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President Obama’s health care summit has spurred debate about Democrats’ political agenda, ranging from taking a “leap of faith” on health care to limiting the filibuster for policy ends. Shifting gears from the sport of politics to actual athletic competition, Newsweek finds that Olympians’ health coverage may not live up to gold-medal standards.

• “The Health Care Leap of Faith”: Do the Democrats have the courage of their convictions when it comes to national health reform? Writing in National Journal’s “Political Connections,” Ron Brownstein isn’t sure. With both political parties –and the public — divided over how much influence the government should have in a redesigned system, White House Communications Director Dan Pfeiffer suggests passing reform despite little public backing and building support through implementation, which Brownstein calls “tak[ing] the leap of faith” (Brownstein, National Journal “Political Connections” 2/27).

• “Health Reform Advice Obama Might Get From Clinton”: In a letter to President Obama, Jamie Stiehm — posing as President Clinton — offers advice on how to strike a deal with her so-called “masters of no,” the Senate Republicans in U.S. News & World Report’s “Thomas Jefferson Street.” Calling the “summer playbook “all wrong,” she (he) writes that Obama should “Seize today!,” and “go with reconciliation” because there are “more Senate Democrats in the chamber than I had when my healthcare plan went down” (Stiehm, U.S. News & World Report “Thomas Jefferson Street,” 2/25).

• “Ban Filibuster Abuse for Good of All”: The filibuster used to be reserved for “extraordinary circumstances,” but the Republican minority’s “nonstop” use of the filibuster is based on a new requirement—that the “Senate is in session,” writes Lincoln Chafee for Politico. Chafee, a former Republican senator from Rhode Island and now an independent candidate for governor, suggests tactics to curb the filibuster’s use. For example, Senate Democrats could work with Republican leadership to create a supermajority of 67 senators and amend the filibuster rule to include extraordinary circumstances language (Chafee, Politico, 2/26).

• “Gold-Medal Coverage?”: One of the perks of being an Olympic athlete is having access to the Elite Athlete Health Insurance plan provided through the U.S. Olympic Committee, Newsweek reports. However, the USOC plan doesn’t pay for what athletes want covered most–sports-related injuries–forcing many professional athletic associations to offer catastrophic plans and complicating the process with more policies. The “losers,” Newsweek adds, are the “almost-Olympic athletes” who practice their sport full time, but don’t qualify for insurance coverage (Kliff, Newsweek, 2/25).

–compiled by Cassandra Blohowiak

Was yesterday’s health care summit about policy, politics or philosophy? Of course it was about policy — we’re talking about reforming the U.S. health care system, after all — but it was also about politics. It’s an election year, and Republicans took the opportunity to lambast Democrats, who were definitely playing hardball, too. But, if you were to listen to yesterday’s seven-hour summit, you also would be correct in thinking the summit was a discussion about the different philosophies of the two political parties. Probably one of the most uttered phrases of the day was “philosophical differences.” In layman’s terms, “Let’s agree to disagree.” Many bloggers picked up on this trend.

After the summit ended, Sarah Kliff of Newsweek‘s “The Gaggle” noted that the idea that the parties have “serious philosophical differences,” is “[p]erhaps the one thing everyone could agree on.” Her conclusion was that the summit was “not a game changer.”

According to Jill Lawrence of Politics Daily echoed what everyone was saying yesterday, that the “real divide” on health care “is not political; it’s philosophical.” According to Lawrence, Republicans will oppose health reform “for political reasons, sure … but also because this is a defining debate. This is a moment for conservatives to make their stand — not against uninsured Americans, exactly, but against the expanded government role that is needed to insure them.”

For his part, Ezra Klein takes note of all mentions of “philosophical differences,” but also points out that during the summit, Republicans “elevated a variety of policies that they’re willing to compromise on in other contexts to the level of philosophical difference,” thus making “compromise very difficult.” Noting several instances where Republicans “drew philosophical battle lines,” Klein concludes, “I’m not accusing anyone of insincerity on these points, but just as many people discover religion in the face of tragedy, the GOP appears to have discovered philosophy in the face of a Democratic majority.”

