For Democrats The Time For Health Care Talk Is Over

Seven hours of sometimes combative, often wonky health care conversation left President Obama and other Democratic leaders with no more Republican support for health reform than they started with. But it did produce one thing: A consensus that there really isn't any point in talking anymore.

Obama held court with congressional leaders all day Thursday, addressing topics including tort reform, cost controls, the need for an individual mandate, and the dangers of incremental reform. But with Republican leaders continuing to express unanimous disapproval of the Democratic proposal, even before the summit was over talk shifted to what the party now has to do if it wanted legislation passed.

"I don't know, frankly, whether we can close that gap [between the parties]," Obama said in his closing remarks. "And if we can't close that gap, then I suspect Mitch McConnell and Harry Reid and Nancy Pelosi and John Boehner are going to have a lot of arguments about procedures in Congress about moving forward."

On Capitol Hill, aides have long been exploring how much they can do using the parliamentary maneuver known as reconciliation, which precludes filibusters and therefore requires only a simple majority vote. Unofficial whip counts determining which Democratic Senators would support the process have been taken.

All of it was supposed to be hush-hush, for fear that it would trample on the overriding message of bipartisan summitry. But few sober-minded observers of the health care reform process had held out hope that even a masterful performance by Obama would sway even one Republican vote.

So at the summit itself, the prospect of reconciliation often took center stage, with a host of GOP lawmakers declaring it a massive assault on the U.S. Constitution, and Democrats responding by pointing to its frequent past use.

The differences between the two political parties -- as even Obama finally admitted -- simply are too vast for the Democrats to pass reform any other way. In his most explicit endorsement of the reconciliation process yet, Obama responded to a question from former presidential campaign rival Sen. John McCain (R-Ariz.) by saying: "I think the American people aren't always all that interested in procedures inside the Senate. I do think that they want a vote on how we're going to move this forward, and I think that most Americans think that a majority vote makes sense."

The most memorable portions of Thursday's summit involved sparks flying between the president and his Republican critics over health care reform issues both substantive and superficial.

  • McCain went through a litany of problems he had with the crafting of the bill -- from the backroom deals to the lack of CSPAN cameras -- only to be shot down by the president, who chided him for regurgitating stale talking points. "[W]e are not campaigning anymore," Obama said.
  • Minority Leader John Boehner (R-Ohio), in the midst of a fairly serious discussion on deficit reduction, trotted out every GOP scare story about the bill, leading a clearly irritated Obama to scold him like an unruly child.
  • No matter how many times Obama pointed out that there are significant areas of overlap between his plan and the Republican Party's proposals, his opponents continued to express strong disagreement over such things as the government's role in expanding coverage (Obama's plan would cover 30 million uninsured, the Republicans would cover three million) or the design of insurance market reforms (Obama would prohibit discrimination against pre-existing conditions, Republicans would not), or the length of the bill.

    Democrats forcefully resisted the Republican's main proposal -- which was to start over from scratch.

    "Starting over in my mind is code for delay and obstruction," David Axelrod, the president's senior adviser, told CNN.

    And so, by summit's end, nothing was resolved and everything was resolved. Reconciliation seems the only immediate path forward even if it continues to make some lawmakers skittish.

    "If nothing comes of this we're going to press forward," Sen. Dick Durbin (D-Ill) told reporters midway through the summit. "We just can't quit. This is a once in a political lifetime opportunity to deal with a health care system that is really unsustainable."

    "Does reconciliation start tomorrow?" one journalist asked.

    "I wouldn't go that far," Durbin replied. "We will sit down in leadership and if we have some helpful Republicans, this could be an easy assignment. But if not, it could be a little harder."

    "George Bush did it five times," declared former Democratic National Committee Chair Howard Dean, in a short interview with the Huffington Post. "I agree [that this is the only path forward]," he added.