GOP calls on Obama to ‘renounce’ reconciliation: Live-blogging the health care summit

Jon Ward Contributor
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5 p.m. – Boehner passes on a final statement. Obama makes his, saying it will take 10 minutes. It took 20.

“This has been hard work,” the president said.

He listed areas of agreement and disagreement. We need insurance reforms but don’t agree on all of them, Obama said: capping out of pocket expenses, insuring coverage for people with preexisting conditions, and regulating the insurance market.

He said he has talked to too many people whose coverage did not cover everything they thought it did and they went bankrupt.

For people trapped in the individual market, Obama said that could be solved if they were allowed to be part of larger group. The idea of an exchange “is not a government takeover. It’s how the market works,” he said, acknowledging “some philosophical difference about minimum benefits in that exchange.”

As for buying insurance across state lines, he said, “the philosophical concern I have on that is that you get potentially what is referred to as a race to the bottom.” He talked about the credit card industry, when cross state purchasing was allowed. Every company went to state with worst consumer protection regulations and fees and gouging went up, he said.

“The question I’m going to have is is there a way for us to deal with the interstate purchase of health insurance, but in a way that provides, again, some baseline protections,” Obama said. “That’s not a big government takeover. That is a standard thing we do.”

On reform of medical malpractice, he said that while Democrats have traditionally resisted that, he would be “interested” in trying to get something done.

The president then laid out his bottom line.

“I’ve put forward then very substantive ideas that are embraced by republicans,” he said. “When it comes to the exchange, that is a market based approach, it’s not a government approach.”

“There were criticism about the public option,” he said, but “even after the public option wasn’t available … we have an argument about how much we should regulate the insurance industry.”

“With respect to the most contentious issue, I’m not sure we can bridge the gap … that’s the issue of how do we provide coverage not only or those who don’t have insurance now but also for those who have preexisting conditions.”

As for Republican insistence on an incremental approach, he said the problem is too complex and interrelated. “It turns out that baby steps don’t get you to the place where people need to go.”

“I’ve put on the table now some things that I didn’t come in here saying I supported,” Obama said. “I’d like the Republicans to do a little soul searching and find out, are there some things that you’d be willing to embrace that get to this core problem of 30 million people without health insurance.”

If they “can’t close that gap,” he said, there will be “a lot of arguments about procedures,” indicating that reconciliation would be used.

The president asked Republicans to see if they could reach a compromise with Democrats ” in a month’s time or a few week’s time or six weeks time.”

“If we can’t then I think we’ve got to go ahead and make some decisions, and that’s what elections are for.”

The meeting wrapped up at 5:22 p.m.

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4:55 p.m. – Pelosi begins closing remarks by stressing how much Democrats have given up, starting with the public option.

“We’ve come a long way to agreeing to a Republican idea: exchanges,” she said.

Pelosi, gesturing attacked insurance companies, saying they have acted “shamefully.”

“We have lived on their playing field all this time. it’s time for the insurance companies to exist on the playing field of the American people,” she said.

Pelosi addressed Boehner: “There is no public funding of abortion in these bills.” [Republicans pushed back hard on this afterward on their blog.]

She addressed Camp’s assertion that the Democrats cut benefits for seniors: “They do not.”

4:49 p.m. – Rep. John Dingell: “Any Republican that says you should start from scratch, that’s bogus talk, and that’s partisan talk.”

Dingell becomes the third Democrat of the day to talk about people coming to them with tears in their eyes asking for help.

Dingell said the “last perfect legislation” was the 10 Commandments.

I believe Rep. Charlie Rangel just uttered the following words: “We are so close to national health insurance.” That would seem to contradict Democrats claims that they don’t want government-run health care.

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4:34 p.m. – Senate Minority Leader Mitch McConnell said HSA’s are “not exactly for rich people,” that the median income of HSA users is $69,000 a year.

McConnell then launched into one of the main Republican talking point.

“We know from the polling that’s been done in this country how the American people feel,” he said. “This is not a close call.”

“We know the American people oppose this bill on an average of 55 to 37 percent,” McConnell said.

