Obama might consider partisan path to health system reform

Washington -- Although President Obama pledged to pursue a bipartisan effort on health system reform legislation and to allow Americans to keep their existing health insurance coverage, members of his administration are not ruling out the possibility that the president would support proposals that go against those stances.

Peter Orszag, PhD, director of the White House Office of Management and Budget, recently has said that the Obama administration would consider backing a process called reconciliation to adopt health reform legislation. The tactic, usually reserved for deficit-reduction bills, would allow legislation to be adopted with simple majority votes in both chambers, instead of the 60 votes needed in the Senate to end debate on a measure. The controversial process was used by Republicans to adopt tax cuts in 2001 and 2003.

Orszag most recently stated the White House's position while speaking with reporters March 21. "We think it's premature to be taking [reconciliation] off the table," he said. Sen. Max Baucus (D, Mont.), chair of the Senate Finance Committee, also has kept open the option of using reconciliation on comprehensive health legislation. Republicans warn, however, that the tactic could have the effect of erasing any goodwill Obama has with the minority party in Congress.

Orszag and other administration officials also left open the possibility that Obama would support changing or reducing the tax exclusion for employer-sponsored health insurance benefits. Such a move could raise billions for expanding health coverage to the nation's 46 million uninsured at a time when the administration is facing trillions in budget deficits.

Obama campaigned against taxing insurance benefits, a key part of Sen. John McCain's (R, Ariz.) presidential campaign platform. Obama still does not support the concept, but "he will listen to good ideas," said Christina Romer, PhD, chair of the White House Council of Economic Advisors, speaking on NBC's "Meet the Press" March 15. Orszag was more direct, telling Senate Finance Committee members on March 10 that taxing insurance benefits "should remain on the table." Baucus also supports examining the tax exclusion issue.