– by Julia Moss, staff writer

Democrats and Republicans engaged in debate at the health reform summit on Thursday, but they emerged without a bipartisan agreement or even a clear strategy for securing one, the Chicago Tribune reports.

According to the Tribune, the differences between the two parties’ preferred reform approaches were reinforced with “crystalline clarity” during the discussion, which was broadcast live through several media outlets. Senate Minority Whip Jon Kyl (R-Ariz.) said, “There are some fundamental differences that we cannot paper over.”

The disagreement centers on the two parties’ differing views of government’s role in health care reform. Democrats want comprehensive reform driven by government regulation, while Republicans prefer a more incremental approach that emphasizes the role of small businesses and individuals. Rep. Paul Ryan (R-Wis.) said, “We don’t want to sit in Washington and mandate these things,” adding that Republicans want to “decentralize” the health system (Levey/Hook, Chicago Tribune, 2/25). House Minority Leader John Boehner (R-Ohio) reiterated the GOP’s position that Democrats should “scrap” their current reform bills (Meckler/Adamy, Wall Street Journal, 2/26).

Democrats maintained that the incremental approach promoted by Republicans would be inadequate. Senate Health, Education, Labor and Pensions Committee Chair Tom Harkin (D-Iowa) said, “We’re drowning, in this country, on health care,” adding, “An incremental approach is like a swimmer who’s 50 feet offshore drowning, and you throw him a 10-foot rope.”

However, Obama and other senior Democrats outlined a few overhaul proposals on which they share common ground with Republicans. They said both parties endorse initiatives to combat Medicare fraud, permit the sale of health insurance across state lines and aid small businesses in providing health benefits to their workers (Chicago Tribune, 2/25).

Obama also said Democrats and Republicans agree on the need to curb rising health care costs. He said if a reform strategy consists of only “adding more people to a broken system, then costs will continue to skyrocket, and eventually somebody’s going to be bankrupt, whether it’s the federal government, state governments, businesses or individual families.” He continued, “So we have to deal with costs. … I haven’t heard anybody disagree with that” (Tapper et al., ABC News, 2/25).

Both Dems and GOP Score Political Points

According to the New York Times, it is unclear if either party had stronger arguments at the summit (Herszenhorn, New York Times, 2/26).

The Christian Science Monitor reports that Republicans fared better than when they met with Obama in January at an annual retreat. According to the Monitor, GOP attendees were more willing to voice their opinions to the president and illustrated their points to Democrats more effectively (Feldmann, Christian Science Monitor, 2/25). The Los Angeles Times, however, reports that Obama led Democrats with a “mastery of the nuances of health care.” According to the Los Angeles Times, Obama might have gained favor with U.S. residents by engaging in what seems to be an irresolvable debate with the GOP (Nicholas, Los Angeles Times, 2/25).

What’s Next?

Obama closed the summit after about seven-and-a-half hours by saying that he does not know if Democrats and Republicans can close the ideological gap between them regarding reform efforts. He said, however, that they “cannot have another yearlong debate” (Chicago Tribune, 2/25).

Obama then said he would allow four to six more weeks of discussion to secure a bipartisan agreement before Democrats would move forward with other options (Hunter/Wayne, CQ Today, 2/25). An administration official later said that Obama was not providing an official timetable. According to the official, Obama “was just saying that we are going to continue moving forward over the next few weeks as we take the final steps necessary for passage” (Bendery, Roll Call, 2/25).

Barring an agreement with Republicans, Democrats likely would use budget reconciliation to pass an overhaul package. Although criticized by Republicans, the strategy is garnering more support from Democrats and has been endorsed publicly by Obama as a viable option for reform. White House officials have confirmed that Obama’s own reform proposal — separate from the House and Senate overhaul packages (HR 3962, HR 3590) and posted online on Monday — was designed to be approved through budget reconciliation, which would result from a two-bill process.

The most likely use of the two-bill process would involve convincing House Democrats to pass the more moderate Senate reform bill unchanged and sending it directly to Obama for his signature. The Senate then could pass a separate package of reform measures through the budget reconciliation process to pacify more liberal House Democrats, which requires only a simple majority for passage (American Health Line, 2/25).