He also said that Gallup polled on whether Americans favored the use of reconciliation and found 52 percent opposition and 39 percent support.

“This has been a fabulous discussion .. but i think it’s really important, since we represent the American people, that we not ignore their opinion on this,” McConnell said.

“They have followed this debate like no other. And they have rendered a judgment about what we have attempted to do so far. The solution to that is to put that on a shelf and start over with a blank piece of paper.”

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Obama repeated what Democrats have said consistently since the summer, when poll numbers began their steep decline.

“There’s been a lot of comments from Republicans about the polls,” Obama said. “I hear from constituents in every one of your districts, and every one of your states.”

“Whats interesting is that when you poll people about the individual elements of these bills, they’re all for them.”

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Coburn, a few minutes later, said there needs to be a reconnection of the mechanism of payment with purchase.

“We ought to have another talk like this … because we all want the same thing, but how we get there, whether we’re in charge of it or the individual patient is in charge of it,” he said, was the key.

4:29 p.m. – Obama pushes back against Barton’s accusation that Democratic proposals are “radical.”

He says Sen. Wyden, Sen. Patty Murray, Rep. Rangell, Rep. Dingell and another Republican or two still have to speak

4:26 p.m. – Sen. Chris Dodd and Rep. Joe Barton have been speaking for the last several minutes. No new ground broken. Mostly just rehashing talking points.

4:18 p.m. – Obama said people who are getting hurt the worst are families who make too much to get Medicaid but don’t make a lot.

“You threw out the word welfare,” Obama said to Roskam, but said that “the fact is that very poor people have coverage that is superior to what a lot of folks who work very hard … do not.”

We are now past the 4:15 p.m. target for ending and there are at least four or five more speakers to go.

4:09 p.m. – Obama admonished Rep. Waxman for going on too long and haranguing the Republicans. “We’re not making campaign speeches right now,” Obama said.

He then asked if Republicans have any ideas on how to cover more than the 3 million in Boehner’s bill.

Rep. Peter Roskam, Illinois Republican, didn’t answer the question. Instead he began talking about what he thought Democrats were thinking, which is, “What is it going to take for you Republicans to vote for our bill?”

4:05 p.m. – Republicans are already claiming victory. A senior GOP leadership aide e-mails the following:

Winner/loser always comes in deliverables. And today that is clear, Republicans have come out well ahead. House/Senate R’s completely erased entire Dem narrative today: GOP is not the party of no, GOP is not thoughtless obstructionists, and GOP cares about health care, but is not willing to bankrupt this or next generation which is why they support an incremental approach to lower costs. Most of All: GOP is listening to the people.

Meanwhile, was that really President Obama? He diminished his own bully pulpit. The longer he’s in that room the less he looks like a president and the more he looks like just another guy in a subcommittee hearing in Rayburn. Most, he showed again how little tolerance he has for tough questions. He really lost his temper with Cantor – very unpresidential. Almost as bad with McCain. And pressed by those two, as well as Ryan and others, President did not wish to talk “numbers” or “details” – namely it appeared that he couldn’t. He says “standard talking points” when he doesn’t want to answer a question. Then resorts to his own “talking points.”

3:51 p.m. – Obama says Paul Ryan’s use of “government takeover” line was “good poll-tested line” but that his proposal doesn’t do that, but does allow individuals and small businesses to pool together, and gives them subsidies.

Obama pointed out that Boehner’s bill only increases coverage for 3 million people while Democrats cover 30 million

The president then implied a question about whether Republicans share Democrats’ commitment to help those without health insurance.

“If we think it’s important as a society to not leave people out, then we’ve got to figure out how to pay for it,” he said, but added that no one should “pretend we’re going to do it, and that there’s some magic wand to do it.”

Sen. John Barrasso, Wyoming Republican, responded.

“Coverage does not equal care,” he said, arguing that expanding coverage in a way that he thinks will bankrupt the system and the country will reduce the quality of care.

Obama said: “Would you be satisfied if every member only had catastrophic care?”

