WASHINGTON - President Barack Obama made a last-ditch effort Monday to save his signature issue, an overhaul of the U.S. health care system, putting forward a nearly $1 trillion, 10-year compromise plan.
Posted Monday morning on the White House Web site, the plan would provide coverage to more than 31 million Americans now uninsured without adding to the federal deficit. It comes just four days before Obama's one-of-a-kind, televised health care summit with Democrats and Republicans.
Even with the latest changes, it's highly uncertain such an ambitious proposal can get through Congress. Republicans are virtually all opposed, and some Democrats who last year supported sweeping health care changes are having second thoughts ahead of November elections. After a year in pursuit of what was once his top domestic priority, Obama may have to settle for a modest fallback.
The plan is Obama's most detailed proposal since he took up the health care overhaul effort a year ago. At the time, he sought to avoid the problems former President Bill Clinton encountered when he issued Congress a detailed prescription in the 1990s, a plan that failed and contributed to the Democrats lost of Congress in 1994. Now Obama is being criticized for having been too deferential to lawmakers.
Weeks ago, the president and congressional Democrats were on the verge of a long-sought remake of the country's health care system after a half-century of unsuccessful attempts by scores of politicians. But in January, Democrats lost a key seat in the Senate that had allowed them to bypass Republican stalling tactics.
Determined to avoid facing voters empty-handed, Obama offered a fresh proposal based on Democratic-passed bills.
The president's plan includes a provision to allow the government to deny or roll back egregious increases that infuriate consumers, an idea is bound to resonate with Americans fed up with insurance companies. It also puts Republican lawmakers who oppose the new plan at risk of appearing to favour big business over the constituents who will be voting in November congressional elections.
House Republican Leader John Boehner dismissed the proposal Monday, saying, "the president has crippled the credibility of this week's summit by proposing the same massive government takeover of health care based on a partisan bill the American people have already rejected."
Senate Republican Leader Mitch McConnell said it was "disappointing that Democrats in Washington either aren't listening, or are completely ignoring what Americans across the country have been saying."
The plan conspicuously omits a government insurance plan sought by liberals and viewed as a non-starter by conservatives and some congressional moderates. It includes Senate-passed restrictions on federal funding for abortion adamantly opposed by abortion foes as well as abortion rights supporters.
Obama, who deferred to Congress on the specifics for more than a year, has finally put forward a detailed plan of his own. By and large, it follows the bill passed by Senate Democrats on Christmas Eve, with changes intended to make it acceptable to their House counterparts.
It would require most Americans to carry health insurance coverage, with federal subsidies to help many afford the premiums. Insurance companies would be barred from denying coverage to people with medical problems or charging them more.
Like the Senate bill, in Obama's plan regulators would create a competitive marketplace for small businesses and people buying their own coverage.
Estimated to cost about $1 trillion over 10 years, Obama's plan would be paid for by a mix of tax increases, new fees on health care industries and cost cutting in an existing government health care program for the elderly.
The new proposal comes just ahead of a White House health care summit Thursday with congressional leaders of both parties. The summit at Blair House, the White House guest residence, will be televised live on cable channel C-SPAN's unedited TV feed and perhaps on cable news networks.
White House spokesman Dan Pfeiffer said the plan released Monday is an "opening bid" going into Thursday's summit. It would cover more Americans - but also includes a new tax on investment income that Republicans object to.
"The president is coming into the meeting with an open mind," said Pfeiffer. "If the Republicans do, too, our hope is that we can find some areas of agreement."