Details Still Lacking On Obama Proposal

White House Unclear on How Some Far-Reaching Goals Would Be Met

Sen. John McCain (R-Ariz.), left, with Sen. Lindsey O. Graham (R-S.C.), was collecting signatures on a petition in opposition to the president's plan.
Sen. John McCain (R-Ariz.), left, with Sen. Lindsey O. Graham (R-S.C.), was collecting signatures on a petition in opposition to the president's plan. (By Andrew Harrer -- Bloomberg News)
Washington Post Staff Writer
Friday, September 11, 2009

One day after President Obama pitched his plan for comprehensive health-care reform to a joint session of Congress, administration officials struggled Thursday to detail how he would achieve his goal of extending coverage to tens of millions of uninsured Americans without increasing the deficit.

In two public appearances and private meetings with a dozen lawmakers, Obama promised a "full-court press," saying, "We have talked this issue to death." He also argued that new Census Bureau figures showing a slight uptick in the number of uninsured Americans only underscores the urgency of enacting major legislation this year.

The 10-year, $900 billion proposal Obama envisions borrows heavily from concepts circulating on Capitol Hill, but there was little evidence that the broad ideas are sufficient to break a congressional logjam.

After declining for months to identify himself with the details of emerging legislation, the president for the first time Wednesday embraced a set of ideas as "my plan." But the White House released scant specifics on legislation advertised as including new taxes, changes in malpractice law, a new national high-risk insurance pool, a commission on eliminating Medicare fraud, and tax credits for individual consumers and small businesses that cannot afford insurance.

"His speech was very specific and, as promised, answered the big questions about how we should proceed on providing a secure and stable health system for all Americans," White House spokesman Dan Pfeiffer said. "Many of the details will be worked out in the legislative process."

Even the president's efforts to bridge the partisan divide -- in his speech, he endorsed two ideas developed by Republicans -- were met with skepticism.

Sen. John McCain (R-Ariz.), who grinned Wednesday night when Obama embraced his idea for a high-risk pool that would serve as a safety net for people who are currently difficult to insure, was collecting signatures Thursday on a petition in opposition to the president's entire plan.

The Obama proposal is an "egregiously expensive and expansive form of government-run health care," McCain said in an online letter to supporters.

More troubling for Obama were the mixed signals from Democrats who, absent any signs of significant Republican support, have increasingly become the focus of the president's lobbying effort. After a White House meeting with Obama, Sen. Herb Kohl (D-Wis.) voiced concerns that the most prominent health-care proposals fall short.

"We all understand that we want to move toward universal coverage, but I don't think we're focusing enough on costs," he said.

Although virtually every Democrat found something to like in the president's 47-minute address, the interpretations of what he meant varied widely, suggesting more difficult negotiations ahead. On the controversial question of whether to form a new public insurance option, many liberals characterized what was widely interpreted as Obama's neutral stance to be unwavering support for the idea.

"We were pleased you explicitly expressed your support for a public option as a central piece of achieving true reform," leaders of the House Progressive Caucus wrote in a letter to Obama.

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