Barrasso said he would, especially if members had health savings accounts.

“Would you feel the same way if you were making $40,000 … b/c that’s the reality for many folks,” Obama said. They’re not premiers … they’re not sultans from wherever … they’re folks who are left out. And this notion somehow that for them, the system is working, and that if they just ate a little better and were better health care consumers they could manage, is just not the case. The vast majority of these people … work, every day, some of them work two jobs. but if they work for a small business, they can’t get health care.”

This was actually probably one of the more revealing comments by the president, and one of the few times over the last year he has really come out and addressed the basic conservative idea that health care should be moved toward a catastrophic care system, which was the argument laid out in The Atlantic magazine’s September cover story.

Obama said health savings accounts can be useful tool but that those who use them “have a lot of disposable income, and the people we’re talking about don’t.”

3:41 p.m. – McCain also addressed reconciliation.

“I understand the frustration that the majority feels when they can’t get their agenda through,” McCain said. “But I remember .. the last time there was a proposal that we Republicans in the majority would adopt a 51 -vote majority on the confirmation of judges.”

“There was a group of us that got together and said, ‘No that’s not right, ” McCain said, referring to his involvement in the Gang of 14, which enraged the conservative base.

“If a 51 vote reconciliation is enacted on 1/6 of our gross national product,” McCain said, “I think it could harm the future of our country and of our institution.”

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Obama did not appear to share McCain’s concern over the use of reconciliation.

“This issue of reconciliation has been brought up. I think the American people aren’t always that interested in procedures inside the Senate. I do think they want a vote on how we’re going to move this forward. I think most Americans think a majority vote make sense.”

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3:36 p.m. – McCain speaks again, this time in medical malpractice reform.

He and Obama seem to have made up from their morning tiff.

“I pay close attention to all of your speeches,” McCain told the president.

“Thank you, that’s more than Michelle does,” Obama said.

3:24 p.m. – House Minority Leader John Boehner spoke, saying that the American people have said they want the Democrats bill scrapped.

“They’ve said it loud. They’ve said it clear,” Boehner said.

Boehner, like Cantor, had a stack of paper, the Democrats bill, in front of him. He put his hand on it.

“It will bankrupt our country,” he said. “This right here is a dangerous experiment.”

Boehner also talked about the abortion language, the first time the issue was mentioned all day. “This bill … begins for the first time in 30 years, allows for the taxpayer funding of abortion.”

Obama put his hand over his face and looked like he was trying to keep himself from cursing.

Obama could barely muster a response, and sounded like he was addressing a rebellious teenager: “John, you know, the challenge i have here is … every so often we have a pretty good conversation .. and then we go back to the standard talking points.”

3:19 p.m. – Sen. Kent Conrad, the chairman of the Senate Budget Committee, gets his first chance of the day to talk. The topic is now entitlements.

Lawmakers who have still not said a word all day: Sen. Patty Murray, Sen. Chris Dodd, Rep. Rangel, Rep. Dingell, Rep. Waxman, and maybe a few others.

3:15 p.m. – Here is video of Biden explaining that he does, maybe, understand what the American people think:

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Sen. Charles Grassley, Iowa Republican, responded to Biden: “If you think I don’t listen to the American people, I’ve held 32 town hall meetings … I think I have a good feeling of what’s out there in the grassroots,” he said.

2:51 p.m. – One of the best 15 to 20 minutes of the day. Rep. Paul Ryan was waiting for his moment. When he got it, he put on a clinic, and threw out some impressive numbers.

Ryan agreed with Obama’s statement that health care reform is budget reform. “You’re right. We agree with that.”

But, he said, the Democrats bill “does not control costs” or reduce the deficit but adds another entitlement.

Ryan took on the Democratic claim that their bill reduces the deficit by $131 billion over 10 years. He said the Congressional Budget Office are “great professionals” but that “their job is to score what’s in front of them.”

“And that is a bill that is full of gimmicks and smoke and mirrors,” he said.

The true cost of the Democrats’ health care bill, Ryan said, is $2.3 trillion over 10 years. The impact on the deficit, he said, was to add $460 billion over the first decade and $1.4 trillion over the second decade.

