After seven hours of debate, parties agree to disagree on whether they are close to agreement

As expected, no new consensus emerged yesterday from the seven plus hours of debate between top Congressional Democrats and Republicans and the President about what was wrong with the nation’s health care system and how to fix it. Despite the Democratic mantra that “we’re not that far apart,” what did emerge was greater clarity about exactly where the differences lie and why they cannot be bridged.

First, there is a fundamental difference between the parties on the issue of how to address problems in the health insurance industry. The proposal being advanced by President Obama and Congressional Democrats contains a strong program of insurance reform including:

  1. Eliminating pre-existing condition exclusions
  2. Setting minimum standards for coverage
  3. Requiring insurers to spend at least 80% of the premium dollars they collect on health benefits
  4. Prohibiting insurers from charging people more because they are sick (or because they are female) and limiting variation based on age
  5. Increasing the ability of state and federal regulators to block excessive and unjustified rate increases
In stark contrast, the proposals advanced by Congressional Republicans would give insurers increased ability to create pools of healthier enrollees, which would lower costs for some but would result in higher premiums for people who are older or sicker.

Anyone? Anyone?

The second major difference is on coverage. According to the Congressional Budget Office, the president’s plan would reduce the number of uninsured by more than 30 million people while the ideas offered by Republicans would insure only around three million (Community Catalyst’s latest paper explores these issues). The President might as well have been the teacher in “Ferris Bueller’s Day Off” given the deafening silence that followed when he asked if there was any way the Republicans could see themselves moving beyond the minimal coverage expansion in their plan.

At the close of the summit, President Obama offered to continue the dialog with Republicans but with the precondition that they rethink their position on these two key issues. House and Senate Republican leaders were quick to decline the invitation, leaving only one path to real reform: Democrats in Congress have to come together to pass a bill by majority vote; the sooner the better.

Moving Right Along

Over the next few days House and Senate leaders will need to consult with their members and with each other to lay out the parliamentary path forward. This “inside baseball” will have to get worked out by the House and Senate leadership and the White House. What matters most is not the sequence, but the outcome.

Keep fighting the good fight

Advocates need to continue to make the case for comprehensive reform. You can help by signing this online petition that is being sponsored by the American Cancer Society/ Cancer Action Network, Community Catalyst, and many other national organizations:

-Michael Miller, director of strategic policy