Healthcare marathon may hit wall this week

If President Obama’s analogy — that reforming healthcare is a long race — holds true, this week might just be Heartbreak Hill.

Beginning on Monday, Obama will find out if congressional Democrats have the wherewithal to push ahead with their — and his — ambitious goal of crossing the healthcare finish line before August, or whether they have to stop and stretch before limping across at a later date.

It’ll be close.

In the House, Democratic leaders are still grappling with severe cramps caused by two different groups: their vulnerable freshman members and the conservative Blue Dog Democrats.

Twenty freshman Democrats, led by Rep. Jared Polis (Colo.), have threatened a revolt against the $544 billion worth of tax increases spelled out in the House bill — one of the two revenue pillars holding up the Democrats’ promise of producing a “deficit-neutral” healthcare bill that is expected to cost more than $1 trillion.

The Ways and Means Committee completed its markup of the tax portion of the bill last week, meaning that if the freshmen aren’t satisfied with the result, close to two dozen votes could be at risk.

So far, all indications point to House leaders sticking with their plan to pay for half of their bill through a sliding surtax on the income of Americans in the top tax brackets — a plan the White House has blessed but for which the Senate has not indicated an appetite.

Beyond that, the biggest threat to the August goal — if not successful passage of the bill altogether — is coming from fiscally conservative Blue Dog Democrats, who have banded together in opposition to everything from Medicare reimbursement rates to an automatic public plan, and have hinted at bolting on the idea of taxes of any kind.

The will of these Democrats, and the power of their leaders to cut deals with them, will be on full display starting on Monday, when the critical Energy and Commerce Committee continues its markup of major portions of the House bill.

Committee Chairman Henry Waxman (D-Calif.) has vowed to finish his markup by midweek as promised. But the Blue Dogs have said they have enough votes to kill the bill in committee if changes aren’t realized. And on issues where the committee lacks jurisdiction, such as the tax portion, Blue Dogs have warned that there are enough votes to kill the bill on the floor as well.

While not indicating any desire to slow down, House leaders on Friday said they expect to reach agreements with any and all Democrats who are now balking.

“There’s no doubt the bill is going to have changes as it moves through the process,” House Majority Leader Steny Hoyer (D-Md.) said Friday afternoon. “We will need to build on the cost-containment measures we already have.”

If the House has leg cramps, the Senate seems completely dehydrated.

Although the Health, Education, Labor and Pensions Committee finished the markup of its portion of the Senate healthcare reform bill early last week, negotiations broke off in the Finance Committee without any sign of when they would pick back up.

Also on Friday, six centrist senators wrote Majority Leader Harry Reid (D-Nev.) and Minority Leader Mitch McConnell (R-Ky.) asking that the August deadline be abandoned altogether.

“While we are committed to providing relief for American families as quickly as possible, we believe taking additional time to achieve a bipartisan result is critical,” wrote Sens. Ben Nelson (D-Neb.), Joe Lieberman (I-Conn.), Mary Landrieu (D-La.), Ron Wyden (D-Ore.), Susan Collins (R-Maine) and Olympia Snowe (R-Maine).

As Obama has been meeting privately with a number of these members of Congress to work out agreements, he’s been publicly urging Congress to act before the summer ends, using an impromptu Friday speech at the White House and his Saturday radio address to keep significant pressure on Congress to act on his top priority.

“Now, I realize that the last few miles of any race are the hardest to run,” Obama said on Friday. “But I have to say now is not the time to slow down, and now is certainly not the time to lose heart.”

This week he will see if the body can do what the heart wants.

— Jeffrey Young contributed to this article.

 
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