Obama expresses interest in four GOP healthcare ideas

With the yearlong struggle over healthcare moving into its climactic final stage, President Obama on Tuesday made a last-ditch bid to win Republican support, raising the possibility of including a bundle of specific Republican ideas in the Democrats’ legislative package.

In a letter to congressional leaders of both parties, Obama said that he was open to considering GOP proposals to root out Medicare fraud, reduce medical malpractice lawsuits and encourage greater use of individual health savings accounts.

“I said throughout this process that I’d continue to draw on the best ideas from both parties, and I’m open to these proposals in that spirit,” Obama wrote.

The overture, which followed Obama’s daylong healthcare summit with senior lawmakers last week, was quickly dismissed by top Republicans as a maneuver to deflect criticism of the bill.

“It’s political cover,” said Virginia Rep. Eric Cantor, the No. 2 House Republican.

But the president’s gambit helped lay the foundation for a final push by Democratic leaders to pass a package of health bills in the next month without Republican support.

To secure final passage of healthcare legislation, Democratic leaders must persuade a majority of their party in the House to approve the bill passed by the Senate late last year. At the same time, they would tweak the Senate plan in a separate bill approved under a budget reconciliation process that cannot be blocked by a Republican filibuster in the Senate.

That reconciliation package could include several of the GOP ideas lauded by Obama, as well as other changes sought by House Democrats, including a reduction in a new tax on high-end “Cadillac” health plans and an increase in subsidies to help low- and moderate-income Americans buy health coverage.

House Speaker Nancy Pelosi (D-San Francisco) said Tuesday that parliamentary rules would prevent the package from changing controversial provisions in the Senate bill limiting federal funding for abortion and preventing undocumented immigrants from buying most private health insurance on their own. If unchanged, those provisions could prompt some House Democrats to vote against the legislation.

In his letter pledging to consider GOP ideas, the president singled out a proposal by Oklahoma Sen. Tom Coburn to use undercover medical professionals to help identify fraud in Medicare, Medicaid and other federal health programs.

He also said he was open to appropriating $50 million in federal funding to help states explore alternatives to resolving medical malpractice lawsuits, including the establishment of so-called health courts.

Tort reform is a top priority of GOP lawmakers, although Republicans have long called for more robust measures to limit malpractice awards.

And the president said he was open to including language to expand health savings accounts, which give tax breaks to individuals who set aside money for future medical expenses.

Finally, Obama gave a nod to criticism leveled by Arizona Sen. John McCain, the 2008 GOP presidential candidate, who has repeatedly criticized deals included in Democratic healthcare legislation at the request of individual lawmakers.

“There are provisions that were added to the legislation that shouldn’t have been,” Obama wrote, singling out a provision to protect seniors in Florida from cuts to the Medicare Advantage program and another provision to give Nebraska special federal assistance to help it expand its Medicaid program.

The president’s letter drew a cool reception from Republican leaders, who urged Obama and other senior Democrats to scrap the sweeping healthcare bill and focus on more limited legislation.

“This is a car that can’t be recalled and fixed,” Sen. Lamar Alexander (R-Tenn.) said Tuesday of the president’s plan. “It has to be parked, [which] would be a generous word for it. And we have to start over in a new vehicle.”

Obama and his congressional allies have repeatedly rejected this approach. And on Tuesday, the president acknowledged the gulf still separating Democrats and Republicans even as he offered to consider GOP ideas.

“While we all believe that reform must be built around our existing private health insurance system, I believe . . . that piecemeal reform is not the best way,” he wrote.

noam.levey@latimes.com

janet.hook@latimes.com