The President met last week with a bi-partisan group of Senators and members of Congress to discuss the future of healthcare reform in the following four areas: controlling costs, reforming insurance, increasing coverage, and reducing the deficit.  The principle of pooling risk through exchanges and the federal government setting nationwide health insurance standards appeared to be the most contentious issues during the discussion.  President Obama argued that standards are needed to set baseline levels of protection for Americans. It was also pointed out by Republicans that the Senate bill may not actually lower premiums.  Sen. Alexander (R-TN) said the bill would not lower premiums but President Obama cited the Congressional Budget Office (CBO) report that premiums would be lowered by 14 to 20 percent.  

The Congressional leaders came to philosophical agreement on not dropping people from plans, extending dependent coverage (to age 26 for example), no annual/lifetime limits, and banning denial based on preexisting conditions.  The President stressed that he incorporated the fraud, waste, and abuse measures, taking into consideration the Republicans’ ideas.  He expressed interest in Sen. Coburn’s (R-OK) idea of using undercover patients to mitigate fraud in hospitals and physician offices.  Both Democrats and Republicans expressed the necessity for prevention measures and curbing defensive medicine.  Heated debate revolved around health insurances exchanges, health savings accounts (HSAs), and the federal government’s oversight of state health insurance.

Sen. Alexander said the President’s plan causes increased taxes, subsidies, and spending, while cutting Medicare and spending $2T annually.  He said that Republicans wanted to start over with a step by step approach to lowering healthcare costs and proposed Sen. Enzi’s (R-WY) small business plan, buying insurance across state lines, ending junk lawsuits, giving states incentives to lower healthcare costs, and encouraging HSAs.  Sen. Alexander said reconciliation was an inappropriate procedure to move the bill. The Senator stressed that decreasing health care costs should be the bill’s main goal for both parties.

Speaker Pelosi (D-CA) said healthcare is not just the issue but also a healthier America as well as the economics.  Senate Majority Leader Harry Reid (D-NV) expressed concern noting that 58 percent of Americans would be disappointed if there was no healthcare reform this year; 45,000 Americans die per year because of no healthcare; and in 2008, 750,000 bankruptcies were due to insurmountable healthcare costs.

It appears if Republican’s will not participate in passing the legislation, then Democrats are ready to forge ahead with reconciliation if they can convince moderate Democrats or find support for the public option.

The President’s recently posted proposal on Health Care can be found by visiting: