Bush Moves to Return Focus to Energy, Health-Care Plans

BRIDGEPORT, Conn., April 5 -- President Bush tried to jump-start his legislative agenda Wednesday, summoning Republican congressional leaders to the White House to consult on strategy and then flying here to pitch his centerpiece health-care plan.

With the White House preoccupied with rumors of further staff changes and Capitol Hill focused on the polarizing immigration debate, Bush tried to steer attention back to a domestic program that has largely languished in the two months since he unveiled it in his State of the Union address.

During an early-morning closed meeting at the White House, aides said, the president pressed House and Senate leaders to move on his energy and tax proposals in hopes of calming election-year anxieties about rising gasoline prices. In a subsequent public forum staged here with local business leaders, he showcased his plan to expand tax incentives for health-care spending.

The president's health-care plan stood in striking contrast to the new legislation passed this week in next-door Massachusetts, which is set to become the first state to require that all residents obtain health insurance just as all drivers must have automobile insurance. Bush did not directly address the Massachusetts plan, but he made the case for his less prescriptive approach that he said would give individual taxpayers the opportunity to make their own decisions about medical care.

"The benefit for society as a whole is this helps control costs and helps make health care more available and affordable," he said.

Under a Medicare law enacted in 2003, Americans can save money tax-free for medical expenses in a health savings account (HSA) set up in combination with inexpensive insurance policies requiring people to pay more of their medical costs before coverage begins. Now, Bush wants Congress to make several changes in a bid to make HSAs more popular, such as letting people invest more money in the accounts.

The plan faces serious hurdles in Congress. Democrats say that health savings accounts are most appealing to high-income workers and will only encourage employers to give up insurance programs, leaving more Americans uncovered. And Senate Finance Committee Chairman Charles E. Grassley (R-Iowa), who is crucial to any tax legislation, has all but declared the proposal dead for the year. "We want to believe that if we just spend more money or provide more tax subsidies, our problems will magically disappear," he said at a hearing last month.

Bush disputed some of the criticisms. Both the White House and the Senate Democratic caucus issued competing "fact sheets" disputing the other's contentions about the savings accounts. Reviving a technique used during his failed Social Security campaign last year, Bush surrounded himself on stage with preselected business leaders and an HSA holder who boasted that she still had $800 left after medical expenses last year.

The president also promoted proposals to improve health-information technology, to restrict medical malpractice lawsuits that he blames for pushing up health costs, and to allow small businesses to pool insurance policies to balance out risks and lower expenses.

In taking his program back on the road, Bush chose a state where he was born and educated but where polls show he is deeply unpopular. Unlike counterparts elsewhere, though, key Republicans joined him, including Rep. Christopher Shays, who despite past disagreements flew here on Air Force One, and Gov. M. Jodi Rell.

Bush joked about Shays's independent streak, praising his "thoughtful approach" and calling him a friend. Addressing Shays from stage, Bush added: "I'm looking forward to hearing your lecture on the way back to Washington."