WASHINGTON — In a final effort to achieve historic health care changes, President Barack Obama unveiled his most detailed plan yet on Monday. Realistically, he's just hoping to win a big enough slice to silence the talk of a failing presidency.
The 10-year, nearly $1 trillion plan, like the current Democratic version in the Senate, would bring health insurance to more than 31 million who now lack it. Government insurance wouldn't be included, a problem for Democratic progressives. Republicans are skeptical about where the money would come from — and about Obama's claim that the plan wouldn't raise the federal deficit.
Striking out in one fresh direction that should have wide appeal, Obama would give federal regulators new powers over the insurance industry, a reaction to a rash of double-digit premium hikes that have infuriated policy holders in California and other states.
The plan is supposed to be the starting point for Obama's televised, bipartisan health care summit Thursday — a new beginning after a year of wrangling and letting Congress take the lead. Yet Republicans were quick to dismiss it as a meld of two Democratic bills the public doesn't want. Democrats, while reaffirming their commitment to major changes, reacted cautiously, mindful that Obama is asking them to stake their political fortunes in the fall elections.
In the end, Americans who have listened to a year of talk about big changes in their health care, may see much smaller changes, if any. The president is likely to have to settle for much less than he wants — small-bore legislation that would smooth the rough edges of today's system but stop well short of coverage for nearly everyone.
Still, any kind of win on health care would be good for Obama right now. For a president, victory often begets victory, defeat spawns defeat. A modest achievement would allow Obama to move on to other pressing issues, claiming credit for getting something done despite the harshest partisan environment in years.
White House spokesman Dan Pfeiffer called the proposal "an opening bid" for Thursday's summit. "One thing I want to be very clear about is that the president expects and believes the American people deserve an up-or-down vote on health reform," he said.
Liberal Rep. Anthony Weiner, D-N.Y., one of the rank-and-file lawmakers who would have to close ranks to pass Obama's proposal, questioned what's left in it for him after the president dumped a government insurance option sought by progressives.
"For many of us, the House bill represented a series of difficult compromises, and if the president is going to ask us to compromise further to go toward the Senate, I have to ask who's vote we're getting," he said.
That means the plan is unlikely to pass without an all-out effort by Obama to muster votes from anxious Democrats. "I think all of us are going to have to sell this," said Rep. James Clyburn, D-S.C., the third-ranking House Democrat. "The devil is in the details."