President Obama tried to woo the GOP with sweeteners and threw out the controversial "cornhusker kickback," but the White House's first stab at resurrecting the health care overhaul was so bare-bones that Congress' budget scorekeeper couldn't put a price tag on it.
In a nod to Republicans, Mr. Obama's proposal calls for a centralized database where government officials can document Medicare and Medicaid abuses — an idea from the conservative House Republican Study Committee.
The president also culled a provision from a centrist House Republican bill that would require background checks for those who provide health care services under Medicare. The plan also adds stronger sanctions such as jail time for those who purchase, sell or distribute Medicare-beneficiary information numbers.
Republicans were not impressed and continued to take aim at Mr. Obama's decision to release a plan before Thursdays televised White House summit with Capitol Hill lawmakers.
"The president has crippled the credibility of this week's summit by proposing the same massive government takeover of health care based on a partisan bill the American people have already rejected," said House Minority Leader John A. Boehner, Ohio Republican.
Saying it "doesn't make sense" to start from scratch, the administration ignored calls from the Republican minority to scrap the Democratic health care bills and instead released a detailed outline based on the Senate version. At the same time, advisers insisted that Mr. Obama is heading into the summit with an "open mind."
The administration did not post the bill's text on the White House Web site but outlined what the legislation would do. It said the measure would cost $950 billion over 10 years.
The information wasn't enough for the nonpartisan Congressional Budget Office, the official keeper of budget costs, to even venture an estimate of the bill's price tag.
"Although the proposal reflects many elements that were included in the health care bills passed by the House and the Senate last year, it modifies many of those elements and also includes new ones," CBO Director Douglas Elmendorf said in a blog post.
"Preparing a cost estimate requires very detailed specifications of numerous provisions, and the materials that were released this morning do not provide sufficient detail on all of the provisions."
Republicans and Democrats have blamed each other for the lack of bipartisanship on health care, but the pressure has been on Democrats to reach out now that they have lost their filibuster-proof majority in the Senate. While Republicans have said that true bipartisanship requires writing bills together, Mr. Obama has argued that it means the minority party must accept some things it doesn't like.
After letting Capitol Hill take the lead for the past year, Monday's proposal was Mr. Obama's first effort at a comprehensive bill. His moves are designed to answer some of the harshest criticisms of the House and Senate bills.
In addition to addressing a couple of Republican ideas, Mr. Obama's version removes one of the flash points of the Senate health care bill — Nebraska's special Medicaid arrangement that guaranteed it more federal dollars than other states, which Republicans derided as the "cornhusker kickback."
The Senate bill expanded eligibility for Medicaid so that more people would qualify. But Medicaid is a shared state and federal responsibility, which means that states eventually would have to pay more to cover the new enrollees. Sen. Ben Nelson, a moderate Nebraska Democrat and a last holdout in the Senate vote last year, negotiated a deal under which his state's increased payments would be funded by the federal government in perpetuity.
Although the White House removed the Nebraska provision, it left other special exemptions, even after Mr. Obama called the deals "ugly" in an ABC News interview last month. He lamented that the deals undermined public support for the bill.
Mr. Obama's bill, for example, kept the $300 million in Medicaid funds that Sen. Mary L. Landrieu secured for Louisiana, according to her office. It has become known as the "Louisiana Purchase."
But White House press secretary Robert Gibbs noted that Mr. Obama's bill would allow any state in which a major disaster occurred to be eligible for additional federal Medicaid funding. "So it's not a carve-out," he said.
Mr. Gibbs on Monday called on Republicans to post their own proposal online. House Republicans responded by pointing out that the text of their bill has been posted on their Web site for months.
"Mr. Gibbs needs to talk with his boss. Our health care alternative — the full text of the legislation — has been available at healthcare.gop.gov for months, which President Obama knows, since he discussed it with us in Baltimore a few weeks ago," said Michael Steel, a spokesman for Mr. Boehner.
Mr. Obama's proposal appeared to leave untouched the special treatment that Sen. Bill Nelson, Florida Democrat, and other senators helped negotiate for Medicare Advantage customers in their states, though Mr. Nelson's office said it couldn't be sure until the CBO scores the bill.
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