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Transcript: Health On The Hill: What A Difference A Year Makes

President Obama has scheduled a bipartisan summit for Feb. 25 to discuss ways to pass health care overhaul legislation this year. On Capitol Hill, Democratic leaders in both chambers are trying to resolve differences between House and Senate-passed health care bills and make progress on the issue once lawmakers return from the President’s Day recess.

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JACKIE JUDD: Good day. I am Jackie Judd with Health on the Hill. Where does health care reform stand on Capitol Hill? Will the Summit President Obama has planned for next week help or hinder his efforts to move a Bill through Congress?

Here to help us answer those questions and more are Mary Agnes Carey of Kaiser Health News and Eric Pianin, Washington Editor of the new online news service, The Fiscal Times. Welcome to you both.

Congress, as we all did, had a snow break last week. This week they are off for President’s Day recess, but what’s the chatter been, Mary Agnes, about the status of health care reform?

MARY AGNES CAREY: Well of course hope springs eternal. Proponents of the Bill site how hard they have worked on it, they’ve gotten so far. They have a House passage of a Bill and the Senate passage of a Bill, but how do you get it over the goal line? There still is talk about trying to have the House Bill, pass the Senate Bill, and then come up with a package of fixes that would pass under a process known as budget reconciliation, but it’s a very limited process.

It deals with things like taxes and spending. And the House would want a significant number of changes in the Bill. As we’ve discussed before, they would want more generous subsidies to help people purchase coverage.

They are no fan of this thing called the “Cadillac Tax” which is in the Senate Bill, a tax on some of the highest cost health plans, and they also are unhappy about provisions in the Senate Bill like the one done for Ben Nelson of Nebraska on Medicaid. So you would have to have a significant set of changes and it is unclear if that could even pass in the Senate.

JACKIE JUDD: Well, several weeks ago, Nancy Pelosi was saying she simply didn’t have the votes to do what you were just suggesting, that is have the House pass the Senate Bill, make changes later, has that changed, Eric?

ERIC PIANIN: I don’t think it has and I think that a lot of the wind has been removed from the sails of this whole enterprise. I think that because the Democrats realize that health care reform is sort of a losing hand, they’ve set it aside for awhile and they are looking at other things including job creation, economic stimulus, that sort of thing. The President certainly hasn’t given up on it, but I think that it’s certainly been put on the back burner.

So, I also feel that leadership is really kind of struggling to find a new formula. The President has called for a Summit next week to meet with Republicans and Democrats and try to find a new direction but Republicans want them to start from scratch.

The President is perhaps willing to hit the rewind button a little and talk some more about it, but clearly he is committed to sort of a grand deal with the Democrats in the House and the Senate with some kind of comprehensive plan.

JACKIE JUDD: So, is the Summit viewed as more about showmanship, about playing chicken with the Republicans, or is there a sense among anyone out there that this could be a meaningful event?

MARY AGNES CAREY: Well, I think that some people would say that President Obama and Democrats kind of want to call the Republicans. You say you want to work with us. Work with us. Talk about our ideas. Where can we find common ground? But to Eric’s point, a lot of Republicans are very concerned that for example if Democrats and the President walk in with an agreed upon package, saying this is the starting point, how much flexibility does that show on Democrats? I don’t think the Summit is really expected to move the ball forward very much.

JACKIE JUDD: Mary Agnes, you wrote a story for the online service about whatever happened to all of the deals that the Obama White House cut with large important sectors of the health care industry? What did you find?

MARY AGNES CAREY: Well, there is concern that if health reform doesn’t pass, you could have a President and a party of Democrats who are very concerned about the rising deficit, look at these savings identified and say well, we could still use those savings in Medicare or Medicaid for deficit reduction, because there will be a lot of pressure to reduce the deficit.

Now of course if that decision was made to take that policy step, there would be a lot of push back, not only by the groups that would be affected but also by all of the interest groups that want health reform to pass. They may say now let’s no take that money and put it toward the deficit. Let’s try to get health reform in some way. So, I think we have to see how it plays out, but the deficit is definitely a concern.


ERIC PIANIN: Well, I think that the President is facing a really tough situation and in some ways he may be trying to operate the way Bill Clinton did after the Republicans took control back in 1994, some way of sort of triangulating his dealings with the Democrats and the Republicans to come up with some kind of compromise, in a sense some face-saving package that could pass the Congress this year.

The Democrats are desperate for a win. I don’t think anybody is seriously thinking that they can pass the big comprehensive packages that have moved through the House and the Senate. It just doesn’t seem possible. They don’t have the votes now.

They are going to have to do business with the Republicans. It will be interesting to see what the Republicans come up with at this Summit. I mean, they have had the advantage of standing on the side lines and taking pot shots at the Democrats for months, complaining about stuff but not really putting anything forward. They may be put in a position where they are going to have to be a little more specific about what they would do.

JACKIE JUDD: And with the announcement over the weekend from Indiana Senator Evan Bayh, that he’s not going to seek reelection, has that changed the dynamics substantially for the Democrats or is it just more piling on that they faced after the election of Scott Brown, Republican Scott Brown in Massachusetts?

ERIC PIANIN: Well I think there is a new dynamic here because there is this real concern now that the Democrats may be in terrible straights. I mean, months ago there was speculation well could they hold on to their 60 vote majority in the Senate, well no, they can’t. Scott Brown came along, and took care of that.

Now with Bayh and four other Democrats announcing that they are retiring, the fact that four or five other Democrats like Blanche Lincoln from Arkansas and Arlen Specter from Pennsylvania who has just converted to the Democratic side, are in big trouble and may lose their seats.

Now there is talk can the Democrats actually hold onto the majority in the Senate? So, yes I think that changes the dynamic a lot and it’s certainly going to affect the thinking of rank in file Democrats when they try to decide whether they want to sign on to some kind of major health care package at this late date.

JACKIE JUDD: What a difference a year makes.


JACKIE JUDD: Okay, thank you both so much, Eric Pianin, Mary Agnes Carey. Thank you for joining us. I’m Jackie Judd and this has been Health on the Hill.