Obama health care planProposal includes 'Republican ideas'; faces uncertain future

The White House released its latest plan for health care reform Monday but a key element is missing. The plan, put together by the Obama administration with help from Democratic leadership, offers a health care exchange but contains no public option.

Republican leaders have called on Democrats to scrap current health care reform plans and start from scratch ahead of a summit scheduled for later this week. By releasing the Democratic plan on its website Monday morning, the White House seems to have rejected the GOP demand.

The Washington Post reports, "The plan, which went live on the White House Web site at 10 a.m., rejects repeated calls from Republicans to scrap Democratic efforts from last year and start over. Instead, it attempts to merge the Senate legislation with its counterpart in the House in ways that would address some of the most controversial provisions in the stalled bill."

Among the changes Obama seeks is a delay of the tax on high-end insurance plans until 2018, an end to the special Medicaid deal that negotiators had cut for Nebraska Sen. Ben Nelson (D) and new federal authority over health care insurance rate increases. The plan does not call for a public option health plan despite pressure from progressives in Obama's Democratic party to do so.

Senior White House officials said the 11-page summary of the changes, labeled "The President's Proposal," would serve as the starting point for the bipartisan, televised health care summit to be held on Thursday. They urged Republicans to come together around their own proposal and make it public.

The Associated Press notes that the "nearly $1 trillion, 10-year compromise that would allow the government to deny or roll back egregious insurance premium increases that infuriated consumers."

"Even with the latest changes, it's highly uncertain such an ambitious proposal can get through Congress," the AP article continues. "Republicans are virtually all opposed, and some Democrats who last year supported sweeping health care changes are having second thoughts in an election year. After a year in pursuit of what was once his top domestic priority, Obama may have to settle for a modest fallback."

The White House website states, "Over the past year the House and the Senate have been working on an effort to provide health insurance reform that lowers costs, guarantees choices, and enhances quality health care for all Americans. Building on that year-long effort, the President has now put forth a proposal that incorporates the work the House and the Senate have done and adds additional ideas from Republican members of Congress. The President has long said he is open to any good ideas for reforming our health care system, and he looks forward to discussing ideas for further improvements from Republicans and Democrats at an open, bipartisan meeting on Thursday."

"The President’s Proposal builds off of the legislation that passed the Senate and improves on it by bridging key differences between the House and the Senate as well as by incorporating Republican provisions that strengthen the proposal," the White House website adds.

A separate link notes the "the new Republican initiatives included in the President’s Proposal."

"In addition to the Republican ideas already included in the legislation that’s passed the House and the Senate, the President’s Proposal incorporates a number of additional proposals that were included in Republican plans that focus on combating waste, fraud and abuse in government," the site states. "The President remains open to other policies as well. And the purpose of the Bipartisan Summit is to review all ideas and ensure that the best ideas are included in the plan."

Think Progress has a table which shows how the "Obama plan compares to the House and Senate proposals."

"But it’s unclear if progressive House members will embrace the new compromise," Igor Volsky writes for Think Progress. "While the bill addresses House members’ affordability concerns, increases the excise tax thresholds and completely closes the donut hole in Medicare Part D, the legislation does not include a public option, retains the Senate bill’s state-based exchanges and keeps the start date for most reforms at 2014. (Obama’s plan also retains the Senate’s abortion compromise and most other core provisions)."

At Huffington Post, Ryan Grim complains about how "Obama is entirely silent" on the public option.

Last week, Health and Human Services Secretary Kathleen Sebelius told MSNBC's Rachel Maddow that Obama would "absolutely" fight for a public option if Senate leadership decided to go for it. "[I]f it's part of the decision of leadership to move forward, absolutely," Sebelius said. "The president said from the outset he thought that was a great way to provide cost reduction and competition moving forward, but if that is not the choice of the majority moving forward, I think there are other ways to get there."

Since then, Senate Majority Leader Harry Reid (D-Nev.) said he would work with his colleagues to find the votes needed for it; Sen. Charles Schumer (N.Y.), the third ranking Democrat, pushed for it to be included; and Sen. Bob Menendez (N.J.), chairman of the Democratic Senatorial Campaign Committee, joined in the call. (Follow the ongoing push for the public option here.)

It wasn't enough to persuade Obama to get behind the immensely popular issue. After months of watching Obama say generally that he supports the public option, while doing little to see it implemented into law, backers of the idea were unsurprised it was left out of his final offer.

"We didn't expect one," said Darcy Burner, head of the Progressive Caucus Policy Foundation.