“Hiding spending does not reduce spending. So when you take a look at all this it doesn’t add up,” he said.

Ryan also said “there really is a difference between” Republicans and Democrats. “We don’t think the government should be in control of all this. We want people to be in control.”

Obama, who showed little patience for listening to some lawmakers throughout the day, was notably interested and took a listening posture.

Here’s video of Ryan:

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Ryan also rebutted Biden: “We are all representatives of the American people … the American people are engaged … if you think they want a government takeover of health care, i would submit you’re not listening to them.”

Obama responded by asking if Ryan thought Medicare advantage is working well. Obama made the case that it’s not.

Mccain, surprisingly, jumped in, and went back to his attack line about carve outs for certain states: “Why in the world then would we carve out 800.000 people in Florida that would not have their medicare advantage cut?”

Obama, surprisingly, conceded the point: “I think you make a legitimate point. I think you do.”

McCain, unsurprisingly, was obviously not expecting the president’s reaction: “Well, thank you very much.”

Obama flashed him a big smile. Here’s video of the exchange:

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Rep. Xavier Bacerra, California Democrat, went after Ryan for calling into question one of the Democrats’ key talking points, that their bills reduce the deficit.

“We have to decide: do we believe in the congressional budget office or not? … if we can’t work with cbo numbers, we’re lost … we have to accept what the referee has said,” Bacerra said.

Bacerra came back to the claim that the CBO says the bills reduce the deficit by over $100 billion over 10 years and by over $1 trillion over the second decade.

2:50 p.m.
– Biden frames the Medicare problem in a way that might have elicited some groans inside the White House: we’ve got to figure out a way to keep it from bankrupting the country without denying seniors the care they’re entitled to.

2:46 p.m. – Vice President Biden began a statement about the long term costs of health care by ridiculing, in his own way, Republican claims to have the support of the country for their push to start over on health care.

“It requires a litle bit of humility to know what the American people think, and I don’t,” he said. “I think I know what they think.”

2:45 p.m. – CNN is the only network showing the forum right now.

2:35 p.m. – Obama explains why he changed his mind from the presidential campaign, when he opposed a mandate for universal coverage.

“I was dragged kicking and screaming to the conclusion I arrived at, which is that it make sense for everyone to have insurance,” Obama said.

He says he came to this conclusion because of preexisting conditions and cost-shifting.

“Everybody who has health insurance is one way or another paying for somebody who doesn’t,” he said. He said each family pays $1000 to $1100 of costs a year because of the uninsured who go to the ER when they need treatment.

2:32 p.m. – Republicans just e-mailed out their talk clock from the morning session. They say the president himself talked longer than all the Republican lawmakers combined. Here’s their count:

President Obama Spoke For 58 Minutes.
Democrats Spoke For 50 Minutes.
Republicans Spoke For 56 Minutes.

Rep. Marsha Blackburn is talking about “structural differences” between how the two sides approach the issue of allowing consumers to shop across state lines for health insurance.

2:23 p.m. – Sen. Jay Rockefeller, West Virginia Democrat, devoted most of his comments to blasting away at the health insurance industry. He said they are “looking for reasons” to kick people off their policies if they are high-cost.

Rockefeller called the insurance industry “the shark that swims just under the water, and you don’t see that shark until you feel the teeth of that shark.”

Because of no regulation, he said, “they can do what they want and they do.”

“It makes me sick,” Rockefeller said. “You have to go at them to clip their wings every way that you can.”

“This is a rapacious industry that does what it wants,” he said.

Rockefeller argued that the mandate is there to guarantee a big pool. He said his own son didn’t have health insurance because he didn’t think he needed it, and he told him to get it the next day.

Obama cut in and tells Rockefeller, “Jay, let’s wrap it up.”

“I’m gonna wrap it up,” the senator said.

“People say decisions can’t come from Washington. Sometimes decisions have to come from Washington,” he said.

