The President has invited Congressional leaders to the Blair House ten days from now to discuss health care reform. While the press has labeled it a summit, it has much more the feel of a televised debate, a kabuki dance played out for the cameras.

I am having difficulty understanding what the President is trying to accomplish with this meeting. Four possibilities are:

  1. If he thinks a Democrat-only deal is possible, then they’ll need to use the reconciliation process to try to pass a bill without Republican help. If the President can portray Congressional Republicans as uncooperative, he may be able to mitigate anticipated Republican process complaints from implementing a partisan two bill strategy. “I tried to work with Republicans, but they wouldn’t work with me. They left us no alternative but to use reconciliation to pass a new bill through the House and Senate on a majority vote.”
    • If this is the primary purpose, then the meeting is not about the substance, but instead about Democrats trying to make Republicans look unreasonable to influence press coverage and public opinion, and to calm Congressional Democrats as they embark on a risky partisan legislative path. This is a cynical view of a potentially important meeting.
  2. If he thinks no Democrat-only bill is possible, and if he thinks no Republicans can be brought around to support a bill, then he may be looking to set up Republicans as the fall guy for his exit strategy. Liberals will be furious if the President, Speaker Pelosi, and Leader Reid abandon their efforts to pass legislation. If he can somehow shift the blame to Congressional Republicans, then at least he gets an election-year benefit from legislative failure.
    • I don’t think this works because everyone knows that two Democrat-only legislative options exist: (1) the House could in theory pass the Senate-passed bill, or (2) the two bill strategy can be implemented using the reconciliation process. If the Democratic votes are there, either option works procedurally, even in the face of unanimous Republican opposition. If he cannot pass a Democrat-only bill through the Congress, it would again be because he could not hold 218 House Democrats and 50 (+VP) of 59 Senate Democrats. This procedural reality makes it hard to credibly blame Republicans for not getting a signed law.
  3. He may want to begin legislative negotiations with Congressional Republicans.
    • If this is his goal he is going about it all wrong. The invitation letter sets up a structure of confrontation and nowhere mentions bipartisanship, inclusion, or compromise. The tone of the letter is horrible. It reads like an invitation to a televised debate rather than an attempt to find common ground. In parallel to the meeting, Speaker Pelosi and Leader Reid continue to work behind closed doors to build a Democrat-only substantive compromise and procedural path, causing key Congressional Republicans to suspect the Blair House meeting is either meaningless or a trap. Leader Reid scuttled a bipartisan Baucus-Grassley “jobs” bill compromise late last week, further undermining any remaining Republicans who might try for a compromise. If the President hopes in this meeting to foster bipartisanship on health care reform, he is setting himself up for failure.
    • Yes, this perspective is skewed based on my partisan affiliation and policy views. Even if you believe the lack of bipartisan progress so far is entirely the fault of Congressional Republicans, that does not change the reality that Republicans are approaching this meeting convinced that it is a confrontation or a trap. Whomever you choose to blame for that, the setup of the meeting discourages anyone in either party who might be interested in building bipartisanship. I see almost no possibility that bipartisan progress results from this debate.
  4. He didn’t have a specific game plan when he announced the invitation, but he knows he performed extremely well when he sparred on camera with House Republicans a few weeks ago. He is recreating a similar environment, one even more favorable to his strengths. Whatever his goal, he knows that a partisan conflict in this environment will likely play in his favor on camera.
    • This seems like the most reasonable explanation.

The President’s new proposal

The invitation letter from White House Chief of Staff Rahm Emanuel and HHS Secretary Kathleen Sebelius says the President will “post online the text of a proposed health insurance reform package.” House and Senate Democratic leaders have so far been unable to negotiate a compromise. What will the President propose?

