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Final health care plan falls short of Obama’s promises

By ERICA WERNER
March 20, 2010

President Obama speaks at George Mason University (AP)

It was a bold response to skyrocketing health insurance premiums. President Barack Obama would give federal authorities the power to block unreasonable rate hikes.

Yet when Democrats unveiled the final, incarnation of their health care bill this week, the proposal was nowhere to be found.

Ditto with several Republican ideas that Obama had said he wanted to include after a televised bipartisan summit last month, including a plan by Sen. Tom Coburn of Oklahoma to send investigators disguised as patients to hospitals in search of waste, fraud and abuse.

And those “special deals” that Obama railed against and said he wanted to eliminate? With the exception of two of the most notorious — extra Medicaid money for Nebraska and a carve-out for Florida seniors faced with losing certain extra Medicare benefits — they are all still there.

For the White House, these were the latest unfulfilled commitments related to Obama’s health care proposal, starting with his campaign promise to let C-SPAN cameras film negotiations over the bill. Obama also backed down with little apparent regret on his support for a new government-run insurance plan as part of the legislation, a liberal priority.

But was it all the president’s doing?

In the cases of the insurance rate authority, the Republican ideas and the special deals, it came down to Obama making promises that Congress didn’t keep. He can propose whatever he wants, but it’s up to Congress to enshrine it into law.

Arguably, the president could have foreseen that outcome, and was making a low-risk p.r. move by floating proposals — dismissed by critics as insubstantial anyway — whose demise he couldn’t be blamed for.

While the White House worked hard to trumpet Obama’s plans for the rate authority, his embrace of bipartisanship and his opposition to special deals, the administration hardly advertised the lack of follow-through. Understandable, certainly, but perhaps not the new way of doing business that Obama promised to bring to Washington.

Removing the special deals ran into opposition from powerful lawmakers including Sens. Chris Dodd, D-Conn., and Max Baucus, D-Mont. The rate-limiting authority and the Republican ideas were left out of the legislation because the bill is going to be considered under special filibuster-proof Senate rules that prohibit provisions that don’t have a budgetary impact, and those ideas don’t fit in.

“There are a number of proposals that the president wanted to incorporate into the legislation including additional Republican proposals, but the parliamentarian ruled against allowing those proposals to be included,” said White House spokesman Reid Cherlin. “We would like to enact those proposals in separate legislation in the coming months. In the meantime, some important Republican measures remain.”

Of the four main Republican ideas Obama endorsed, only one made it into the final bill — a proposal embraced by Sen. Charles Grassley of Iowa to bump up payments to primary care physicians under Medicaid. A proposal to expand the use of health savings accounts was rejected out of hand by congressional Democrats, while a plan to increase funding for medical malpractice reform projects was also determined to be undoable under fast-track Senate rules.

Coburn’s spokesman, John Hart, complained that Democrats “found time to buy votes with earmarks but couldn’t include bipartisan ideas endorsed by President Obama.” House Minority Leader John Boehner, R-Ohio, had dismissed the GOP ideas Obama endorsed as “bread crumbs” sprinkled atop the health bill — and now even most of those bread crumbs are blown away.

At the same time, Baucus got to keep a provision to give Medicare benefits to asbestos-sickened residents of Libby, Mont., and Dodd still has one that could result in a new hospital being built at the University of Connecticut. Both senators argue their special deals aren’t really special deals, because the Medicare provision could apply to other places where public health emergencies are declared, and other sites outside of Connecticut could be eligible for the hospital.

Most of the provisions of the health care bill don’t kick in until 2014, so Obama still has time to make good on everything he promised — or try to get Congress to do so.

“To hold the president accountable for every single provision he advocates for is simply unreasonable,” said Alec Vachon, a health policy consultant and former Republican Capitol Hill aide. “Some things aren’t in there because the members of Congress who have the votes don’t want it. Some things aren’t in there because congressional rules which Republicans will be enforcing won’t allow it. But Democrats will have three years to tinker with health reform before universal coverage goes live.”

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4 Responses to Final health care plan falls short of Obama’s promises

  1. dtotire

    March 20, 2010 at 8:06 am

    True, the bill is flawed. It should be considered as a work in progress, which needs improving. I believe that one provision requires insurers to pay 85% of premiums collected to paying medical bills. This will limit their profits, and can be increased at a later date.

    • Jim C

      March 21, 2010 at 6:30 pm

      Yeah , you do know that according to the insurance industry they only have a 2
      % profit margin ? Of course they also are allowed to make up their own formula for what is profit . The rate you mentioned is only for the largest groups , the smaller groups in these new scam collectives will have a 20% allowable margin . But don’t worry , I’m confident the oversight will be fierce . All they now have to do is jack the rates up and up go the profits with them , who’s going to stop that ? Plus , they will now be subsidized with our tax money so the actual rates won’t be as noticeable to most policy holders , we’ll be paying them right out of the treasury . Sounds like a great deal to me , for the insurance industry .

  2. WayneKDolik

    March 20, 2010 at 2:53 pm

    The time for democrats to stand up for the Constitution has already expired. I’ve always said if the shoe fits wear it. We have been sold out.

    A work in progress? How preposterous, like the loss of habeas corpus, or the patriot act? People wake up you have been had.

  3. Jim C

    March 21, 2010 at 6:09 pm

    I just wish this grinning jackass would stop worrying himself sick about republican ideas and perhaps put maybe one or two democratic ideas in this sorry excuse for a bill . The only ” ideas ” in this bill seem to be to force us into the tender grasp of the insurance industry and allow them access to the treasury with no real rules or strings attached . I know , I know , the insurance industry hates this bill . You can tell by all the adds etc they’ve been running against it . I know they must be , I just seem to have missed them . Then of course there was the little ruse of raising the rates in California , just what you would expect from an industry trying to fight the implementation of a bill they hate . Yeah , just pull a stunt like that right at a critical juncture to give the proponents of the hated bill ammunition , yep , they’re that stupid . They did supposedly run some adds ( a couple of million dollars worth ) on some cable channel somewhere , anybody see those ? I didn’t either . That’s certainly what one would expect from a multi billion dollar corrupt industry fighting tooth and nail to kill a feared and hated piece of legislation . The only real fight going on here is the fight for corporate money between the republicans and the new third way corporate democrats . I knew as soon as Obama started putting together his administration we’d been had , not a liberal in sight , all these guys would be perfectly comfortable in a republican administration. One more thing , has anyone else noticed that the so called liberal talkers and commentators ( except for a few ) have become nothing but Obama cheerleaders ? Schultz and Miller and that little smart aleck twerp Hal Sparks etc are marching lockstep waving pompoms making excuses for his lies and deceit , it’s sickening , I can hardly listen to them anymore . If a liberal calls in and dares to bring any of these double cross’s up they are berated and essentially dismissed as left wing liberal extremists . They might as well be talking to right wing radio . It seems that the corporate boys have gained complete control of both right wing media and what used to be liberal media with a few and declining number of exceptions . We are in big trouble people .