Rep. Rob Andrews (D-N.J.) thinks that, in the aftermath of the summit stalemate, Obama will work faster than the weeks he allotted for further discussion of a bipartisan solution. According to Andrews, the president likely will send a modified version of his own bill to the House by next week (Frates/O’Connor, “Live Pulse,” Politico, 2/25).

Another option for Democrats is to pass a series of smaller bills while they work out the details of a large overhaul package, CongressDaily reports. For example, House Democrats on Wednesday passed legislation that strips health and medical malpractice insurers of an antitrust exemption that allows them to collectively set prices. According to senior leadership aides, Democrats are moving closer toward pushing smaller bills through Congress. However, the aides said they do not anticipate that any smaller bills will be considered before the week of March 8 (Edney/Condon, CongressDaily, 2/26).

– compiled by Matthew Wayt

Today’s health reform summit stretched on for seven hours, one hour more than scheduled — but participants “walked away without much agreement on major outstanding issues,” the New York Times notes.

Friday’s edition of American Health Line will provide a break-down of the Thursday summit and potential next steps for Democrats’ health reform effort.

Courtesy of the White House, a video feed of the summit at Blair House today:

Bipartisanship — or the lack of it — is the theme of the day, it seems. Down at Blair House, a hand-picked group of Republican and Democratic lawmakers are discussing potential bipartisan solutions to health reform. However, analysts increasingly expect Democrats to use the budget reconciliation process to push through final legislation. While Democrats call GOP rebuke of the procedure “hypocritical” because they themselves used it, all politics is hypocrisy, according to Slate.

Meanwhile, CQ Politics comments on a conundrum for Democrats: The party cannot afford to not pass health reform, but they cannot afford to do it using reconciliation either.

• “All Politics Is Hypocritical“: “Hypocrisy is the seesaw of American politics,” but “not all hypocrisy is the same,” John Dickerson writes in Slate, commenting that Democrats’ “hopes of limiting 2010 elections losses hinge on” voters being able to distinguish between policy hypocrisy and procedural hypocrisy. According to Dickerson, procedural hypocrisy — like that over the use of reconciliation — is “less politically potent,” while policy hypocrisy “is worse both morally and politically” (Dickerson, Slate, 2/24).
• “Reconciling Health Care and 2010 Realities“: From a political standpoint, “[f]ailure to pass a health care bill is the single worst outcome possible for Democrats,” but “[u]nfortunately for party leaders, passing a bill using [budget reconciliation] looks like a very close second,” Stuart Rothenberg, the editor of the “Rothenberg Political Report,” writes in a CQ Politics column. According to Rothenberg, passing health reform using reconciliation could “energize Democrats” and “close the enthusiasm gap that separates the two parties going into the midterm elections.” However, he notes that it “could also give Republicans yet another arrow in the party’s already well-stocked quiver” (Rothenberg, CQ Politics, 2/25).

While legislators grapple with the optics of reconciliation, a column in the Baltimore Sun stresses the need to examine the underlying reality of health care in the United States. According to the author, any argument that health care as a right also requires acknowledging that the right may come with responsibilities. Likewise, a HealthLeaders Media piece suggest that Americans consider all the facts before jumping to conclusions on rate increases.

• “Beyond Health Care ‘Rights’“: While the question has been posed about whether health care is a right, Stephen Schimpff suggests that “Congress and the president need to also confront the issue of responsibilities,” saying that balancing the two is the “key to success.” Schimpff suggests that in exchange for guaranteed coverage for everyone regardless of preexisting conditions, there should be a “responsibility” for everyone to enter the risk pool and to lead a reasonably healthy lifestyle. Combining rights and responsibilities like these “satisfies the legitimate argument that medical care is something everyone deserves to have with the equally important argument that we all need to accept a meaningful level of responsibility for our health and its costs,” he concludes (Schimpff, Baltimore Sun, 2/24).
• “Michigan Blue Cross: Health Reform Villain or Health System Victim?“: Joe Cantlupe in HealthLeaders Media examines the proposed 56% rate increase that Michigan Blue Cross Blue Shield has proposed for individual policyholders. “[T]here’s a lot more behind the curtain of political statements and instant numbing number tallying, whether it’s about proposed rate hikes or actual,” in MBCBS case, he writes, noting that “it’s fiscal situation has been a mess for years, and it’s only going to get worse, unless the state acts, with or without” national health reform (Cantlupe, HealthLeaders Media, 2/24).

