Something New On Health Care: Deal-Breakers From The President

This time, the President is going to be specific. Next week, President Obama is going to give Democrats a health care plan they can begin to sell.

He plans to list specific goals that any health insurance reform plan that arrives at his desk must achieve, according to Democratic strategists familiar with the plan. Some of these "goals" have already been agreed to, including new anti-discrimination restrictions on insurance companies. Others will be new, including the level of subsidies he expects to give the uninsured so they can buy into the system.


Obama will also specify a "pay for" mechanism he prefers, and will specify an income level below which he does not want to see taxed.

He will insist upon a mechanism to cut costs and increase competition among insurance companies -- and perhaps will even specify a percentage rate -- and he will say that his preferred mechanism remains a government-subsidized public health insurance option, but he will remain agnostic about whether the plan must include a robust public option. Officials won't say whether the president intends to endorse a specific "trigger" mechanism if the competition mechanism fails, but they say he will make it clear that the final bill must contain language that increases competition.

Though officials would not provide the numbers Obama plans to use, they say that the goal is to give his side -- Democrats -- a true presidential plan that they can sell. That includes the rebranding of several consensus initiatives, like the insurance reforms, as his own. The effect of this sales job, if it works, will be to associate the president with parts of the reform bills that are almost certainly likely to pass -- assuming the Senate doesn't bog down.

The White House hopes the specifics will be specific enough to gradually soothe the concerns of the Democratic caucus. The budget reconciliation process remains a cudgel -- it's still the weapon of last resort, and President Obama has told his advisers that he does not want to ask Congress to use the mechanism until it becomes necessary, politically -- that is, until the public understands that the popular elements of reform will not pass without using it.