Obama unveils healthcare proposal, starts next political round

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President Obama on Monday unveiled his healthcare overhaul package, and the focus now turns from policy to politics.

The proposal combined many of the same points in the separate Senate and House versions of the healthcare overhaul bills that passed late last year after fierce partisan bickering. Only one Republican in the House voted for the bill, and no GOP senator backed the proposal that passed that chamber.

But as Obama and congressional leaders of both parties prepare for their summit this week on healthcare, it is important to keep in mind the old political adage: “If you can’t win the policy, take the politics.”

In effect, both Republicans and Democrats will be waging a political battle at the summit that is distinct from the policy consideration of healthcare overhaul. And in some ways, the political battle is tougher to resolve.

What are the basic strategies for each side?

Expect Obama and the Democrats to press Republicans by arguing, “See, we have included some of your proposals so now you have no excuse not to back the bill.”

Democrats may also press their argument with something along the lines of, “If you have something better than what we have proposed, put it on the table now, because we have to do something to curb healthcare costs.”

Even if Republicans reject a compromise, Democrats can score a political win by showing that they were willing to include the GOP, perhaps easing some of the sting of last year’s partisan wrangling.

Expect Republicans to counter with something like, “Thank you for including our proposals but the final product at nearly $1 trillion over 10 years is still too large. There is too much government and the impact on the economy will be bad.”

Those arguments are unlikely to shake Democrats but do set the stage for what the GOP wants to use as its political template in this midterm-election year. It wants to shift the political debate from being the party of no (a label the Democrats have hung on the GOP) to a party that is willing to listen but is unwilling to cave under pressure.

Polls show that Republicans can afford to be rigid in opposing an omnibus healthcare package and still score victories as seen in the recent Senate election in Massachusetts.

For both sides, the summit is a chance to appear reasonable in the face of what polls show is increasing voter annoyance at all incumbents, regardless of party. The politicians have to show that they are at least trying, while maintaining their policy objections.

Obama has noted that the overwhelming majority of the healthcare bills already have significant bipartisan support. Key consumer issues such as ending insurance companies’ policy of blocking coverage because of pre-existing conditions would likely pass if that were the only part of the bill. There is also a consensus on halting the growth of healthcare costs and the need to share the pain among consumers, hospitals and drug companies.

There are policy issues that are still to be negotiated. Republicans will likely argue that a big government bill is unneeded to make the kind of small fixes that will help right now. They also oppose any new taxes to pay for the subsidies to bring health insurance coverage to another 31 million people.

After a year of very tough votes in the House and Senate, Democrats have to bring something to the people as a platform on which they can run. Democrats now hold 255 of the House’s 435 seats, and all are stake this year.

Democrats already have indicated they are working on a reconciliation strategy that would allow them to pass their version of healthcare without the need for the Senate supermajority they no longer enjoy.

--Michael Muskal
Twitter.com/LATimesmuskal