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Health reform written behind closed doors

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By day, Democrats tout how open they have been while crafting a bill to reform the nation's health care system. By early evening, they're behind closed doors.

Three times last week, White House officials went to Capitol Hill to meet in closed sessions with top Senate Democrats to put together a health bill. They left with not much more than a thumbs up or a "we're making progress"-type comment to the reporters waiting outside.

It's not exactly the level of transparency that President Obama promised during the campaign, when he said health care talks would be aired live on C-SPAN.

"I'm going to have all the negotiations around a big table," he told a town hall audience in Chester, Va., in August 2008. "We'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents and who are making arguments on behalf of the drug companies or the insurance companies. And so, that approach, I think, is what is going to allow people to stay involved in this process."

The small group of White House officials and three senators met in Senate Majority Leader Harry Reid's office three evenings last week to discuss what kind of bill to send to the Senate floor. The negotiation team includes Mr. Reid, Finance Committee Chairman Max Baucus of Montana, and Christopher J. Dodd of Connecticut, who led the work on the Health, Education, Labor and Pensions (HELP) Committee bill.

White House officials seen leaving the meetings include Chief of Staff Rahm Emanuel, Health and Human Services Secretary Kathleen Sebelius, health care "czar" Nancy-Ann DeParle, and Peter Orszag, director of the Office of Management and Budget.

It's hardly unexpected that major legislation on Capitol Hill, particularly on an issue as complex as health care reform, would be done in a small group and behind closed doors. The reform debate is now at a particularly sensitive stage, as House and Senate leaders have to make major political and policy decisions on what kind of legislation to send to their chambers' floors.

But Mr. Obama's campaign promises have provided Republicans and other opponents of the Democrats' reform plans with an easy criticism of how he's crafting the legislation.

"They're writing a health care bill in secret, even though the president called for all of this to be out on an open table and have C-SPAN cameras in the room," House Minority Leader John A. Boehner of Ohio said last week.

"We're about to significantly alter one-sixth of the economy, and if there was ever a need for transparency it is now," Sen. Mike Johanns of Nebraska warned in a recent Republican address.

Rep. Mike Pence of Indiana, chairman of the House Republican Conference, has made repeated reference to the health care debate moving "into the smoke-filled rooms" of the Capitol. (Though technically smoking has been banned in the public spaces of the Capitol for two years.)

Mr. Obama argued in a January 2008 Democratic debate that transparency would ensure that special interests couldn't overtake the reform bill.

"If the drug companies or a member of Congress who's carrying water for the drug companies wants to argue that we should not negotiate for the cheapest available price on drugs, then I want them to make that argument in front of the American people," he said.

When asked in a July press conference about the level of transparency, Mr. Obama defended the process.

"You will recall in this very room that our kickoff event was here on C-SPAN and, at a certain point, you know, you start getting into all kinds of different meetings," Mr. Obama said. "Senate Finance is having a meeting; the House is having a meeting. If they wanted those to be on C-SPAN, then I would welcome it. I don't think there are a lot of secrets going on in there."

A White House official did not return a request for comment Friday.

Senate Democrats involved in the conversations defended their process. After the discussions in Mr. Reid's office, one of the lawmakers or spokesmen have given reporters a broad outline of what topics were discussed. Last week, they talked about the employer mandate and the public option.

Mr. Dodd, who led the health bill through the HELP Committee as a stand-in for then-ailing Sen. Edward M. Kennedy, defended the process.

"The suggestion, somehow, that this is being done otherwise is just blatantly false and a distraction from what, really, we need to be talking about, and that is what's in these bills, what are we trying to achieve?" he said.

The Finance Committee posted its overhaul legislation and proposed amendments on its Web site, and its mark-up sessions were aired on C-SPAN and the Internet.

"The Finance Committee, the HELP Committee, there were countless hearings, all public, all in the open," Mr. Baucus, chairman of the Finance Committee, told reporters.

"I have not been involved in such an open and transparent process as this, and I'm very, very proud that we've done it," Mr. Baucus said. "We embarked on this process because it's the right thing to do, but also to help give senators the comfort that we had a good idea of what it is that we're doing."

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