White House: Our Health Care Fixes Can Pass Without GOP Support

President Barack Obama
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The White House has outlined a package of fixes to the Senate health care bill, which they hope can bring reform over the finish line, and they’re prepared to push the changes through the filibuster-proof reconciliation process if Republicans insist on filibustering.

“This package is designed to help us [use reconciliation] if the Republican party decides to filibuster health care reform,” said White House Communications Director Dan Pfeiffer. “That was certainly a factor that went in to how we put this proposal together.”

Pfeiffer said the White House views this as “the opening bid,” for the bipartisan health care summit scheduled for this Thursday. The hope–a long shot–is that one or more Republicans can agree to support this proposal, allowing Dems to pass it via more standard legislative channels. But if that fails, reconciliation can be used as a backstop.

“The president expects, and thinks the American people deserve, an up or down vote on health care reform,” Pfeiffer said.

Working within those guidelines, the White House has modified an agreement it reached with organized labor on a controversial tax on so-called Cadillac insurance plans. Instead of exempting union health care plans from the tax for the first few years of the reform, the White House wants to delay the excise tax altogether until 2018, at which point it will be implemented across the board, and at a higher threshold than the Senate bill mandates.

Union officials are still examining the proposal, but the 2018 implementation date and raised thresholds will be key to winning their support. To replace the lost revenue, the White House supports expanding the tax base on high-income Medicare taxes to include investment income.

Separately, the White House proposal strengthens the employer responsibility requirement in the Senate bill. Like the Senate bill, it does not specifically require employers to provide insurance to their workers, but would require them to pitch in more money for each employee who ends up on federal assistance to buy their own health insurance. That money will be used to help cover the cost of subsidies, which are slightly higher on average in the White House bill than in the Senate bill.

Using the Senate bill as a baseline, White House proposal preserves the Senate bill’s abortion language, and state-based exchanges, while scrapping the Nebraska Medicaid deal. It does not include a public option.

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