Obama releases $1 trillion health care bill

UPDATED:

The White House on Monday released a nearly $1 trillion health care overhaul bill that will block extreme insurance premium increases in a new, likely last attempt to revive President Obama’s top reform priority on Capitol Hill.

The bill, largely modeled on the legislation that passed the Senate on Christmas Eve, was written so that it can pass Congress by traditional means or pushed through the Senate under “reconciliation,” a complicated procedural tool that circumvents a filibuster by the Republican minority.

The bill’s release comes four days ahead of Mr. Obama’s bipartisan, televised health care reform summit, where Republicans had hoped to restart the health care bill negotiations from scratch or suggested they would oppose Mr. Obama’s plan. But the White House dismissed that notion on Monday, arguing that too much work already has been done.

“The president believes we’ve done a lot of very good work on health reform over the last year, and starting from scratch doesn’t make sense,” White House Communications Director Dan Pfeiffer said. “However, we are coming to this meeting with an open mind to additional ideas, and we hope the Republicans will do the same.”

Almost immediately after the White House made public Mr. Obama’s preferred plan, Republicans were dismissing the bill as nothing more than what congressional Democrats tried to pass before.

“The president has crippled the credibility of this weeks summit by proposing the same massive government takeover of health care, based on a partisan bill the American people have already rejected,” House Minority Leader John A. Boehner, Ohio Republican, said. “This new Democrats-only backroom deal doubles down on the same failed approach that will drive up premiums, destroy jobs, raise taxes and slash Medicare benefits.”

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House Speaker Nancy Pelosi, California Democrat, said the plan includes “positive elements” from the House and Senate bills, but she did not immediately endorse the Obama plan.

“I look forward to reviewing it with House members and then joining the president and the Republican leadership at the Blair House meeting on Thursday,” she said in a statement.

White House officials said they believe the approximately $1 trillion, 10-year plan will be fully paid for and say they are ready to make tweaks if the Congressional Budget Office — the nonpartisan budget monitor — says otherwise.

Mr. Pfeiffer called the legislation, posted on whitehouse.gov Monday morning, “the opening bid of the health meeting” and challenged Republicans to post their own bill online. A year ago, Mr. Obama said he wanted to leave the details of the health plan up to Congress. But the effort stalled last month with Republican Scott Brown’s surprise win in a Massachusetts special Senate election, stripping Democrats of their 60th vote in the Senate and sending the health bill to Congress’ back burner.

Mr. Pfeiffer said the president’s bill was “informed” by the House-Senate negotiations that took place up until Mr. Brown’s election. The two chambers were trying to reconcile two very different versions of the bill when Mr. Brown’s victory upset their calculations.

The legislation addresses a number of concerns Democrats had with the two bills — it eliminates special funding for Nebraska’s Medicaid expansion, dubbed the “Cornhusker kickback,” in favor of more funding for all states, for instance. The original provision was added to woo centrist Democratic Sen. Ben Nelson of Nebraska, but Mr. Nelson said later he was merely hoping to get more funding for all states and not a special benefit for Nebraska.

The plan includes more generous tax subsidies than the Senate’s bill originally had. It also reduces the Senate’s tax on high-cost insurance plans, a proposal that faced harsh criticism from House Democrats and labor unions. Some of the lost revenue will come from a new Medicare payroll tax on non-wage income from the nation’s top earners.

The federal government would be able to block or reduce extreme insurance premium hikes under the new plan. Mr. Obama has criticized insurance companies for unfairly springing massive price increases on customers — such as Anthem Blue Cross’s recent announcement that premiums could go up 39 percent for California policyholders.

The legislation also would require all Americans to carry health insurance, with exceptions for the poor and help in the form of tax break for the middle class. It would set up state-based insurance exchanges from which consumers would purchase their coverage.

As was the case in both the House and Senate bills, the White House legislation also would ban insurance company practices such as denying customers for pre-existing conditions.

• Kara Rowland contributed to this report.