– by Julia Moss, staff writer

The bipartisan health reform summit broke for lunch and a House vote around 1 p.m., four hours after the event began. Thus far, Democrats and Republicans mostly have restated their positions on key proposals and decided where they stand together and, more frequently, where they stand apart.

However, a few moments of genuine debate — or just plain dramatic politicking — occurred during the first half of the summit, and the New York Times‘ “Prescriptions” blog and the Washington Post‘s Ezra Klein provide good rundowns, complete with helpful analyses.

Below the fold, we’ve listed some takeaways:

Some highlights from first half of the reform summit follow:

• Obama and Sen. Tom Coburn (R-Okla.) came to terms with the fact that they agree on something: combating “waste, fraud and abuse” in the U.S. health system. However, they still disagree on whether the Democratic overhaul proposals do enough to address the problem.

• Obama faced off with Sen. Lamar Alexander (R-Tenn.), who said that current health reform proposals would not reduce premiums. Obama said that they would in fact reduce premiums and presidentially dismissed the argument.

• Obama criticized Senate Republican Whip Jon Kyl (Ariz.) for using “talking points” to make it seem as though Democrats are inherently aligned with government intrusion into health care.

• Sen. John McCain (R-Ariz.) criticized “special interest” deals made by Democrats in 2009 in order to further reform legislation, to which Obama responded that the “campaign is over” and that the purpose of the summit is to discuss how reform can work, not the quality of its failed process. Obama lectured, “We can have a debate about process, or we can have a debate about how we are going to help the American people at this point.”

• Vice President Biden told Minority Whip Eric Cantor (R-Va.) that if Republicans acknowledge that the federal government should end annual and lifetime caps on insurance benefits and bar insurers from denying coverage based on pre-existing medical conditions, the GOP cannot also argue that the government should have a limited role in the U.S. health care system.

The excitement continues as the summit reconvened at 2 p.m. Please keep checking this blog and following us on Twitter for more updates.

by Matthew Wayt, staff writer

It seems more likely with each passing day that Democrats will try to circumvent Republican opposition by passing a health reform bill through the budget reconciliation process. However, for the GOP, reconciliation is the dirtiest word in Washington right now. They are betting that the American people will feel the same way if Democrats use the strategy to push an overhaul package through Congress.

Terence Kane in The Hill‘s “Pundits Blog” reports that “Republicans are predicting a backlash” from U.S. residents if Democrats use reconciliation. However, Kane writes, “[a]ssuming Republican arguments are correct — that the American people revolted at the plodding and confusing process of health reform — it seems unlikely they will object to the new developments because they take exception to the Congressional Budget Act of 1974.” Kane continues, “If the public suddenly finds its inner parliamentarian and disapproves of Democrats’ use of budget reconciliation, it will go up against both the frequent past history of reconciliation and health reform and the Republican use of reconciliation.”

The Hill‘s “Congress Blog” features input from “[s]ome of the nation’s top political commentators, legislators and intellectuals,” who “offer their insight into the biggest question” in the reform debate of whether there will be a voter backlash with the use of reconciliation. Some contributors predict a substantial backlash, while others say the backlash is likely but can probably be quelled by Democrats reminding U.S. residents how often reconciliation has been used — especially by Republicans. Other experts suggest that, frankly, Americans don’t know enough or care enough about the reconciliation process to have a strong opinion, according to the blog.

