terça-feira, 23 de fevereiro de 2010

Reforma da Saúde: Barack lança jogada de risco e faz nova insistência no Senado

Mesmo depois da perda da supermaioria no Senado, com a derrota de Martha Coakley no Massachussets, Obama não desiste da Reforma da Saúde e fará, nos próximos dias, uma nova tentativa de conseguir uma aprovação bipartidária de um texto único que resulte das duas propostas já aprovadas no Congresso (a primeira na Câmara dos Representantes, a segunda, mais modesta, no Senado).

É uma jogada de alto risco, porque falta, pelo menos, um voto para chegar aos 60 que evitem um filibuster de bloqueio. Mas convé lembrar que os republicanos ainda estão em clara minoria no Congresso -- e esta será uma grande prova sobre se existe ainda uma réstia de vontade de cooperação por parte do GOP...

«WASHINGTON—President Barack Obama is upping the ante on health care.

In a last-ditch effort to salvage his overhaul of the sector, the president unveiled a $950 billion plan that lays the groundwork for his party to try pushing its legislation through Congress without Republican support.

Mr. Obama's plan, released ahead of a televised health summit with congressional leaders Thursday, didn't include any additional nods to Republican ideas. Republican leaders denounced it, suggesting that the summit is unlikely to lead to bipartisan breakthroughs. White House aides said the president was prepared to incorporate Republican ideas into the framework set by the Democratic bill, almost daring Republicans to remain opposed.

The proposal is an attempt to jump-start one of the President's top priorities, which has been nearly paralyzed since Democrats lost their 60-seat supermajority in the Senate on Jan. 19.

The chances of reconciliation succeeding remain iffy. House Democrats passed their version of a health overhaul in November by a narrow 220-215 margin, and some of the yes votes are uncertain now that some House lawmakers don't like aspects of the Senate bill. Democrats have more breathing room in the Senate but the procedure carries political risks and Republicans could use delaying tactics.

White House aides said the proposal keeps the best features of the Senate bill, while making insurance more affordable for lower- and middle-income Americans. It would extend insurance to about 31 million Americans by providing them with tax credits to offset the cost of coverage and expanding the Medicaid federal-state insurance program.

"Starting from scratch doesn't make sense," said White House Communications Director Dan Pfeiffer, rejecting Republican calls to begin again.

The Obama plan also scales back a tax on high-value or "Cadillac" insurance plans, which had roused opposition from unions and others.

Republicans are expected to call at the summit for more targeted legislation that curbs malpractice lawsuits, creates high-risk insurance pools for sick people and allows consumers to purchase insurance across state lines.

"I don't think that people like this any more than…the approach that came down the pike earlier," said Virginia Rep. Eric Cantor, the House Republican whip. "People are incredulous. I just think they are wondering, does the White House not get it?"

President Obama's health plan adds about $75 billion to the 10-year cost of the $871 billion Senate health-overhaul bill, and includes new taxes.

White House aides said they were satisfied that the new tax would help control health spending over the long term even though it no longer does much to fund the bill in the short run.

Couples who make more than $250,000 would see higher Medicare taxes under the Obama plan. The Medicare payroll tax would be extended to cover unearned income from dividends, interest and other sources.

To raise money for more generous subsidies helping lower earners buy health coverage, the Obama plan would make deeper cuts to Medicare Advantage, a program under which some seniors get their Medicare benefit through private insurers.

Like the Senate bill, the Obama plan doesn't include a government-run health plan or "public option" to compete with private insurers. That idea, a favorite of liberals, was part of the House bill.

Mr. Obama has largely tied his own fate and that of his party to the fate of the health-care measure, and his job approval numbers have fallen along with support for the plan.

Most Democrats in Congress have already voted yes on a version of the plan. Advocates for pushing through an overhaul argue that those up for re-election will be forced to defend those votes anyway, and will be better off if they have something to show for their effort.

The White House has begun to make the case that using reconciliation would not represent an extraordinary step. The "extraordinary step" would be for Republicans to filibuster the bill, Mr. Pfeiffer said. The president simply wants an "up or down vote," he added.

The new White House plan contains stiffer penalties for most Americans who don't carry insurance and for businesses that don't provide coverage for workers. By 2016, consumers who lack insurance would have to pay a flat annual fine of $695 or 2.5% of income, whichever is higher. Lower earners who couldn't afford coverage would be exempt from the fine.

Employers who do not offer insurance coverage would face fines of up to $2,000 per employee, up from $750 per worker in the Senate bill. Firms with fewer than 50 workers would be exempt, and small businesses would get $40 billion in tax credits to offset the cost of coverage.»

in Wall Street Journal

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