Obama, Democrats to ponder next healthcare moves

After a seven-hour healthcare summit that did little to change Republican hearts and minds, president Barack Obama and congressional Democrats face a challenge on Friday in deciding their next moves to reform the costly US system.

Obama ended Thursday's summit with an appeal for Republicans and Democrats to consider whether they could resolve some of their differences over healthcare reform in the next six weeks, but Republicans called that time frame unreasonable.  

"It's not going to be possible with that kind of an approach to come together within the time frame that he indicated," said senate Republican Whip Jon Kyl, flanked by fellow Republican leaders as he spoke to reporters outside the White House.  

That leaves the White House and congressional Democrats in the difficult position of deciding whether to try to force a reform of the $2.5 trillion US healthcare system through Congress with a little-used parliamentary maneuver that would allow approval by a simple majority vote.                                           

Republicans have condemned any such move, but Obama suggested at the end of the healthcare summit the Democrats might have to consider it.

"We cannot have another yearlong debate about this," the president said. "Is there enough serious effort that in a month's time or a few weeks' time or six weeks' time we could actually resolve something?"                                           

"If we can't, then I think we''ve got to go ahead and make some decisions," he added, saying the voters could then pass judgment in November on the differing Republican and Democratic visions for the country.                                                                                   

FUNDAMENTAL DIFFERENCES                                           
Leaders of the two parties clashed frequently during the summit, with Democrats pushing their ideas for a sweeping reform of US healthcare, which now consumes some 16% of the economy while still leaving 48 million people uninsured with little access to regular care.                                           

While Obama argues sweeping reform is necessary to the long-term health of the economy, Republicans sharply disagree with the size and scope of the plan.

"There are some fundamental differences between us that we cannot paper over," Kyl, the No. 2 Senate Republican, told Obama, adding his plan gave Washington too much power over the health system and took it away from patients and doctors.

"We do not agree about the fundamental question of who should be in charge," Kyl said.

Obama had hoped the daylong summit at Blair House, the presidential guest house across the street from the White House, would revive momentum in Congress for his faltering attempt to make healthcare more affordable and extend coverage to tens of millions of uninsured Americans.                                           

But at the end of the day, both sides seemed disheartened by the result. Obama admitted it might not be possible to bridge the differences, but said, "I thought it was worthwhile for us to make this effort."                                           

Republican Senate leader Mitch McConnell said he was discouraged and thought it was clear Democrats planned to ram through a version of the Senate-passed healthcare plan.  

'TIME TO DO SOMETHING'                                           
Senate Democratic leader Harry Reid seemed to reinforce that view, telling reporters, "It is time to do something and we are going to do it."

Democrats in the Senate and House of Representatives passed healthcare reform bills last year that would reshape the industry by cutting costs, regulating insurers and expanding coverage to tens of millions of Americans.                                           

But efforts to merge the different measures and send a final version to Obama collapsed in January after Democrats lost their crucial 60th vote in a special US Senate election in Massachusetts. Sixty votes are needed in the 100-member chamber to clear procedural hurdles by the opposition.

Without the 60th vote, Democrats may either have to scale back their plan enough to get Republican support or attempt a seldom-used tactic known as reconciliation to win Senate passage of legislation with a simple majority vote.

McConnell and other Republicans condemned any Democratic effort to pass the bill by reconciliation. Reid defended the procedure and noted Republicans had used it before "for major things" like tax cuts and reform of Medicare, the federal health program for the elderly.                                           

But many Democrats fear reconciliation would spark a costly political backlash heading into congressional elections in November that could erase Democratic majorities in Congress.

"You can say that this process has been used before, and that would be right. But it's never been used for anything like this," Republican senator Lamar Alexander told the summit.