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NPRObama Declares Health Debate Over, Urges Action

President Obama makes a final attempt to push forward health care legislation. - Alongside health care professionals at the White House, President Obama makes a final attempt Wednesday to push forward health care legislation, calling for an "up or down vote" within weeks. (Saul Loeb / AFP/Getty Images)

On Tuesday, President Obama reached out to Republicans by including several of their ideas in the health care proposal he wants Congress to pass. But in a speech Wednesday at the White House, he made it clear that he won't accept their threshold demand — to start the process over.

"I don't see how another year of negotiations would help," he said.

And he picked apart their other major argument, that it would be better and more politically acceptable to do a health overhaul in small pieces.

"The problem with that approach is that unless everyone has access to affordable coverage, you can't prevent insurance companies from denying coverage based on pre-existing conditions; you can't limit the amount families are forced to pay out of their own pockets," he said. "The insurance reforms rest on everybody having access to coverage."

And, perhaps most important, people without insurance end up costing everyone more when they use the emergency room for nonemergency care.

"So the fact is, health reform only works if you take care of all of these problems at once," he said.

Fall Elections Will Be 'Referendum'

Republicans, however, were so prepared for what the president was going to say that they actually gave some of their reactions in advance of the speech.

"Well, it's pretty clear that the Obama administration and my colleagues in Congress are going to continue on their march to shove this government-run health care plan down the throats of the American people," House Minority Leader John Boehner said Wednesday morning, well before the afternoon event at the White House. "You can't add a couple of Republican sprinkles on the top of a 2,700-page bill and claim that it's bipartisan."

Senate Republican leader Mitch McConnell pointed out that without Republican support, Democrats have a difficult path ahead. House Democrats, for example, will have to pass the bill the Senate passed on Christmas Eve — complete with all the individual deals cut to get that measure through.

"House Democrats only are going to be called upon to vote on a bill that has the Cornhusker kickback, the Louisiana purchase, the Gator aid, and all the rest," he quipped, referring to the special favors to benefit Nebraska, Louisiana and Florida. Democrats hope to erase those special deals with a second bill, using a budget technique that would let them sidestep a potential Senate filibuster.

But McConnell warned that even if Democrats manage that, the debate will be far from over, "because every election in America this fall will be a referendum on this issue."

"And there's an overwhelming likelihood that every Republican candidate will be campaigning to repeal it," he said.

But defending a health care bill that actually becomes law is a prospect many Democrats relish. At the Democrats' news conference, Maryland Sen. Ben Cardin said Democrats are happy to debate the prospect of something versus nothing. And when it comes to health care, he said, nothing is really what Republicans want, despite their claims to the contrary.

"The Republicans do not want a health care bill. It's not that they want us to start over. They don't want a health care bill," he said. "And the Democrats believe it is time to act."

And time, it seems, is of the essence. Democrats had hoped to be long since done with the health care bill. They want to refocus their legislative efforts on jobs and the economy. Now Democratic leaders — with the help of President Obama, who will stump for the health bill in Philadelphia and St. Louis next week — have to convince wavering moderates that it will be more in their interest to pass this bill than to let the effort die.

Copyright 2012 National Public Radio. To see more, visit http://www.npr.org/.

Transcript

STEVE INSKEEP, host:

Its MORNING EDITION from NPR News. Im Steve Inskeep.

One week after his dramatic televised meeting with Republicans, President Obama effectively acknowledged the obvious. If theres going to be a health care bill this year, its going to happen exclusively with Democratic votes. The president gave a speech to a group of doctors and nurses in the White House East Room. He said the debate is over, and he said its time for Congress to send him a bill. The only way to get it past unanimous Republican opposition will be to use a budget maneuver that limits Republican power. Well have more on that in a moment.

We start with NPRs Julie Rovner on the presidents plan.

JULIE ROVNER: On Tuesday, the president reached out to Republicans by including several of their ideas in the proposal he wants Congress to pass. But in yesterdays speech, he made it clear that he won't accept their threshold demand to start the process over.

President BARACK OBAMA: I don't see how another year of negotiations would help.

ROVNER: And he picked apart their other major argument that it would be better and more politically acceptable to do a health overhaul in small pieces.

President OBAMA: The problem with that approach is that unless everyone has access to affordable coverage, you can't prevent insurance companies from denying coverage based on pre-existing conditions; you can't limit the amount families are forced to pay out of their own pockets. The insurance reforms rest on everybody having access to coverage.

ROVNER: And perhaps most important, people without insurance end up costing everyone more when they use the emergency room for non-emergency care.

President OBAMA: So the fact is, health reform only works if you take care of all of these problems at once.

ROVNER: Republicans, however, were so prepared for what the president was going to say they actually gave some of their reactions in advance of the speech. Heres House Minority Leader John Boehner yesterday morning, well before the afternoon event at the White House.

Representative JOHN BOEHNER (Republican, Ohio; House Minority Leader): Well, it's pretty clear that the Obama administration and my colleagues in Congress are going to continue on their march to shove this government-run health care plan down the throats of the American people. You can't add a couple of Republican sprinkles on the top of a 2,700-page bill and claim that it's bipartisan.

ROVNER: Senate Republican Leader Mitch McConnell pointed out that without Republican support, Democrats will have a difficult path ahead. House Democrats, for example, will have to pass the bill the Senate passed on Christmas Eve, complete with all the individual deals cut to get that measure through.

Senator MITCH MCCONNELL (Republican, Kentucky; Senate Republican Leader): House Democrats only are going to be called upon to vote on a bill that has the Cornhusker Kickback, the Louisiana Purchase, the Gator Aid, and all the rest.

ROVNER: Those are the special favors to benefit Nebraska, Louisiana and Florida. Democrats hope to erase those special deals with a second bill using a budget technique that would let them sidestep a potential Senate filibuster. But McConnell warned that even if Democrats manage that, the debate will be far from over.

Sen. MCCONNELL: Because every election in America this fall will be a referendum on this issue. And there's an overwhelming likelihood that every Republican candidate will be campaigning to repeal it.

ROVNER: But defending a health bill that actually becomes law is a prospect many Democrats relish. At the Democrats' news conference, Maryland Senator Ben Cardin said Democrats are happy to debate the prospect of something versus nothing. And when it comes to health care, he said, nothing is really what Republicans want, despite their claims to the contrary.

Senator BEN CARDIN (Democrat, Maryland): Republicans do not want a health care bill. It's not that they want us to start over. They don't want a health care bill. And the Democrats believe it is time to act.

ROVNER: And time, it seems, is of the essence. Democrats had hoped to be long since done with the health care bill. They want to refocus their legislative efforts on jobs and the economy. Now Democratic leaders, with the help of President Obama, who will stump for the health bill in Philadelphia and St. Louis next week, have to convince wavering moderates that it will be more in their interest to pass this health care bill than to let the effort die.

Julie Rovner, NPR News, Washington. Transcript provided by NPR, Copyright National Public Radio.

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