White House mulling limits on scope of proposed health overhaul

The Wall Street Journal: "The White House, with its health-care initiative in doubt, on Sunday zeroed in on several elements it hoped would survive, including measures to extend the life of Medicare, lower prescription drug costs for seniors and cap consumers' out-of-pocket medical expenses." Obama advisor David Axelrod raised the examples of cuts to health providers to extend Medicare's solvency beyond 2017, tax breaks for small businesses offering insurance, the closing of the Medicare prescription "doughnut hole" and protections for people with pre-existing conditions. "White House officials notably didn't emphasize that any revised legislation should include a major expansion of health insurance" (Adamy, 1/24).

The Los Angeles Times notes that, speaking on the ABC's "This Week," Axelrod said "The president will not walk away from the American people, will not hand them over to the tender mercies of health insurance companies who take advantage." Axelrod's remarks "echoed strategy laid out by Obama's 2008 campaign manager, David Plouffe, in an opinion article Sunday as the administration took steps to save major healthcare legislation." Senate Minority Leader Mitch McConnell, meanwhile, said President Obama should "start over" on health reform. And with Republican Scott  Brown's Massachusetts' Senate seat victory, "Democrats appear to have little flexibility to push through their legislation. Either the House passes the Senate bill intact, or at least one Senate Republican would have to cross party lines to support a compromise between the versions that passed each chamber" (Puzzanghera, 1/25).

One provision that may attract support from some Republicans is a change allowing insurance companies to sell policies across state lines, a practice that is now forbidden, NPR reports. But, that plan could find resistance at the state level and from Democrats. Rep. Jackie Speier, D-Calif., said, "California laws have managed to reign in the insurance industry and protect consumers. And she's unswayed by explicit language in the congressional designed to uphold those standards" (Varney, 1/24).

Related earlier KHN story: The Debate Over Selling Insurance Across State Lines (Galewitz, 11/8)