Paul Bedard of U.S. News & World Report‘s “Washington Whispers” writes that Republicans are willing to grant Obama a second audience after today’s health reform summit if it means avoiding reconciliation. He writes, “Key GOP officials … have suggested a possible avenue for President Obama to work toward a bipartisan deal” by way of another summit at Camp David. According to Bedard, “They are hoping that Obama will raise the idea at or right after … the health care summit.” However, he writes, the GOP is not optimistic that Obama will grant the request.

by Matthew Wayt, staff writer

One year—to the day—after President Obama called on Congress to enact meaningful health reform in 2009, White House-backed legislation remains stalled in the House and reform-related fatigue has set in with lawmakers and the public. Kicking off his likely final push, the president released his own reform bill on Monday and will convene a high-profile, bipartisan health care summit on Thursday.

While optics—essentially, how the participants stage-manage their performances—appear to trump optimism that the summit will lead to meaningful change, analysts expect the session to have “practical and political consequences for years to come,” as Obama’s health reform bill hangs in the balance.

Here are five key indicators to watch for at Thursday’s summit.

1. Competing efforts to seize the stage

Although Obama convened several bipartisan summits early in his presidency—to mixed effect—Thursday’s summit is widely anticipated because it follows a remarkable January session where Obama jousted live with House Republicans on C-SPAN. Although both sides offered frank debate, analysts generally credited the president for articulating in-depth policy points and carrying the day.

To avoid a similar outcome at Thursday’s summit, Republican leaders have spent the past 10 days mapping out a coordinated strategy, Roll Call reports (see below), and have planned for a broad post-summit message campaign on news and talk programs. The GOP also won “subtle but significant changes” in the summit’s set-up. To avoid the appearance of the president “lecturing,” there will be no podium, Politico notes; instead, all attendees will sit around a large, square table.

Meanwhile, the White House hopes Obama can repeat his performance and either force the GOP to appear obstructionist or recast Democrats’ plans in favorable light. One analyst suggests that Obama is aiming for a “game-changer” that boosts public support for health reform above 50%; a recent Kaiser Family Foundation poll showed that just 43% of respondents were in favor of White House reform efforts.

2. Battle to frame the discussion

Having released his own reform plan with provisions that cater to House Democrats—who essentially hold the key to passing a bill—Obama is expected to stress that the coming weeks are the “last, best hope for [Democrat-led] health care reform,” says one strategist.

In addition, the president will continue to cast Democrats’ plan as needed reforms for the insurance industry, which the Obama administration believes is a winning message with the public. For example, the White House has sought to portray recent rate hikes by Anthem Blue Cross of California as a potential outcome for most Americans should Congress fail to pass health reform legislation. Obama also has urged Congress to repeal the insurance industry’s anti-trust exemption.

Republicans, meanwhile, say that Americans have rejected Democrats’ plans and insist that lawmakers must start fresh with a new bill. Dismissing the summit’s attempt to keep Congress’ legislation alive, Sen. John McCain (R-Ariz.) revived Obama’s line from the 2008 presidential campaign—“Why put lipstick on a pig?”

3. Can Republicans win ‘bipartisan’ label?

Roll Call notes that Republicans are expected to stress three messages: The Democrats’ current reform bills are broken and the summit is a “charade”—but they have substantive ideas to offer, too.

Republicans may reiterate several proposals that are based in the private market, which they say foster greater competition. For example, the GOP would allow individuals to purchase health insurance across state lines. The party also would not ban insurance companies from denying coverage to individuals with pre-existing conditions, but instead better fund high-risk pools for these consumers.

House Republicans also could tout their own reform plan, which is less expansive than the Democrats’ plan, but considerably less expensive, too; it would cost $61 billion across ten years and cover an additional 3 million uninsured Americans.

Using the summit to appear constructive and conciliatory would serve Republicans well, according to analysts. The GOP hopes to take back one, if not both houses of Congress in the November midterm elections and likely needs independent voters—frustrated at “incompetent” legislators—to do so.

However, analysts note that Republicans are trying to follow the winning strategy mapped by Democrats in 2006 and Republicans in 1994: Keep pressure on the majority party by resisting and delaying legislation, which conflicts with any major bipartisan effort.

4. Concessions—or lack thereof

While some expect the president to broach new deals at the summit—perhaps offering new medical malpractice reforms, giving ground on abortion funding, or even introducing a last-ditch effort to revitalize the public option—the White House has not briefed congressional leaders on any pending concessions.