Meanwhile, Boehner spokesman Michael Steel e-mails that Democrats “won’t talk about the actual bill. They know the American people can’t stand it, and they can’t defend it.”

2:08 p.m. – Enzi ends his statement in less than five minutes. The president looks genuinely touched by the shocking display of brevity.

Sen. Tom Harkin, Iowa Democrat, is next, and is the second Democratic senator (Baucus was the first) to downplay the distance of the gap between the two sides on how they want to solve the health care problem, which is totally at odds with how almost every Republican characterizes the debate:

“We may actually be closer together than people actually think,” Harkin says.

2:07 p.m.
– Rep. Joe Barton, Texas Republican, sent the Daily Caller this comment about the morning session:

“We’re having a good discussion with the president. I think it’s obvious he really doesn’t want to listen to the Republican ideas or the Republican concerns about the House and Senate bills and the president’s proposal. Having said that, I think we’re making a good case to the American people that Republicans don’t want a government-mandated, government-run health system in America but we do want to solve the problems. We want to cover pre-existing conditions. We want to keep people from losing their insurance. We want to help low-income Americans who need some assistance. However, we want to do it in a market-based, open and transparent process as opposed to a government-mandated, government-controlled process.”

2:02 p.m. – Obama says they’re running a little behind but on target to end by 4:15 p.m. “That will require a little more discipline

Obama said the tone of the morning session was “helpful.”

Both Rep. Charles Rangel and Rep. John Dingell, long time Democratic veterans, appear to have just asked Obama to give them some time to talk.

Sen. Mike Enzi, Wyoming Democrat, is the first afternoon speaker. He begins by talking about Medicare.

Enzi also says that the White House should have held this summit nine months or a year ago.

2:01 p.m.
– President Obama is back in the room. He’s getting ready to restart the meeting.

1:38 p.m. – Rep. Tom Price, Georgia Republican, disagreed with the president’s line that the GOP feels Democrats are “regulating the insurance market too much.”

“That’s great spin. That’s just not the truth,” Price said. “The truth is that their bills … all include huge moves toward the fed government being involved in personal medical decisions that people and their doctors and family members should be making.”

1:25 p.m. – Republicans are jumping all over Obama’s backtracking during the morning session about whether his plan raises premiums. Here’s the exchange from early in the session where the president initially said that his proposal would not raise health care prices:

SEN. LAMAR ALEXANDER (R-TN): “The Congressional Budget Office report says that premiums will rise in the individual market as a result of the Senate bill.”
PRESIDENT OBAMA: “No, no, no, no. Let me — and this is an example of where we’ve got to get our facts straight.”
ALEXANDER: “That’s my point.”
OBAMA: “Well, exactly, so let me — let me respond to what you just said, Lamar, because it’s not factually accurate. Here’s what the Congressional Budget Office says. The costs for families for the same type of coverage that they’re currently receiving would go down 14 percent to 20 percent.”

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But later in the session, after an aide handed the president a note, Obama admitted he had been wrong.

“What the Congressional Budget Office is saying is, is that if I now have the opportunity to actually buy a decent package inside the exchange, that costs me about 10% to 13% more but is actually real insurance, then there are going to be a bunch of people who take advantage of that. So yes, I’m paying 10% to 13% more because instead of buying an apple, I’m getting an orange.”

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Rep. Tom Price, Georgia Republican, called it the “gaffe of the morning.”

1:22 p.m. – CNN is reporting that the Democrats’ new goal to pass a bill is by the end of March.

Meanwhile, on Fox News just now, White House spokeswoman Linda Douglass just downplayed the idea that the White House has a smaller, scaled-down health care bill that they will push if a comprehensive bill cannot pass.

“The talk of a plan B is … much, much overstated,” Douglass said. “What the president is committed to is what he’s talking about now.”

12:58 p.m. – Obama breaks for lunch until 1:45 p.m. House members have one vote, meaning they have to return to the Capitol and then dash back.

As the lawmakers break up, Rep. George Miller, California Democrat, comes up to the president and has him autograph a picture.

Obama, shown on live TV walking back to the White House, stopped and spoke briefly to reporters.

