Democrats Threaten Reconciliation After Healthcare Summit

It was a clarifying event, but, unfortunately for those seeking bipartisanship, it wasn't a unifying one. Not only did President Obama's daylong healthcare summit illustrate the deep divisions between Democrats and Republicans, but it also showed that healthcare legislation is hanging by a thread.

Obama convened the summit at Blair House as a last-ditch effort to find compromise on the Democrats' proposed $1 trillion, 10-year overhaul. But all sides—three dozen leaders of both parties crammed around a hollow square table—frequently resorted to talking points in what was often a serious but tedious example of political theater.

"We all know that this is urgent," President Obama said in opening the proceedings, adding that the healthcare system represents "one of the biggest drags on our economy." House Speaker Nancy Pelosi said, "Inaction and incrementalism are simply unacceptable." The basic Democratic bill is a complex rewrite of existing law designed to extend coverage to 30 million uninsured people. It includes requiring most Americans to get health insurance and provides subsidies for many in the form of tax credits. But Rep. Eric Cantor of Virginia, the second-ranking House Republican, countered, "We have a very difficult gap to bridge here. We just can't afford this." GOP Sen. Lamar Alexander of Tennessee urged taking a series of small steps, such as expanding health savings accounts and altering rules on medical malpractice.

The seven-hour talkathon, was civil but at times sharp-edged. Arizona Sen. John McCain, the 2008 GOP presidential nominee, chided Obama for breaking a promise to conduct healthcare negotiations on C-SPAN from the start and for allowing special interests to hold sway. "We're not campaigning anymore," Obama replied. "The election's over." He urged McCain to drop the "talking points" and focus on "how we actually get a bill done."

After the summit was over, little had changed. Obama asked the GOP to do some "soul searching" about how to cover the uninsured and how to improve the system by working with Democrats. But he said "baby steps" wouldn't be enough and admitted that the gap between the parties might be too big to bridge.

White House officials said that they would probably take some time to evaluate the situation and that if there is no accommodation, congressional Democrats are likely to proceed without any GOP help. Obama said all sides will have to do what they think is best and defend their decisions to the voters. "That's what elections are for," he said.

The administration might try a scaled-back bill or might still push for a comprehensive measure using a Senate procedure called "reconciliation." This would require only a simple 51-vote majority and avoid the 60-vote requirement to end a filibuster. And Democrats have begun a major push to persuade voters that this process is fair and justified as they prepare a final push to enact healthcare legislation. "In their drive to paint passing legislation with a simple majority as radical, Republicans want you to forget that they have used reconciliation to pass major pieces of legislation including the $1.8 trillion Bush tax cut with a simple majority in the past," said Democratic National Committee spokesman Hari Sevugan in an E-mail to reporters this morning.

And yesterday, White House healthcare adviser Nancy-Ann DeParle suggested on NBC's "Meet the Press" that the administration may be moving toward using reconciliation in the next few weeks. President Obama is expected to announce his intentions in the next few days. "Healthcare reform has already passed both the House and the Senate with not only a majority in the Senate but a supermajority," DeParle said. "And we're not talking about changing any rules here."

Republicans say using reconciliation to enact a final compromise would be an unfair tactic that would amount to jamming the bill through Congress without adequate support. Rep. Eric Cantor, a Virginia Republican and a House leader, told NBC that if the Democrats use the tactic to pass the healthcare bill on party lines--which is the likely outcome under reconciliation--they will "lose their majority in Congress in November."

But even if they use reconciliation getting a House majority remains a daunting challenge. It is a pattern that has plagued comprehensive healthcare legislation for a half-century. When one obstacle is cleared away, another one always seems to loom ahead.