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Obama offers to include GOP ideas in health bill

WASHINGTON – President Barack Obama offered Tuesday to include four Republican initiatives in his health care bill, but GOP leaders were unenthusiastic as Democrats prepared a last big push to get legislation passed.

Obama is expected to signal today how he wants Congress to proceed. By telling Republicans he wants to incorporate some of their suggestions, Obama can argue that the Democrats' approach is bipartisan regardless of whether any Republicans vote for it in the end – and few if any were signaling Tuesday that they're inclined to do that.

The Republican ideas Obama said he's considering – ideas that GOP leaders offered at last week's bipartisan health care summit – include conducting undercover investigations of health care providers that receive Medicare and Medicaid reimbursements.

Another would provide $50 million to states to pursue alternatives to medical malpractice litigation, a major Republican initiative.

Obama reiterated Tuesday that he wants a comprehensive health reform bill, not a series of incremental steps. "Piecemeal reform is not the best way" to make coverage more affordable, he said.

Congressional Democratic leaders agree, and are seriously considering using the controversial "reconciliation" process to get the bill through Congress by the end of this month. It was unclear whether Obama would recommend that approach today.

Reconciliation is a way to expedite Senate passage of legislation with 51 votes instead of the 60 usually required to shut off debate. Democrats now control 59 seats in the 100-member Senate.

Under one popular scenario being seriously discussed by Democratic leaders, the House of Representatives would pass the health care bill that the Senate adopted Dec. 24. A simple House majority, which next week would be 216 votes, would be needed to pass. Democrats control 254 of the 431 filled seats; four seats will be vacant.

In addition, both houses would take up separate reconciliation legislation that would make changes to the Senate bill sought by Obama and House Democrats. That bill also would require only simple majorities in both chambers to pass.

However, that process could create political problems.

It would require the House to vote on an $871 billion Senate bill that includes ideas many Democrats dislike, notably the lack of any government-run program, or public option. The House-passed version had a public option.

The Senate version also contains somewhat less restrictive abortion language. About 20 House Democrats are adamant that any bill contain strict limits.

The other political problem concerns how Democratic lawmakers, especially those from more conservative states and congressional districts, would explain to constituents why they voted for a process that Republicans say is simply "ramming the bill through Congress."

"I don't prefer reconciliation," said Sen. Joe Lieberman, I-Conn. "This is so big a change that affects every American. This ought to be bipartisan."

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