  • If there is a Pelosi-Reid-Obama substantive deal by the 25th, then it’s easy and ideal from the President’s standpoint. He can tell the Republicans, “Here’s the deal. I’ll tweak it for you to get your support. Otherwise we’ll pass it with only Democratic votes using reconciliation.” Democrats have so far been unable to close such a deal and round up 218 + 50 votes for it. I’ll give them a 3-5% chance of success before the 25th. It should be lower, but I think they deserve some credit for bull-headed perseverance.
  • If there is not a Pelosi-Reid-Obama agreement by the 25th, then what will the President propose?
    1. Something midway between the House-passed and Senate-passed bills? If so, then Republicans can just reject it (easy for them, since they opposed both endpoints of that negotiation) and turn the focus back to disagreements between Pelosi and Reid. In the meeting Republicans could ask Congressional Democrats if they support the President’s new proposal and if they have the votes for it, and likely watch it break down in intra-party squabbling.
    2. The President could make concessions to Republicans in his proposal, even if they are only token concessions. In doing so he would risk angering Speaker Pelosi and Leader Reid, whose help he needs to pass a bill.

I am perplexed by the Emanuel/Sebelius commitment. The letter also challenges Congressional Republicans to offer their own proposal. Again, this makes sense if Team Obama is looking to embarrass Congressional Republicans for not having a unified substantive proposal transparently available to the public. I struggle to think of another context in which this idea makes sense for the President.

What should Republicans do?

I think that good policy is also good politics for Republicans. Even if they take the most cynical view of the Blair House meeting, I recommend they take the invitation at face value and attempt to participate constructively.

  • Show up as invited.
  • Focus your public comments on substance more than process. Republican leaders are spending too much time on a “start over” message. I would instead talk about why you oppose the House-passed and Senate-passed bills, and how you are open to any legislative process and solution that addresses those problems. Since the policy problems are core to the bill, you achieve the same effect, but you will be getting your substantive message out rather than looking like you’re bickering over process.
    • The bills create a nearly trillion dollar entitlement program when we know that entitlement spending drives our long-term budget problem.
    • The bills slow the growth of Medicare spending (a good thing) but then turn around and respend that money on a new spending program (bad).
    • Health insurance would essentially become a governmental function, even without a public option.
    • More decisions about the costs and benefits of various medical procedures and treatments would be pushed away from individuals and toward government officials.
    • National health spending would increase. Health premiums would increase for most who have employer-based health insurance today. The cost control measures, weak as they were, have been further watered down to the point of irrelevance.
    • The bills are filled with targeted benefits and carve-outs: especially the Nebraska and Louisiana Medicaid deals, exempting unions from the Cadillac tax, and carve-outs for certain Blue Cross / Blue Shield plans.
  • Offer a wide range of substantive health policy changes (to current law, not to the bill), but do not feel obliged to have a single unified Republican proposal. It’s critical that Republicans step up and offer policy solutions, but they don’t have to be afraid of admitting that they are not unified as a party on those solutions. Different Members can push for different reforms: talk about medical liability reform, buying insurance across state lines, replacing the current law tax exclusion with a deduction or a credit, high risk pools, association health plans, health savings accounts and high deductible health plans. Republicans need to be aggressive in pushing positive policy ideas for health policy reform, even if they disagree amongst themselves. Embrace the differing views within the big tent, and use those differences to make your argument for an open amendment process.
  • Hammer home that this should have been a legislative debate and process among multiple options, rather than a take-it-or-leave-it or option A vs. option B exercise.
  • Aggressively push back on anyone who suggests this is “reform vs. status quo.” And push back on anyone who insists that reform must be all-or-nothing.
  • When in doubt, shift the camera’s focus to your disagreements with Congressional Democrats, who will be a far easier opponent in a public snowball fight than the President.

When he announced this invitation the evening of the Super Bowl, the President bought himself nearly three weeks of breathing room. If the meeting fulfills my pessimistic expectations, I would expect a lot of partisan finger-pointing in the days following. Team Obama, Speaker Pelosi, and Leader Reid will then be back in the hot seat as they struggle to answer the question, “OK, so what are you going to do?”

(photo credit: No room at the inn by afagen)