By Ceci Connolly
Washington Post Staff Writer
Friday, June 19, 2009
President Obama's hopes for quick action on comprehensive health-care reform ran headlong this week into the realities of Congress, as lawmakers searching for the money to pay for a broad expansion of coverage discovered that it wasn't easy to find and descended into partisan -- and intraparty -- bickering.
A set of unexpectedly high cost estimates -- arcane data that nevertheless carry enormous import in the legislative process -- sent shockwaves along Pennsylvania Avenue and forced one key committee to delay action on its bill, probably until after the July 4 recess.
In a high-level meeting at the White House yesterday, Obama conveyed his concern over early pronouncements by the Congressional Budget Office that a bill drafted by the Senate health committee would cover just 16 million additional people at a cost of $1 trillion, said one official with knowledge of the session who was not permitted to talk to reporters and so spoke on the condition of anonymity.
"That is not his idea of good, affordable, universal coverage," said this adviser. The preliminary estimate, pounced on by Republicans, "has rattled everyone."
House Democratic leaders, meanwhile, said they will wait until next month to unveil plans for financing their bill.
"All I know is that health-care reform is on life support because the Senate can't figure out how to pay for it," said Rep. Jim Cooper (D-Tenn.), who was touting his bipartisan bill.
Obama has imbued the health-care debate with a sense of urgency, pressing party leaders to conclude action on the House and Senate floors by Labor Day. But progress has slowed because of the realization that any attempt to provide coverage to the bulk of the nation's 46 million uninsured people will cost an enormous amount of money, even when factoring in potential long-term savings from modernization and efficiencies.
In a speech to the American Medical Association on Monday, Obama bragged that he had spelled out $950 billion worth of budget cuts and tax increases over the next 10 years -- an amount, he said, that takes "us almost all the way to covering the full cost of health-care reform."
But the independent CBO estimated that a draft bill by the Senate Finance Committee would cost $1.6 trillion, a figure that Sen. Olympia J. Snowe (R-Maine) described as "a jolt of reality."
"That was a wake-up call that we have to approach this reform with some caution," she said.
White House Chief of Staff Rahm Emanuel acknowledged that $1.6 trillion "is a big number" that forced administration aides and congressional staff to rework the plan. "Everybody now is going to take these bills back and come in below $1 trillion," he said yesterday.
But Emanuel described haggling over cost estimates as a routine part of lawmaking. "Since it's the first inning, I wouldn't call the game," he said.
Late yesterday, Finance Committee members began reviewing the outlines of a more modest approach in the hopes that scaling back some of their plans to cover the working poor could save money.
Though early in the process, administration allies are divided over the timetable.
Ralph Neas, a veteran liberal advocate who runs the National Coalition on Health Care, said a thorough debate is likely to continue through Thanksgiving or Christmas.
But John Podesta, who oversaw the Obama transition and now leads the Center for American Progress, a liberal think tank, said the most promising window of opportunity is before Labor Day.
"If this languishes into the fall, there's every reason to believe the attempts to make this bipartisan will be overwhelmed by the attacks coming from partisans in particular," he said.
The arduous task of overhauling the nation's entire $2.2 trillion health system has been further complicated by the absence of Sen. Edward M. Kennedy (D-Mass.), chairman of the health committee, who is arguably the most knowledgeable lawmaker on the issue. He is battling brain cancer.
"His absence has an enormous impact," said Sheila Burke, a health-policy expert and longtime aide to former Senate majority leader Robert J. Dole (R-Kan.). Still, she said, tackling sweeping health reform would be difficult even with Kennedy on the job full-time.
The Senate Health, Education, Labor and Pensions Committee, under the temporary leadership of Sen. Christopher J. Dodd (D-Conn.), began work on a partial bill crafted largely by Kennedy aides. Republicans complained of being left out.
"I am personally somewhat -- well, actually, very -- disappointed," said Sen. Orrin G. Hatch (R-Utah). "I wanted a thoughtful bipartisan compromise that could have become a lasting legacy for my dear friend, Ted Kennedy."
Like Obama, Sen. Mike Enzi (Wyo.), the panel's ranking Republican, said he was distressed by the CBO report showing that the bill would cost $1 trillion and cover just 16 million more people.
In addition, the draft did not include some of the most costly and controversial sections of the bill. That situation "does nothing to advance the cause," said Richard Kirsch, national campaign manager of the labor-backed pro-reform group Health Care for America Now.
A frustrated Senate Majority Leader Harry M. Reid (D-Nev.) blamed the delays on Republicans.
"I'm sorry to say they have subscribed to more of the same stalling strategy that the American people are sick and tired of," he said in a floor speech yesterday.
But there was disagreement within his own party.
As Finance Committee Chairman Max Baucus (D-Mont.) assembled a bipartisan group of senators dubbed the "coalition of the willing," Dodd played down the need to negotiate with the other side. "My goal is to write a good bill," he said. "My goal is not bipartisanship."