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What can Obama trade?

obamatrader.JPGIn Roll Call, Norm Ornstein games out Thursday's health-care summit:

Here is my suggestion for how the summit and its aftermath might go. First, the president could explain the core components of this plan in ways that will reassure Americans that this is no wacky or extreme venture. Second, there could be ample opportunity for Republicans to offer their ideas, including discrete ones like Pawlenty’s and comprehensive plans like Wisconsin Rep. Paul Ryan’s. Have a lively exchange of views.

And then follow the summit with a statement by the president to this effect: “I said at the House Republican retreat that I welcomed constructive Republican ideas for health reform that would make a better, fairer and more effective health care system. There were several outlined today. I am going to incorporate many of them into my plan, including better malpractice reform and ways to reduce defensive medicine, more choice for empowered individuals through Health Savings Accounts and the ability for people to buy insurance across state lines — but with federal minimum standards so we do not get the race to the bottom that we experienced with credit cards. I will add more resources and leeway for Medicare to gather and provide data and measure outcomes.

“As soon as I can get such ideas translated into legislation, I will give a new, revised and scored bipartisan plan to Congress and ask Harry Reid to schedule a vote in the Senate. I will ask Republicans to support the new plan — or at minimum to allow an up-or-down vote and not engage in a united effort to filibuster the bill.”

This is, I think, the consensus expectation for Thursday's summit. But one complication: The White House has not communicated with congressional Democrats on any serious concessions. There is no secret plan for adding tort reform to the bill, or for plugging an expansion of health savings accounts into the exchanges. Any serious concessions, of course, will provoke a reaction on the Democratic side. Tort reform that really hits trial lawyers will probably lose a couple of votes. Trial lawyers are major Democratic donors, and some of them are even serving in Congress.

But none of these additions are likely to gain any Republican votes. Nor will they shut off a Republican filibuster. So if Obama tries to add these ideas just to look bipartisan, he's liable to lose more votes than he gains, and he doesn't have many votes to lose.

Photo credit: Ethan Miller/Getty.

By Ezra Klein  |  February 24, 2010; 8:04 AM ET
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I think the president will only trade on something that big if the GOP agrees not to filibuster, which I think they will not do. Those things could only happen in that event because they couldnt be done through reconciliation. I expect that he will point out where he has already incorporated GOP ideas and he may be expecting some GOP idea at the summit that he can add in, that could be done through reconciliation, but will then point out that if the GOP wants more it has to be willing to vote for the bill, because that is the only way such a bill could pass, and which they wont be willing to do. I think the president is primarily looking to convey that the only reform worth doing is comprehensive reform, that certain elements are required for that, that he has been and is willing to incorporate GOP ideas that meet that goal but that if the GOP is not willing to have comprehensive reform, then it is only Dems who understand what has to be done and, thus, the bill will have to be passed by Dem votes only.

Posted by: gregspolitics | February 24, 2010 8:33 AM | Report abuse

Dems are incompetent at git'r'done.

Here's an easy and guaranteed way to get a good health plan passed:

1. Present two plans for consideration and vote. Plan A is a plan the GOP should like, and it is modelled after the current Senate bill but includes such things as tort reform and other compromises. Plan B is a single-payer or public option plan, devised in a way to guarantee at least 51 votes in the Senate.

2. Announce that if Plan A does not win passage, Plan B will be immediately voted on in the reconciliation process.

43. Hold the vote, and follow through on the threat if Plan A fails.

With such a process, I predict enough republicans would vote for Plan A to ensure Plan B never comes up for vote.

Posted by: Lomillialor | February 24, 2010 8:43 AM | Report abuse

Agree on the over vote calculus.

Two related thoughts:

1) I was surprised you didn't post on the Pawlenty op-ed that is mentioned above. The one thing that he lays out is the clarity that he doesn't believe the American public supports a trillion-dollar expenditure to expand coverage to 30 million Americans right now. My long-standing suspicion is that Obama et al has the same fear, as he has NEVER led with coverage expansion when describing the benefits of health care reform. The order has always been 1) cost control 2) insurance reform 3) coverage expansion. It'd be interesting to see if the simple principles laid out by Pawlenty, including a rationale to not fund coverage (rather than the current game where Republicans offer plans that don't provide coverage but never address it explicitly and vice-versa) would win over the electorate over the Dem plans. My suspicion is yes.

2) Great two see you address tort reform more fairly the past few days: acknowledging both the benefits of doing so and that the core reason Democrats are opposed is due to campaign donations from trial lawyers.

Posted by: wisewon | February 24, 2010 8:59 AM | Report abuse

If the House passed the Senate bill, could it also then pass two separate riders, one with liberal tweaks to the Senate bill and another with things like tort reform and purchasing across state lines? Would that be preferable to passing one rider with all the tweaks? It seems to me that separate riders would be easier as long as Republicans agreed to let the "liberal" rider go first in the Senate so it would be apparent if they filibustered it.

Posted by: MosBen | February 24, 2010 9:05 AM | Report abuse

I still believe the House is the problem. More reporting, pretty please?

Posted by: scarlota | February 24, 2010 9:21 AM | Report abuse

Democrats original plan to regulate private insurance out of business and have a public option become the new single-payer has certainly hit its share of roadblocks and obstacles.

But why do Democrats now seem to be fretting about the simpler more achievable goal of the current legislation to simply regulate private insurance out of business.

Even with out an explicit public option, this legislation still achieves progressives' goal of eliminating middle class liberty with regard to their healthcare choices? Why all this drama?

