Republican attendees sounded a populist note, citing an American public increasingly skeptical over health reform, and Democrats parried with polls of their own as an unusual meeting between the president and congressional leaders of all political stripes came to a close.
In a little over 7½ hours, the bipartisan group traded shots—and occasionally ideas—over how to find common ground in what has proven to be a Herculean effort to reshape the U.S. healthcare system.
But in the end, a clear consensus had not emerged as politics trumped policies and lawmakers reverted to their party-line talking points.
“The truth of the matter is, there might not be any reason for Republicans to want to do it,” President Barack Obama said in his closing remarks. “I know the answer. I don't need a poll to know that most Republican voters are opposed to this bill and might be opposed to the kind of compromise we could craft.”
Rifts between Democrats and Republicans, while tamped down most of the summit, surfaced over ways to expand coverage to the more than 45 million Americans who currently go without.
“We think we should use free markets to empower people and give them choices,” said Rep. Joe Barton (R-Texas), the senior Republican on the Energy and Commerce Committee. “Democrats seem to believe that the government, either through mandate or regulatory requirement, knows better or could do better for the American people.”
Early discussions centered on whether the current legislation would increase premiums for everyday Americans, ways to staunch fraud and abuse in government health programs, and prevention as a way to corral healthcare costs. A proposal that could garner the support of both parties over selling health insurance across state lines also garnered attention early on.
“We're doing a lot of listening,” said Rep. Jim Cooper (D-Tenn.), a summit attendee, during a brief return to the Capitol.
“Well, we're hoping we're making progress,” said Rep. John Dingell (D-Mich.), a longtime health reform proponent. When asked what he wants to hear addressed during the summit, Dingell said, “I want to hear that the Republicans agree with us.”
But that wish greatly dimmed just minutes into the second half of the daylong meeting, which focused primarily on health insurance reform.
Even where Republicans and Democrats agree—such as intrastate health plans and other insurance reforms—a path forward on massive legislation seems dim.
Obama, using one of the perks of the highest office to gather Democrats and Republicans alike for the televised sit-down, continued with a plea for bipartisanship.
“Here's the bottomline: We all know this is urgent,” Obama said. “And unfortunately, over the course of the year, despite all of the hearings that took place … this became a very ideological battle.”
He continued: “But what I'm hoping to accomplish today is for everybody to focus not just on where we are different, but focus on where we agree.”
Sen. Lamar Alexander of Tennessee, speaking first for the Republicans, again called on the president and Democratic leaders to renounce the use of a legislative maneuver that would allow a bill to pass on a simple majority.
“You can say this process has been used before, and that would be right,” Alexander said, referring to a parliamentarian procedure known as reconciliation. “But it's never been used for something like this.”
Such is the battle the president and his Democratic counterparts on Capitol Hill face. What's more, fissures have continued to appear within their own party that could make the job of finishing the job on health reform even harder.
House Democrats on Wednesday said they remained disheartened by several components of the Senate's bill and, by extension, the president's proposal.
Just moments after the party earned a major win on the House floor by steering legislation that strips health insurers of their exemption from antitrust laws, several Democrats declared they would vote against a healthcare reform bill unless major changes first occur.
“It's not a popular bill with members,” said Rep. Bart Stupak (D-Mich.), who last year successfully led a key bloc of Democrats to hold out on passing a bill until stronger abortion language was included.
The contrarian comments were made prior to today's summit meeting. But with both parties squabbling, few—if any—lawmakers and policy shapers say they expect a consensus to emerge.
Obama's reform proposal, released on Monday, remains the centerpiece of the meeting. Republican lawmakers have readied their own platform that places more emphasis on cost containment and less on expanding access to health insurance.
The president's proposal has proven contentious for House Democrats, who face the uncomfortable position of deciding whether to pass the bill or see their efforts to overhaul the healthcare system fail once again.
“I've told the White House, I'll see what the final language is,” Stupak said. “But if it's the Senate's proposal, it's a nonstarter. It's not going to go anywhere.
To be sure, abortion isn't the only sticking point among party members.
Rep. Richard Neal (D-Mass.) said he opposed a provision that would create a Medicare advisory commission, while other House members have voiced opposition to a tax on high-valued health plans, state-based health insurance exchanges and a number of targeted earmarks.
“I have no idea how we work through this muddle,” said Rep. Peter DeFazio (D-Ore.).
Although House Democrats sounded increasingly leery, across the capitol in the Senate party members spent the last week surprisingly coalescing around the aforementioned procedural move that would allow legislation to pass on a simple majority vote.
Senate leaders are likely to decide this week whether to use reconciliation to unstick the current bill. The move is contingent on the House passing the Senate's version of the bill, and then moving a smaller package of “fix-its,” possibly mirroring the president's plan, under reconciliation.
Previously, the more moderate wing of the party has been wary of using such a move. But since Democrats lost their ability earlier this year to break a filibuster, it has increasingly become the favored path forward for many lawmakers.
Sen. Evan Bayh (D-Ind.) warned that Republicans would likely use a series of procedural moves to effectively shut down the Senate for the balance of the year in retaliation if Democrats choose to use reconciliation.
“If the minority is just frustrating progress, that argues for taking steps to get the public's business done,” Bayh said. “At the same time, we're not going to get much done around here the rest of the year because the Republicans will just probably shut the place down.”
Bayh added: “But you could make an argument that they're doing that anyway.”
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