As a result, no major changes are likely forthcoming.

Instead, Obama has already offered his compromises within the outline he released on Monday, analysts say. Many critics said the Senate reform bill was built on excessive deal-making; Obama would do away with the “Cornhusker kickback,” which offered special Medicaid provisions for Nebraska. The president also would delay a proposed excise tax on so-called Cadillac health plans, which disproportionately affects labor unions and has drawn criticism from liberal House Democrats.

Conversely, Republicans are not expected to offer significant compromises given their goals for the midterm elections and the advance messaging prepared by the party.

5. Post-summit momentum for budget reconciliation

Strategists generally anticipate that the session will provide political theatre but few policy advances. Most Americans have low expectations, too; 77% of respondents to a Tuesday USA Today/Gallup Poll doubt the summit will produce a bipartisan deal.

However, a bipartisan deal is unnecessary for the president’s purposes. The summit will be a success if Obama can simply convince his own party to move forward with budget reconciliation measures to pass reform.

Analysts suggest that there are a handful of strategies, pending the summit’s outcome. Although Pelosi said she lacks sufficient votes to pass the Senate’s version of reform through the House, new enthusiasm generated by Thursday’s session could win additional supporters for the bill while reconciliation measures passed later this year could strip out some of the more troubling provisions. Alternatively, a new reconciliation bill could be crafted and sent through both chambers. Notably, Obama’s own proposal also includes provisions that would allow it to be passed through budget reconciliation.

Essentially, the summit serves as a prime, and perhaps final, opportunity for Obama to convince the public—and his party—”that reform is necessary and that Republicans don’t have a plan,” notes Slate.

by Dan Diamond, Managing Editor

Sources: Advisory Board interviews and analysis; Babington, Associated Press, 2/24; Leonhardt, New York Times, 2/24; Page, USA Today, 2/24; Thrush/Budoff Brown, Politico, 2/23; Politico “Live Pulse,” accessed 2/24; Dickerson, Slate, 2/22; Murray/Bacon Jr., Washington Post, 2/24; Health Policy and Marketplace Review, accessed 2/23; Fritze/Wolf, USA Today, 2/23; Kucinich/Stanton, Roll Call, 2/24; Klein, Washington Post blog, accessed 2/24.

And then there were three health reform plans. The House and Senate have long been trying to reconcile proposals in their respective health reform bills, and now President Obama has joined the fight by releasing his own measure, which uses both the Huouse and Senate’s overhaul packages as inspiration. However, various proposals in each of the three bills have come under heavy criticism, and no one knows which bill, if any, will blossom into fully formed law.

Igor Volsky at “The Wonk Room” wishes Obama would “pick a position on the public plan option and stick to it.” He writes that Obama once supported the option but that now, “openly supporting the public plan may tip the scales and alienate important moderate votes.” Volsky continues, “I think the White House feels that they don’t have the luxury of choosing a side.”

Robert Laszewski of “The Health Care Blog” thinks Obama has more to worry about than his stance on the public option. He writes that the president’s bill features too much of the other two pieces of legislation to make any real change. According to Laszewski, “There is nothing new in it save a health insurance rate regulatory board that is an awkward political proposal at best,” adding, “What powers would it really have and how would it operate in conjunction with the states already charged with insurance company oversight are just two of the first questions” that Obama’s bill does not address.

On the other hand, The New Republic‘s Jonathan Cohn feels that Obama’s calls for bipartisanship input on his health care plan are wasted because the two congressional bills are already bipartisan, in the sense that they feature “Republican ideas and closely [resemble] plans prominent Republicans have endorsed in the past.” He continues that the bills in Congress share many similarities with those of the late John Chafee, a moderate Republican who proposed several reform initiatives when President Bill Clinton tried to overhaul U.S. health care system in the early 1990s. According to Cohn, “The similarities between what he proposed then and what Democrats are proposing now are nothing short of striking — particularly when you put them alongside what House Republicans now proposed to do instead.”

by Matthew Wayt, staff writer