By Shailagh Murray
Washington Post Staff Writer
Friday, September 4, 2009
LOUDON, Tenn. -- Republican Sen. Bob Corker stood before a packed high school auditorium this week for his 24th and final town hall meeting of the summer, sketching out his vision for the bipartisan health-care plan he says he is convinced Congress can pass.
A contentious August recess dramatically reshaped the debate, and lawmakers will return to work next week facing a landscape that even a conservative first-term senator in the minority party such as Corker has the opportunity to influence.
After Democratic proposals endured weeks of battering in public forums, President Obama will attempt to restore momentum to the reform process he initiated, beginning with an address to a joint session of Congress on Wednesday night. And while the administration was reluctant to make major concessions on the shape of health legislation before lawmakers left town, Obama aides are making it clear that they are ready to listen to any ideas that could help make significant change a reality.
Although heated rhetoric over a potential government takeover of health care has been a staple of the hundreds of town meetings lawmakers held this summer, many Republicans say they heard a second message back home: No matter how flawed the plans being pushed by Democrats, the status quo is not a popular alternative.
Some GOP lawmakers, including Corker (Tenn.), say they think bipartisan agreement may become more attainable if those demonstrations lead Democrats to scale back their reform ambitions, particularly when it comes to creating a new government-run insurance program, or "public option."
"There is a common ground," Corker said Wednesday in an interview before his final town hall meeting. "It's half a loaf, possibly, from the administration's viewpoint. But what it does is take us way down the field."
For two months, the bipartisan efforts to compromise on health care were limited to the Senate Finance Committee's "Gang of Six." That group will reconvene Friday by conference call and is tasked with producing a bill by Sept. 15. But there are glimmers that support for a less ambitious bill may be expanding and could include some unlikely participants.
Many of the proposals Corker mentioned to his constituents are ideas that Democrats also support and have included in their own reform plans. As he sees it, insurers would no longer be allowed to deny coverage for preexisting conditions, Corker told the crowd, and would offer an array of plans via a new insurance exchange, unrestricted by the current boundaries of state insurance laws. To help the uninsured gain coverage, the government would provide vouchers or tax credits, and would tax the most generous employer-offered plans to pay the cost.
But a public insurance option is a non-starter, Corker warned, and unless Obama pushes the idea off the table next week, meaningful GOP support will not materialize. A serious and gradual bid to control costs and expand coverage, however, could prove difficult for certain Republicans to resist, he said.
Even some liberal Democrats are beginning to concede that the terms of the debate need to shift to get 60 Senators, a filibuster-proof majority, to support a measure.
"Getting people to understand that costs are out of control, and the system can't continue with costs going up as rapidly as they are, and we need real cost-cutting as the centerpiece of a bill -- that's what you need in terms of being bipartisan," said Sen. Charles E. Schumer (N.Y.), a member of the Senate Democratic leadership.
Any discussions about potential bipartisan agreement must be measured against harsher political realities. Republicans are not eager to hand a landmark victory to a president who has quickly seen his fortunes take a turn for the worse, particularly on an issue that helped them derail President Bill Clinton's health-care agenda in the early 1990s. And GOP strategists say the events of the past month have increased doubts about the Democratic reform effort, and said GOP lawmakers would continue to attack any provisions that would expand the government's role in health care, increase the federal deficit or threaten Medicare.
Given the acid tone of the health-care debate, many Democrats scoff at the idea that Republicans will bargain in good faith. At the moment, the list of Republican senators likely to side with Obama consists of only Olympia J. Snowe (Maine), a moderate who has expressed willingness to support a public insurance plan as a fallback option, if private insurers do not offer affordable coverage.
Snowe and White House officials are deep in discussions, and her spokeswoman, Julia Wanzco, said that the senator remains "committed to finding a bipartisan solution" but added that her "foremost goal" remains reaching a deal with her finance panel colleagues.
Sen. Charles E. Grassley (Iowa), the senior Republican in the Finance Committee talks, said he has not given up on finding consensus, although White House officials doubt his commitment, after the senator assailed Democratic priorities such as the public option at his own town hall meetings. Grassley also sent out a fundraising letter last month pledging to defeat "Obama-care."
"I'm still going to be at the table as long as I can be, for a bipartisan bill," Grassley said in an interview. "I think we can still do something this year. It's probably something that would reflect the tone that is out there in the town meetings -- that people want things done, but want them done maybe a little smaller."
Republicans are waiting for cues from the president, Grassley added. "If the White House wants a bipartisan plan, there can be a bipartisan plan," he said.
The lack of Republican cooperation has been a serious obstacle in the Senate, and Democratic leaders continue to explore moving a bill through the chamber under a special budget rule known as reconciliation. But some Democrats are reluctant to force action along party lines on an issue that evokes such emotion. "People will be more comfortable with a bipartisan solution," said Sen. Ben Nelson (Neb.), a conservative Democrat. "You're going to have some among the Republican ranks who will be complaining about it, but if you've got a fairly sizable number coming over . . . then you have credibility."
If contentious provisions such as the public option and end-of-life counseling are sidelined, and a smaller, less costly and less controversial plan emerges, the legislation could eventually resemble GOP health-care proposals that aim to contain costs and expand coverage, although mainly through the private sector.
"You can get where we need to go, which is give adequate insurance to people who aren't insured, while controlling out-year costs, without a massive rewrite of the whole exercise," said Sen. Judd Gregg (R-N.H.).
But Congress is stuck in a partisan stalemate, Gregg noted, and only Obama can pry it loose. "The White House has to first incentivize, or at least give its imprimatur of authority, to a bipartisan negotiating group," he said, adding: "I do think the opportunity is sitting there -- and has been literally in the Senate for six months."
White House officials also took note when Sen. John McCain (Ariz.) signaled late last month that Republicans could be responsive to a direct appeal from Obama to participate in crafting a bill.
"All of us agree that health-care costs are out of control and we have to bring them under control," McCain told ABC News. "So maybe it would be a good idea for us to sit down, and after consultation and agreement, the president could say, "Here's the health-care plan that I want passed through the Congress. At least we ought to try it."
Although Corker drew the same kind of raucous crowds that have turned out across the country, he used his opening statement to point out areas of common ground and breezed past flash points such as the public option.
"I actually want to see us solve this problem, and I start out every meeting saying that, which is a little disarming to some people who might think I would just be bashing," Corker said.
One proposal that appears to be gaining traction among some Democrats and Republicans, including Corker, would limit the insurance people are required to buy to only a catastrophic coverage plan. Another idea, proposed by McCain on the 2008 campaign trail and now getting a second look from certain Democrats, would create special risk pools for people with serious illnesses. Some individuals familiar with health-care negotiations said that if Obama chooses to take a staggered approach, gradually expanding coverage over time, either of these ideas could prove promising starting points.
Corker said both parties have "clumsily handled" the debate, and conceded, "I do think Republicans have wanted to halt what's happened. But I don't think it's to halt it to end it. I think it's to halt it to get to a point where we can sit down and do something that's pragmatic. For what it's worth, I think we might end up with a policy that will stand the test of time and really help create opportunities for access to millions of Americans."