Health Care Reform Bill Expected This Summer; White House Se

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April 20, 2009

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Health care reform bill expected this summer; White House seeking input from Congress, Obama official says

JERRY GEISEL

A top Obama administration official predicts that comprehensive health care reform legislation could reach the Senate floor by this summer.

Since shortly after President Obama took office in January, administration officials, members of Congress and congressional staffers have been meeting on health care reform legislation, said Nancy-Ann DeParle, the director of the White House Office of Health Reform.

``Very active work is going on,'' Ms. DeParle said.

Speaking last week in Washington at a briefing sponsored by the Kaiser Family Foundation, Ms. DeParle described the drive to develop and win support for health care reform legislation as one strikingly different than the last presidential effort—led by then-First Lady Hillary Clinton.

While the Clinton administration developed its reform package without seeking input from congressional leaders, Ms. DeParle said the current drive is one of administration and congressional collaboration in which ideas and information are exchanged constantly.

``It is active give and take, mostly with staff, sometimes with members,'' Ms. DeParle said, adding that the process has been largely harmonious.

Another difference between the failed 1993 effort and this drive is the interest of congressional leaders in enacting a bill.

``There was not the same kind of engagement'' from congressional leaders in 1993 as there is today, Ms. DeParle said.

For example, while Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, is an ardent and longtime crusader for health care reform, the late Sen. Daniel Patrick Moynihan, D-N.Y., the committee's chairman in 1993, was not convinced of the need for reform and was a harsh critic of the Clinton plan. He once described the administration's assertion that universal coverage could be financed through a combination of cuts in projected increases in spending on Medicare and Medicaid as ``fantasy.''

Outside observers agree that the current administration's approach, one of working with legislators, is no accident.

``Lessons were definitely learned. It is much more of a partnership,'' said Paul Dennett, senior vp-health care reform with the American Benefits Council in Washington.

``It is a much more collaborative effort,'' concurred James Gelfand, senior health care policy manager with the U.S. Chamber of Commerce in Washington.

Yet another difference between 1993 and today is the pace of developing the legislation.

Ms. DeParle said she expects reform legislation to be on the Senate floor by summer, followed shortly thereafter by the House of Representatives. ``We are making a lot of progress in realizing the president's goal of getting health care reform enacted this year,'' she said.

By contrast, the Clinton administration took much longer after taking office to assemble its plan, giving opponents more time to marshal opposition.

``The pace is faster. They have learned'' how costly the delays in 1993 were, said Frank McArdle, a consultant with Hewitt Associates Inc. in Washington.

While the Obama administration may have learned from mistakes that plagued the Clinton administration's reform drive, many observers say legislation still will be difficult to pass.

``While the odds of passing reform may be the best they have been in 15 years, it is anything but a slam dunk,'' said Kelly Traw, a principal with Mercer L.L.C. in Washington.

Passing health care reform legislation will be ``extraordinarily difficult, if only because they don't have the revenue to pay for all the new entrants'' in a universal coverage system, said Mark Ugoretz, president of the ERISA Industry Committee in Washington.

Ms. DeParle shied away from providing details of where revenues would be found to pay for expanding coverage.

However, she said the administration is not in favor of taxing employees on employer-paid health insurance premiums, one idea being floated to help fund universal coverage.

President Obama, Ms. DeParle said, is very ``skeptical'' about taxing health care benefits as a way to fund an expansion of coverage.

She also said the administration is committed to offering coverage through a public plan. But, she acknowledged, final decisions have yet to be made on the structure of such an arrangement.

One approach, Ms. DeParle said, could be for the plan to be offered by and underwritten by the federal government, much like the Medicare program. But the administration also is looking at other approaches, such as one similar to the Massachusetts model in which private health insurers offer coverage through an exchange administered by a public agency.

Such key decisions may not be made until just before the legislation is introduced, observers say. ``They want to be sure on getting it right,'' Mr. Dennett said.