The Miami Herald

80 percent agreement on health care? No way that's true

WASHINGTON -- President Barack Obama has said this repeatedly: Members of Congress agree on "about 80 percent of what needs to be done" to overhaul America's health care system.

Democratic congressional leaders have echoed that claim, using it to underscore that overhauling America's health care system is within their grasp.

No one, however, can offer specifics about what that 80 percent entails, other than to say that everyone agrees on key principles. A lot of lawmakers scoff at the figure, particularly since Democrats disagree sharply on two central elements: Whether to create a government-run health-insurance plan, and how to pay for all the changes under discussion.

"I don't know what that number means. I have no idea how you'd calculate something like that," said Sen. Kent Conrad, D-N.D., a senior member of the Senate Finance Committee. On Wednesday that panel labored through another round of bill drafting. It hopes to finish its work later this week, but final congressional action on the legislation is still probably months _and lots of tense votes and debates — away.

Conrad's view has bipartisan support.

"I don't see it," said Sen. George Voinovich of Ohio, a centrist Republican whom Democrats often woo.

"Most of the 80 percent doesn't involve money," quipped Finance Committee member Sen. Orrin Hatch, R-Utah.

Nevertheless, "80 percent" has become Washington-speak for legislative progress on Obama's major 2009 domestic initiative.

Obama regularly cites the number.

"There is agreement in this chamber on about 80 percent of what needs to be done, putting us closer to the goal of reform that we have ever been," he told a joint session of Congress on Sept. 9. Eleven days later, he told CNN that "basically we've got 80 percent agreement."

White House spokesman Robert Gibbs tried Wednesday to explain what Obama meant:

"I think it represents a confluence by many involved in the health care reform debate on agreement as to how we get affordable, accessible insurance for 30 million Americans that don't have it, how we get important insurance reforms and how we cut costs for millions of Americans that are fortunate to have health insurance."

However, it was noted, no health care measure today would get 80 percent support in Congress.

"The 80 percent number wasn't to be used in any scenario," Gibbs replied.

Yet the 80 percent mantra has become Democratic gospel.

After meeting with Obama on Sept. 8, Senate Majority Leader Harry Reid, D-Nev., even went one better, declaring: "We think we're up to 90 percent of things there are agreed upon."

A few days later, House Speaker Nancy Pelosi, D-Calif., told reporters that of the bills approved so far by four congressional committees, "we're at least 80, 85 percent in harmony. We have to resolve the remaining pieces of it. That is very much within range."

Asked to clarify what those percentages mean, Reid spokesman Jim Manley said, "There is no list, but the House and Senate are getting closer to action."

Pelosi spokesman Nadeam Elshami said that the figure represents agreement among Democrats and includes accords on barring companies from rejecting people with pre-existing conditions, creating an insurance exchange or marketplace, helping lower income people get coverage, and increasing Medicare prescription drug benefits for seniors.

To be sure, lawmakers do agree on certain principles.

"They agree everyone should have access to affordable coverage and the market should be reformed," said Elizabeth Carpenter, associate policy director of the New America Foundation's Health Policy Center, a liberal research group.

Karen Ignagni, the president and chief executive officer at America's Health Insurance Plans, listed specific areas of agreement: Requiring everyone to seek coverage, increasing the safety net by providing help for lower-income people, and making changes in the insurance market.

However, Carpenter noted: "Where there's not agreement is on the choices necessary to solve the problem."

Democrats are split over whether to back the public option, a government-run insurance plan, or instead to encourage co-ops -- nonprofit consumer-run companies that would provide coverage. Most Republicans oppose both ideas.

And wide divisions still split Democrats about where to find revenue, with Republicans flatly opposed to the leading proposals. House Democratic leaders prefer imposing income tax surcharges on wealthier taxpayers, while Finance Committee Democrats are eyeing a 40 percent excise tax on high-end insurance policies.

Committee votes have rarely reflected an 80 percent majority on anything major. The House Energy and Commerce Committee approved health care legislation this summer by 31-28. The Senate Finance Committee this week rejected two efforts to include a public option, by 15-8 and 13-10.

Other flashpoints remain, notably on abortion, Medicare and other hot topics. These aren't small details; there are wide gaps on each, lawmakers concede.

Maybe that's why, when pressed, Democratic leaders edge back from the 80 percent claim. On Tuesday, House Majority Leader Steny Hoyer, D-Md., cited comments on health care recently by Republican Whip Eric Cantor of Virginia, and saw little common ground.

"It did not appear to me to leap off the page that we agree with 80 percent of what has been proposed," Hoyer concluded.

(Margaret Talev and William Douglas contributed to this article.)

ON THE WEB

Kaiser chart on health insurance costs

President Obama's Sept. 9 address to Congress

Congressional Budget Office analysis of House bill

CBO preliminary analysis of Baucus bill

Side by side comparison of health care bills

MORE FROM MCCLATCHY

Baucus unveils health plan, draws fire from all sides

In Obama setback, Senate panel rejects health care option

How much will health bill cost? Depends on what language it's in

For more McClatchy politics coverage, visit Planet Washington




© 2009 Miami Herald Media Company. All Rights Reserved.
http://www.miamiherald.com