Obama Pushes Health Reform Toward Possible Vote

President Barack Obama is pushing Congress for a final vote on his health care reform proposal, using an approach in the U.S. Senate that had been used by the previous presidential administration on a number of major bills, allowing for a simple majority approval.

"It deserves the same kind of up-or-down vote that was cast on welfare reform, the Children's Health Insurance Program, COBRA health coverage for the unemployed, and both Bush tax cuts -- all of which had to pass Congress with nothing more than a simple majority," Obama said in a March 3 White House speech.

Robert Zirkelbach, a spokesman for America's Health Insurance Plans, said in a statement after Obama's speech, "With each passing day, rising costs are putting coverage out of reach for working families and small businesses, and there is very little in the current legislation to solve this problem."

Meanwhile, Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, is expected to meet March 4 with chief executive officers of several major health insurers to discuss premium rate increases.

Obama noted the reform bills have already passed with a strong House majority and with a filibuster-proof 60-vote majority in the Senate, though those versions have significant differences. Obama's proposal leans heavily toward the more conservative Senate version, which would only require a House approval before it could be sent to the White House for a presidential signature and become law. But Democratic leaders in the House want to make several changes to the Senate's bill, and they would probably have to do that by arranging a subsequent amendment bill with Senate leaders to ensure they have sufficient votes in each chamber. Once that amendment bill were to pass the House, Democrats would have to use the parliamentary "budget reconciliation" procedure to get beyond a potential filibuster in the Senate so the changes could be considered with a simple majority vote.

The amendments, according to reconciliation rules, would have to be budget-related.

Sen. Mitch McConnell, the Republican minority leader in the Senate, responded to the latest presidential speech, saying Democrats will face a difficult election season if they keep pressing for this health care bill. "Every election in America this fall will be a referendum on this issue," he said. "What we know about the health care bill is people don't want it to pass. It's overwhelmingly unpopular."

McConnell, R-Ky., suggested the members of his party will push back against an attempted use of the reconciliation process. "This is an extraordinary use of this device," he said. GOP lawmakers will examine all the barriers they can take advantage of, though he wouldn't show his party's hand when asked for details. "We're going to scrub the bill thoroughly, but I'm not going to announce in advance what efforts would be made," he said.

Republicans have repeatedly asked that the health care reform process be started over from scratch. Obama answered that request -- which emerged from the GOP again in anticipation of his speech -- by saying, "I do not see how another year of negotiations would help."

"Everything there is to say about health care has been said, and just about everyone has said it," the president said.

Obama said his proposal has been modified after a recent White House health care meeting between Republican and Democratic lawmakers (BestWire, Feb. 25, 2010). "It incorporates the best ideas from Democrats and Republicans -- including some of the ideas that Republicans offered during the health care summit, like funding state grants on medical malpractice reform and curbing waste, fraud, and abuse in the health care system," Obama said. "No matter which approach you favor, I believe the United States Congress owes the American people a final vote on health care reform." And he'd like to see it "in the next few weeks," he said.