to see the healthcare debate linger, however. “If it doesn’t get done in the next few weeks it’s hard to see how it will,” said Rep. Lynn Woolsey (D-Calif.), co-chairwoman of the Congressional Progressive Caucus.

Opposition to the excise tax remains fierce in some quarters. Democratic Reps. Joe Courtney (Conn.) and Sandy Levin (Mich.) said on Wednesday said they have now collected more than 190 signatures on a letter opposing the tax. Moreover, AFL-CIO and the Service Employees International Union members paid visits to offices across Capitol Hill on Wednesday to deliver messages of protest.

Nevertheless, Andrews, Rep. Frank Pallone (D-N.J.) and other Democrats indicated that a compromise that excluded more middle-class workers from the tax is possible. “I think we could build a consensus around that idea, a majority,” he said. Increasing the Medicare payroll tax further than the Senate bill and applying it to investment income would help make up for the lost revenue, he said.

Congressional Democrats will resume the talks Thursday both on Capitol Hill and at the White House.