On Health Care Reform, President Obama Tells Congress: Finish Your Work, Bring This Journey to a Close

Jake Tapper and Sunlen Miller report:

Flanked by health care professionals in white lab coats and blue hospital scrubs, President Obama Wednesday afternoon called on Congress to vote on final passages of health care reform in the “next few weeks.”

“No matter which approach you favor, I believe the United States Congress owes the American people a final vote on health care reform,” Obama said from the East Room this afternoon paving the way for the use of the controversial parliamentary procedure of reconciliation, which requires only 51 Senate votes for final passage, as opposed to the customary 60 needed to fend off a filibuster and proceed to a final vote..

“Reform has already passed the House with a majority,” he said. “It has already passed the Senate with a supermajority of sixty votes. And now it deserves the same kind of up-or-down vote that was cast on welfare reform, the Children’s Health Insurance Program, COBRA health coverage for the unemployed, and by the way for both Bush tax cuts – all of which had to pass Congress with nothing more than a simple majority.”

Those five bills were all passed in the Senate using reconciliation rules.

The president called on members of both Houses of Congress to “finish their work” and “schedule a vote in the next few weeks,” promising to do everything in his power before no and then to help make the case for reform. He said it is time to “bring this journey to a close,” being almost one year to the day since opening up the health care summit last March in the same room.

The White House has since announced that the president will travel to Philadelphia, Pa., and St. Louis, Mo., next week to build public support for final passage of the bill.

The debate, the president said, “easily lends itself to demagoguery and political gamesmanship and misrepresentation and misunderstanding. But that's not an excuse for those of us who were sent here to lead. That's not an excuse for us to walk away.”

Speaking to the many House and Senate Democrats worried that this vote will hurt their chances of re-election, the president said, “We can't just give up because the politics are hard. I know there's been a fascination, bordering on obsession, in this media town about what passing health insurance reform would mean for the next election and the one after that. How will this play? What will happen with the polls? I will leave it to others to sift through the politics, because that's not what this is about. That's not why we're here.”

The proposals have been debated, changed, and “improved over the last year,” the president said, arguing the process has ended up incorporating ideas from Democrats and Republicans – including, he said, ideas heard during last week’s Blair House summit – like funding state grants on demonstration projects for alternatives to medical malpractice lawsuits and using an idea proposed by Sen. Tom Coburn, R-Okla., a practicing ob-gyn, on using medical professionals to work undercover to ferret out waste, fraud and abuse in Medicare and Medicaid.

The president added that his proposal also gets rid of many provisions – like the deals made to win the votes of Sen. Ben Nelson, D-Neb., and Sen. Bill Nelson, D-Fla., extra federal aid to Nebraska for Medicaid expansion and protection for Florida seniors from Medicare Advantage cuts, respectively – that the president said “were more about winning individual votes in Congress than improving health care for all Americans.”

The president said that there might be some Republicans who disagree with his belief that there should be more oversight of insurance companies.

“On the other end of the spectrum, there are those, and this includes most Republicans in Congress, who believe the answer is to loosen regulations on the insurance industry – whether it’s state consumer protections or minimum standards for the kind of insurance they can sell,” he said. “The argument is that will somehow lower costs. I disagree with that approach. I’m concerned that this would only give the insurance industry even freer rein to raise premiums and deny care.”

The president said that his proposal will give Americans more control and promised again, “If you like your plan, you can keep your plan. If you like your doctor, you can keep your doctor.”

(When he visited the GOP House retreat in January, the president had said that “some of the provisions that got snuck in” to the health care reform legislation during House and Senate negotiations “might have violated that pledge.” He said, "we were in the process of eliminating" those provisions. Asked repeatedly as to what provisions were added, White House officials never responded.)

Mr. Obama today outlined the three areas where he believes his proposal would change the current health care system.

1. It would end the “worst practices” of insurance companies, such as denying coverage to consumers because of pre-existing conditions, or dropping coverage for patients who get sick.

“No longer would they be able to arbitrarily and massively raise premiums like Anthem Blue Cross recently tried to do in California,” the president said, “up to 39% increases in one year in the individual market. Those practices would end.”

2. The president said his proposal would give the uninsured and small business owners the same kind of choice of private health insurance that Members of Congress get for themselves.

“The reason federal employees get a good deal on health insurance is that we all participate in an insurance market where insurance companies give better rates and coverage and better rates because we give them more customers,” he said. “This is an idea that many Republicans have embraced in the past. Before politics intruded.”

3. The president said his proposal would bring down the cost of health care for millions – families, businesses, and the federal government.

“We have now incorporated most of the serious ideas from across the political spectrum about how to contain the rising cost of health care – ideas that go after the waste and abuse in our system, especially in programs like Medicare,” he said.

The president pledged that the plan is deficit-neutral; “our proposal is paid for,” he said, arguing that some of the cost-cutting measures of the Senate bill reduce premiums and would bring down the deficit by up to $1 trillion over the next two decades.

“With this plan, we’re going to make sure the dollars we spend go toward making insurance more affordable and more secure. We’re also going to eliminate wasteful taxpayer subsidies that currently go to insurance and pharmaceutical companies, set a new fee on insurance companies that stand to gain a lot of money and a lot of profits as millions of Americans are able to buy insurance, and make sure the wealthiest Americans pay their fair share of Medicare.”

The president argued against calls to scrap the bill or to pursue a scaled-down piecemeal approach to reform. Painting a picture of the cost of doing nothing, President Obama warned against more American losing their insurance if they switch or lose their jobs, small businesses forced to choose between health care and hiring, insurance companies deny people cover, and rising costs of Medicare and Medicaid sinking the government deeper into debt.

“For us to start over now could simply lead to delay that could last for another decade or even more. The American people, and the U.S. economy, just can’t wait that long.”

- Jake Tapper and Sunlen Miller

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