Obama and Congress press ahead on health care

WASHINGTON - President Obama left the door open to a new tax on health-care benefits yesterday, and officials said top lawmakers and the White House were seeking $150 billion in concessions from the nation's hospitals as they sought support for legislation struggling to emerge in Congress.

"I don't want to prejudge what they're doing," the president said, referring to proposals in the Senate to tax workers who get expensive insurance policies. Obama, who campaigned against the tax when he ran for president, drew a quick rebuff from organized labor.

Obama also fielded a pointed personal question during an ABC News town hall at the White House yesterday. The program, aired in prime time, was the latest in a string of events designed to build public support for his plan to slow the rise in health-care costs and expand coverage to the nearly 50 million uninsured.

Orrin Devinsky, a neurologist at the New York University Langone Medical Center, challenged Obama: What if the president's wife and daughters got sick? Would Obama promise that they would get only the services allowed under a new government insurance plan he is proposing?

Obama wouldn't bite. If "it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care," Obama said.

"If we are smart we should be able to design a system in which people still have choices," he said.

Earlier in the day, the administration and its allies pushed for a prominent display of progress in the Senate before Congress begins a weeklong vacation tomorrrow.

On Capitol Hill, Senate Finance Committee Chairman Max Baucus (D., Mont.) labored in a daylong series of meetings to produce at least an outline of legislation that could command bipartisan support. Of the five House and Senate committees working on health care, Finance is the only one that appears to have a chance at such an agreement.

Key Republicans, meanwhile, pressed the White House for assurances that any concessions made now would not merely lead to additional demands at a later date. "We want to know the president is working in good faith along the way as we are," said Sen. Olympia Snowe (R., Maine), after meeting with Nancy-Ann DeParle,the top White House official on the issue.

Baucus appeared especially eager to show progress before the exodus from the Capitol began. Several officials said he was negotiating with representatives of the nation's hospitals, hoping to conclude an agreement that would build on an $80 billion weekend deal with the pharmaceutical industry.

Hospitals were being asked to accept a reduction of roughly $155 billion over the next decade in fees they are promised under government programs such as Medicare and Medicaid, according to numerous officials.

Officials at the American Hospital Association and the Federation of American Hospitals said they could not comment on any discussions. Baucus is seeking similar concessions from nursing homes, insurance companies, medical-device makers and possibly others, noting that any legislation would create a huge new pool of customers for industry providers.

At its heart, any legislation is expected to require insurance companies to offer coverage to any applicant, without exclusions or higher premiums for preexisting medical conditions. Baucus has said he hopes to hold the size of any legislation to $1 trillion or less, and in private negotiations, there were discussions about further scaling back eligibility for insurance subsidies from the government.

Baucus was still searching for ways to cover the cost of his emerging legislation, and numerous officials said he appeared roughly $200 billion shy of achieving that goal. They added that a proposal to make it harder for taxpayers to itemize their medical expenses was drawing renewed interest among key senators as one way to raise revenue.

Current law allows those expenses to be itemized when they exceed 7.5 percent of adjusted gross income. The proposal under review would raise that to 10 percent, officials said.

At the White House, Obama sidestepped when asked if he was open to taxing health-care benefits.

"I have identified the ways that I think we should finance this. I think Congress should adopt them. I'm going to wait and see what ideas ultimately they come up with," he said on ABC's Good Morning America.

Organized labor weighed in quickly. Gerald W. McEntee, president of the 1.6 million-member American Federation of State, County and Municipal Employees, said that union leaders believe Obama is "a person of his word" - referring to Obama's opposition to taxing those benefits during the campaign.

"They're not going to take it," McEntee said of workers' views of that proposal. "They're not going to tolerate that."

Obama also left open the possibility that he could sign legislation that does not contain an option for a government-run insurance plan. And he has said he could accept a requirement for individuals to buy insurance, a position he opposed last year.