Congressional Democrats cautiously embraced President Barack Obama's new healthcare plan as their last, best hope for enacting a comprehensive overhaul. Republicans derided the new blueprint as same as the old one.
Two days before Obama's televised health summit with Republicans and Democrats, the prospects for any bipartisan deal dimmed as the administration set the stage for pushing ahead with only Democratic support, a risky move that would require the president's political capital and elusive unity from a fractious party.
Democratic congressional leaders would have to scramble for votes, and Republicans signaled they wouldn't help.
"It should be clear by now that Americans are tired of grand schemes imposed from above," Senate Republican Leader Mitch McConnell of Kentucky said Tuesday. "Incredibly (Democrats) still don't seem to get it." It seemed unlikely that McConnell would go along with a White House request for a simple up-or-down vote on Obama's plan, unobstructed by delaying tactics.
A year after calling on Congress to act to reform the nation's costly and inefficient healthcare system, Obama finally produced a plan of his own Monday. It used legislation already passed by the Senate as its starting point, making changes designed to appeal to House Democrats.
Even after months in which healthcare gradually turned from Obama's top domestic priority into a political albatross, Obama opted for one last attempt at full-scale legislation. It costs around $1 trillion over a decade, requires nearly everyone to be insured or pay a fine, and puts new requirements on insurance companies, including — in a new twist responding to recent rate hikes — giving the federal government authority to block big premium increases.
In the end Obama may have to settle for much less than what he proposed Monday — or nothing at all. But many Democrats said that despite all the bad-news polls and the loss of their filibuster-proof Senate supermajority in a special-election upset, it would still be better to pass a sweeping bill than make small changes or none at all.
If Obama fails on a comprehensive healthcare overhaul where Bill Clinton and other presidents failed before him, the chance won't come around again anytime soon.
"This is the last time out," said House Ways and Means Committee Chairman Charles Rangel, D-N.Y. "So this is it. This is it."
The whole endeavor will now rise or fall on Obama's ability to sell his plan at the summit Thursday, and the reaction from lawmakers and the public in the days ahead.
Only 32 percent of Americans say Congress should move soon to pass a comprehensive bill, embodied in the House and Senate Democratic legislation and Obama's new plan. That was the finding of a poll released Tuesday by the nonpartisan Kaiser Family Foundation. Americans were evenly divided on the legislation, in a 43-43 percent split.
Most still want Congress to pass something this year, and 58 percent say they'll be disappointed or angry if that doesn't happen. But 20 percent say lawmakers should pass a scaled-back bill, and 22 percent say it would be a good idea to call a time-out on health care and come back later in the year.
Obama's plan does not include the government insurance option sought by liberals and it dramatically scales back a tax on high-value insurance plans from the Senate bill that was opposed in the House. It eliminates a controversial Medicaid deal for Nebraska, offers all states more help with Medicaid funding, and beefs up subsidies to help lower-income people buy care, all changes that won praise from House Democrats. It also closes the so-called "doughnut hole" in Medicare's prescription drug coverage.
Individuals and small businesses would shop for insurance in regulated state-based marketplaces called exchanges.
Obama tried to avoid the mistakes Clinton made in delivering a healthcare proposal to Capitol Hill and telling Congress to pass it, but many now believe he erred in the opposite direction.
Republican leaders made no secret of their contempt.
Rep. Eric Cantor, the House Republican whip, assailed the proposal Tuesday as a "repackaged" version of Senate-passed legislation that the American people already have rejected. Cantor, R-Va., called it a "nonstarter" and said Obama's healthcare summit likely won't be productive.
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