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Correction to This Article
This article about Democrats already looking beyond the Feb. 25 White House health-care summit incorrectly said that lawmakers who support abortion rights had sent a delegation to the White House to discuss President Obama's latest health-care proposal. Abortion rights advocates in the House say that they have renewed their request for such a meeting but that it has yet to occur, although informal discussions are ongoing.
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Democrats looking beyond health-care summit to final talks within party

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The Washington Post's Ezra Klein and Chris Cillizza preview the White House health-care summit taking place February 25 at the Blair House. The administration is billing the event as a 'bipartisan meeting on health reform.'

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The faction that most concerns House leaders is the conservative Blue Dog coalition, which saw 24 defections when the health-care reform bill came to a vote in November. With a 10-year price tag of about $950 billion, Obama's compromise is less costly than the House measure, a point that should appeal to members of the fiscally conservative caucus. But health-care reform has become so fraught politically that House leaders worry about losing Blue Dogs who previously supported the bill, as they run for cover in their districts, which are often closely contested.

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Another nettlesome issue is abortion. The Senate plan takes a slightly more lenient approach to preventing federal subsidies from paying for insurance policies that cover abortion, and abortion opponents have deemed it unacceptable. Rep. Bart Stupak (Mich.), a leader among antiabortion Democrats in the House, warned that an additional dozen Democrats could join him in voting against the Senate bill.

Abortion rights supporters are not happy, either. More than 40 House Democrats signed a letter saying they would vote against any measure that would restrict current access to coverage, and a delegation of abortion rights supporters visited the White House on Tuesday to lobby on the issue.

Immigration is also an area of contention. The Senate bill would bar undocumented immigrants from purchasing insurance through exchanges that would be created under the plan, even with their own money. Like abortion, the issue would be difficult to address in the reconciliation bill, and it is unclear whether Hispanic House members who expressed strong opposition to the Senate legislation would be willing to accept the language.

Medicare board at issue

Still other House members are pressing the White House to surrender on another key Senate proposal, supported by Obama, that would create an independent board empowered to control Medicare spending. Members of the House Ways and Means Committee oppose giving up their authority to manage Medicare, and the board was a topic of fierce discussion at a committee meeting Tuesday.

One member of the panel, Rep. Richard E. Neal (D-Mass.), said Wednesday that he could vote against a health-care reform package that includes the Medicare board, which he deemed "an indefensible transfer of legislative authority."

But House Democrats said they are open to Obama's compromise proposal for an excise tax on high-cost "Cadillac" insurance policies. Although the president has backed the idea as a way to control premiums, he has proposed delaying the tax's implementation until 2018 while raising the threshold to exempt many union plans.

First-term Rep. Gerald E. Connolly (D-Va.) said the summit marks the beginning of Obama's last, best chance to achieve his top domestic policy goal.

"It may involve hand-holding or holding of noses, but either you buy into the idea of health-care reform that transcends everything else you want to do, or you seal its fate," Connolly said. "On our side, the time for haggling is over. The question is: Do you want this, or do you want nothing?"


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