President Barack Obama and his Democratic allies are pleading their case for healthcare overhaul in an extraordinary summit with Republicans, broadcast live to a divided public on daytime TV.
But Democrats are already looking beyond Thursday's meeting at historic Blair House. With GOP lawmakers remaining steadfast in their opposition, the president and his party are preparing to move on alone.
At stake in the high-risk strategy is the Democrats' stalemated legislation to extend coverage to more than 30 million people who are now uninsured. Politically, it's an all-or-nothing gamble in a midterm election year for Democrats bent on achieving a goal that has eluded lawmakers for a half-century.
Polls show Americans want their elected leaders to address the problems of high medical costs, eroding access to coverage and uneven quality. But the public is split over the Democrats' sweeping legislation, with its $1 trillion, 10-year price tag and many complex provisions, including some that wouldn't take effect for another eight years — after Obama has packed up and left the White House.
For Obama, the summit is his chance to make a compelling closing argument to the American people. If he succeeds, Democrats will push ahead to pass the legislation with a package of revisions he's proposed. If Obama falters, another Democratic president will have been humbled by healthcare. He will have to appeal to both sides to at least give him a modest bill smoothing some of the rough edges from the current system.
Wednesday, on Capitol Hill, the statements of two leaders illustrated the chasm between the parties.
"We'll have that meeting," said Sen. Chris Dodd, D-Conn., who helped write the Senate bill. "But far more important, after that meeting, you can either join us or get out of the way."
"I think it's nearly impossible to imagine a scenario under which we could reach an agreement," said Senate Republican leader Mitch McConnell of Kentucky. "Because we don't think we ought to pass a 2,700-page bill that seeks to restructure one-sixth of our economy."
Both men will be at the summit, which begins at 10 a.m. EST, and will be carried live from Blair House, the presidential guest quarters. C-SPAN will carry complete coverage. News operations from CNN to public broadcasting are planning to make it the focus of their day.
"Not only are lawmakers polarized, the parties' constituencies are far apart," said Robert Blendon, a Harvard University professor who follows public opinion trends on healthcare. "The president is going to use it as a launching pad for what will be the last effort to get a big bill passed. He will say that he tried to get a bipartisan compromise and it wasn't possible."
In an eleventh-hour move, the White House invited Maine Sen. Olympia Snowe, one of the few Republican moderates the White House courted throughout last year in hopes of winning her support for the legislation. She declined since she wasn't chosen under the long-standing rules for the event.
Democrats say no decision on legislative strategy will be made until after the summit.
Three dozen lawmakers, plus several administration officials, were to sit at a hollow square table with name placards. Leaders of both parties planned to speak. Topics were to include controlling healthcare costs and expanding coverage, deficit reduction and insurance reform.
Republicans will focus on six areas: funding high-risk insurance pools for people denied coverage because of medical problems; expanding health savings accounts; allowing consumers to shop out of state for lower-cost plans; capping malpractice judgments to reduce the practice of defensive medicine; helping small businesses afford coverage; and supporting state innovation in trying to control costs.
Like the Democrats' plan, those ideas have their pros and cons. Some undoubtedly would help people now struggling with costs and coverage. But the GOP proposals, even if taken together, probably would not put the nation on a path toward coverage for all. Since health insurance is expensive, that would take a major commitment of federal dollars that Republicans are loath to make.
The Democratic bills would require most Americans to get health insurance, while providing subsidies for many in the form of a new tax credit. They would set up a competitive insurance market for small businesses and people buying coverage on their own. Democrats also would make a host of other changes, which include addressing the coverage gap in the Medicare prescription benefit and setting up a new long-term care insurance program. Their plan would be paid for through a mix of Medicare cuts and tax increases.
Barring an unlikely bipartisan breakthrough, all but a handful of Democrats' votes would be needed to pass the legislation under Senate budget reconciliation rules, which would disallow GOP filibusters.
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