Friday, August 21, 2009

The White House and lawmakers continued the public push for a bipartisan health care reform bill Thursday, even as Democrats were preparing alternatives to bypass Republican blocking tactics if necessary.

President Obama, answering a call on conservative talk-show host Michael Smerconish’s radio program, guaranteed Thursday that his health care reform would pass and rallied his most loyal supporters, just as the Senate Finance Committee’s “gang of six” planned to confer in its first negotiating session since the start of the August recess.

The group of three Republicans and three Democrats is trying to come up with a reform plan that can please both parties, a tough process that likely has grown more difficult since a series of inflamed town-hall meetings across the country. Four other congressional panels have passed reform bills, but none have obtained Republican votes.

The six-member group has until Sept. 15 to come up with legislation, and Democrats say they are prepared to pursue nontraditional means of passing the bill if the bipartisan effort collapses.

For Democrats skeptical of any Republican support and fearful the measure will bog down in the Senate, the concept of “reconciliation” — an arcane parliamentary procedure that sidesteps minority filibuster threats — has gained increasing prominence in recent days. The maneuver brings political headaches of its own, but the White House has consistently refused to rule it out.

With the health care battle approaching a showdown, there are a number of alternatives floating around Capitol Hill on how the endgame will play out. They include:

• Reconciliation: Under the budget rules in the Senate, portions of the reform bill could pass with just 51 votes, eliminating the chance of a Republican filibuster that would require 60 votes.

• Reconciliation 2: Pass the noncontroversial insurance industry reform measures through traditional measures and then pass the controversial portions under reconciliation, according to the Wall Street Journal.

• Slim down: Sen. Charles E. Grassley wants to pare down the reform bill because Americans are concerned about the large size of the reform plans, he told The Washington Post.

• Start over: Republicans, angered over the current legislation, repeatedly have demanded that lawmakers start the process from the beginning. At least one Democrat, Rep. Emanuel Cleaver II of Missouri, told local reporters this week that he would consider hitting the “reset button” on the whole reform drive as well.

Senate Democratic leaders don’t plan to pursue reconciliation until they have exhausted bipartisan measures, said Jim Manley, spokesman for Senate Majority Leader Harry Reid, Nevada Democrat.

“While the White House and Senate Democratic leadership still prefer and are working hard toward a bipartisan bill, our patience is not unlimited,” he said. “We remain committed to trying to get something done this year.”

But reconciliation has its obstacles: Only portions of the reform bill would be able to pass and any item not related to the budget could be challenged and stripped from the legislation.

That means relatively bipartisan reform measures, such as the ban on insurance companies denying patients with pre-existing conditions, likely would be excluded.

“Clearly there could be a number of options on the table at this juncture,” said Martie Kendrick, partner in the health practice at Patton Boggs LLP.

The anger in the town-hall meetings, which some say has been fabricated by opponents to health care reform, also has become a factor.

“Some amount of strategic regrouping is likely to occur out of the town-hall meetings,” Ms. Kendrick said. “This is creating a choice between whether Congress should move forward with a Democrat-only approach or revisit and possibly reconfigure the scope and breadth of the bill.”

The “gang of six” leaders on the Senate Finance Committee reiterated their support for a bipartisan bill.

Chairman Sen. Max Baucus, Montana Democrat, and ranking Republican Mr. Grassley said in separate statements earlier this week that they will plod ahead.

Mr. Obama lauded the three Republican senators in the group during a radio interview hosted by Michael Smerconish at the White House on Thursday but said he doesn’t know yet whether there is Republican support for the bill.

He said Mr. Grassley of Iowa, Michael B. Enzi of Wyoming and Olympia J. Snowe of Maine are under “enormous pressure” not to negotiate and are “showing some significant resolve” by sticking with it.

“I don’t know if in the end they can get there, I hope they can,” Mr. Obama said.

An Obama supporter from Pennsylvania called in, asking whether the president’s knees were “buckling a little bit” and whether he was trying to compromise on health care.

Mr. Obama dismissed that, saying, “Passing a big bill like this is always messy.”

Separately on Thursday, Vice President Joseph R. Biden Jr. announced almost $1.2 billion in grants to help health care providers convert to electronic medical records during a stop to promote the administration’s health care and economic policies, the Associated Press reported.

Mr. Biden and Health and Human Services Secretary Kathleen Sebelius were set to detail how that part of the $787 billion economic stimulus package would help Americans when they go to the hospital or to their doctor. It also is a what’s-in-it-for-me way for the White House to illustrate how it is spending parts of the massive amount of taxpayer dollars.

Back in Washington, Mr. Obama rallied his supporters and campaign organizers to remember the work they did in Iowa as the real hard work begins on health care reform.

Mr. Obama, speaking during an Organizing for America event not paid for with government funds and broadcast online, thanked volunteers for hosting 11,000 events on health care this summer and pressing on even when people slam doors in their faces and the television cameras are off.

“We’ve been through this before,” he said.

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