Posted by: FastEddieO007 | February 24, 2010 9:42 AM | Report abuse

Of course the House is the problem: a simple up-or-down vote would either pass the current House bill as amended by the Senate or would clear the way for a new initiative. It's easier to catch the House flies with honey, so the Senate is smeared with a honey-pot of blame while the red-herrings of reconciliation and the filibuster help to cloud the real issues.

Only yesterday, this column was touting how much legislation had been passed by the House and awaiting action by the Senate... leaving out the one huge measure -- health care reform -- passed by a supermajority in the Senate and now languishing on the desk of the Speaker of the House. Such double-standards are to be expected... and seem to be effective at drawing attention away from the Speaker's obstructionism.

Posted by: rmgregory | February 24, 2010 9:46 AM | Report abuse

"But none of these additions are likely to gain any Republican votes. Nor will they shut off a Republican filibuster. So if Obama tries to add these ideas just to look bipartisan, he's liable to lose more votes than he gains, and he doesn't have many votes to lose."

Duh. The Dems start with compromise and move to surrender, and gain nothing. It is like they are RETARDED.

Posted by: AZProgressive | February 24, 2010 10:10 AM | Report abuse

What can Obama trade? Nothing, of course. A trade is a transaction involving at least two parties where each involved party gives something in exchange for something they receive. In this case, for a trade to happen, Obama would have to offer to modify his plan in exchange for Republican votes. Republicans will NOT vote for the health care bill no matter what Obama offers them, therefore no trade is possible.

Now, could Obama GIVE something to the Republicans in exchange for no votes? Sure, but there would have to be an incentive for him to do so.

Posted by: nisleib | February 24, 2010 10:18 AM | Report abuse

wisewon, the point that Dems tend to support positions held by trial lawyers because trial lawyers are big donors is pretty much a cliche. But that's just politics in a system where money is king. The GOP certainly has big industry donors and it's not surprising that they then take the positions favored by those donors.

What matters is to what degree you can reasonably square the support of a position with whether it is good policy. Personally, I think the total Republican opposition to something like climate change legislation is harder to square as a matter of policy than the Democrats' position on tort reform.

I think there's a 99% chance that if the Republicans propose tort reform that's more thoughtful than a simple cap on damages or some hurdle to getting a case into court at the summit tomorrow that they'll get it in exchange for ensuring votes on the bills.

Posted by: MosBen | February 24, 2010 10:30 AM | Report abuse

Ezra, your caveat on "secret plans" ignores one small item: This isn't a meeting between Obama and the Republicans. It is a meeting between Obama and the Republicans and the Democrats.

If the Democrats have any objections to any possible concessions, then they already know them from years of experience, and they must speak at this time. Everybody now puts up or shuts up, ON CAMERA. There will be no backroom dealing after this meeting. Politicians may think that is true, but their game just changed.

"Secret plans" are off-the-table. The voters will absolutely vomit.

For the American people, it's gone on long enough: everybody who cares knows everything that matters. This meeting will become the instant standard by which the voter consensus is formed (whether you are for it or against it.) Independent op-edders across the country will adopt this attitude, and say "Enough is enough!"'

That means this summit potentially has an unusual outcome: It will let politicians from chancier districts off-the-hook with their constituents -- and on this account, healthcare reform won't change the electoral outcome much, for Democrats OR Republicans. They can each say to their voters, "I gave it my best shot, but the leadership had to come to a summit -- now let's go back and fix it, or do more, or reverse it," or whatever.

On the other hand, once the summit is over, if things don't move extremely QUICKLY after this to the floor, then Obama, the Democrats, AND the Republicans may ALL be out of their jobs. Republicans can't win a public concession from this President, on torts for example, and then vote down the bill. Reconciliation is a mere insider's issue by comparison.

Ornstein has one small point wrong. The President's statement doesn't FOLLOW the summit. It should happen at the end of it, while still on camera. No more backroom discussions! You don't even need a new CBO score. It won't matter anyhow.

Posted by: Lee_A_Arnold | February 24, 2010 11:08 AM | Report abuse

The GOPers aren't going to vote for the bill no matter what is in it. They have made that clear, and the reaction to Scott Brown's vote for cloiture on the jobs bill makes it even clearer, because they are afraid of their base (unlike Dems). So all Obama can do is point out all the GOP ideas that are already in the bill, maybe add one or two minor things, and ask them if they will support the bill. They will either say no or t5emporize. But they won't agree. Obama will say ok I tried, and then the Dems need to go forward with reconciliation, with or without the sweetners. Gregspolitics @ #1 lays this out.

Posted by: Mimikatz | February 24, 2010 11:31 AM | Report abuse

"if Obama tries to add these ideas just to look bipartisan, he's liable to lose more votes than he gains"

That hardly means he wouldn't do that, if past history is any indication.

Posted by: toweypat | February 24, 2010 11:45 AM | Report abuse

So isn't this just when the republicans look for things that poll well but can't be done in reconciliation?

Posted by: spotatl | February 24, 2010 12:26 PM | Report abuse


The thoughtful right approach is to pull it out of the courts altogether. Patient compensation via a worker's comp-type administered model, coupled with federally-regulated physician oversight rather than the loosely run state medical boards today. But no more torts in medicine, just like in many European countries.

There's 0% chance that a) Republicans propose it, or b) Democrats accept it.

Tort reform may be less important than global warming, but Democrats are very clearly in the wrong on the policy merits of the topic. Torts don't belong in medicine at all from a policy perspective. You can read my comments on yesterday's post on this topic for more.

Posted by: wisewon | February 24, 2010 12:29 PM | Report abuse

I can see the President's response being more along the lines of:

"We've tried really hard to get Republican compromise. This summit proves that they are only interested in obstruction. Thus we're going to have to push this through without their support"

Posted by: zosima | February 24, 2010 3:03 PM | Report abuse

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