The discussion will focus around four main themes: controlling costs, insurance reforms, reducing the deficit, and increasing coverage. The president has stated many times that he is looking for bipartisan support for health-care reform. On Monday, he released his eleven-page blueprint for reform that is based, for the most part, on the bill passed by the Senate on December 24. There are some tweaks to the Senate bill, including reduced fines under the mandate, increased exemptions under the Cadillac Tax, and a new 2.9 percent tax on unearned income and dividends for couples earning over $250,000. The one new idea was setting up a federal board, the Health Insurance Risk Authority, which would review premium increases by insurance companies. If deemed unjustified or unrealistic, the board would take measures to have them rolled back.
By hosting the summit, I believe the president is under no illusion that he can gain the support of Republicans for his $950 billion over-ten-year proposal which will result in increased taxes, mandates, subsidies, and controls on insurance companies. The Republicans have called many times for abandoning the House and Senate bills and starting afresh.
The reason behind this show is to gather support from his own Congressional team. After his campaign in 2008 where health-care reform was a major plank and over a year in office where reform was front and center on his domestic-policy agenda, he has not been able to get a bill on his desk for signature. This has been a major frustration for President Obama. By holding a summit, I believe his goal is to get the Democrats in the House and the Senate to agree on his agenda and to get the Democratic members within the House and the Senate to agree also.
The strategy for passing health-care reform is now using budget reconciliation, which should be used for dealing with budget issues not for major policy issues, such as reforming health care.
Will the summit give President Obama the confidence and commitment to reform that he is looking for? If not, it will be a major blow to his presidency and may in fact make him a lame duck for the last three years of his term. I dont know if he can succeed in getting his team listed on the same dance card, but what I do believe is that, even with reconciliation, it is going to be very difficult for House Speaker Pelosi to get the 217 votes she needs and for Senate Majority Leader Harry Reid to get the 51 he will need in order for the legislation to reach the presidents desk.