“We’re establishing that there are actually some real areas of agreement,” and said much of the disagreement is over “how much government should be involved.”

Obama added: “The argument that Republicans are making really isn’t that this is a government takeover of health care … but that we’re regulating the insurance market too much.”

12:56 p.m. – It’s interesting. Republicans are fact-checking this session pretty aggressively, but there doesn’t appear to be a similar rapid response effort from Democrats.

Republicans went hard after Reid’s statement early on that “no one” was talking about reconciliation, noting that Reid said just the other day that Republicans should “stop crying” about the potential use of the procedure.

12:52 p.m. – Obama says there are five more speakers “and not a lot of time” before they break for lunch.

I have no idea what Rep. Louise Slaughter, New York Democrat, is talking about. (She just talked about a constituent wearing her dead sister’s teeth.)

And Fox News is the only network, besides CSPAN, to have showed the entire session so far without cutting away from it.

12:47 p.m. – Obama is again making the point that if there is no government oversight over insurance pools, all the older and sicker people will get stuck in high-risk pools with much higher rates.

Cantor responds: “We just cant afford this. That’s the ultimate problem here. In a perfect world, everyone would have everything they want.”

“Were asking that you set aside this mandate form of helath care regulation and let’s go back to things we can agree on,” Cantor says.

12:43 p.m. – Yep. Obama didn’t like the big bill in front of Cantor.

“When we do props like this … these are the kind of political things we do that prevent us from actually having a conversation,” the president says.

Obama addresses one of Cantor’s points. He says that meat could be cheaper if the government got rid of meat inspectors, but that that would be a bad idea.

“We make some decisions to protect consumers in every aspect of our lives, and we have bipartisan support for doing it.”

12:39 p.m. – House Minority Whip Eric Cantor, Virginia Republican, begins talking, with the entire 2,400-page Senate bill laid out in front of him. Obama clearly thinks its a prop.

Cantor says that Republicans care about people being wronged by insurers just as much as Democrats do.

You can tell, sometimes, from Obama’s expressions whether he thinks people are making legitimate arguments or not. The look on his face as Cantor speaks? Not all that happy or positive.

12:26 p.m. – Sen. McCain begins talking. Blasts Obama for producing bill “behind closed doors .. with unsavory deal making.”

McCain says the carve out for 800,000 Florida seniors from Medicare cuts was offensive, and says the 300,000 seniors in Arizona are angry.

“We promised them change in Washington and what we got was a process that you and I both said we would change in Washington,” McCain said to Obama, referencing their run against one another in the 2008 presidential campaign.

McCain also criticizes Obama for making a deal with Phrma. Obama grimaces. TV stations are showing this part in split screen.

Obama tries to break in, but McCain refuses. “Can I just finish please,” McCain says.

McCain says Americans “overwhelmingly reject” the Dems bill, and says the bill should be rewritten so that its beneficial “not just for some people who live in Florida or other favored states.”

He calls for Obama to “remove all the special deals for the special interests .. and treat all Americans the same.”

The president is not amused.

“We’re not campaigning anymore. The election’s over,” Obama tells McCain.

“We were supposed to be talking about insurance,” Obama says. “My hope would be we could focus on … how we could actually get a bill done.”

McCain breaks in. “The American people care about what we did and how we did it” and says it should be discussed.

Obama agrees but disputes the way McCain characterized the bill’s process.

Speaking in terms of drama and theater, that was pretty good.

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12:21 p.m. – Rep. George Miller says he has two artificial hips, “a little bit of arthritis” and a kidney stone. TMI congressman.

The point, he says, is that if he wanted to switch to a different insurer or change jobs he would be “dead.” The Democrats plan, he says, would guarantee that someone in his situation could get coverage if they ended up needing to change jobs or switch insurers.

12:18 p.m. – Obama makes the third or fourth plea of the morning that lawmakers keep their statements brief.

One of the Republicans, however, says they were not told what the time limits were on their statements.

“Well I’m trying to be flexible,” Obama says, but asks lawmakers to be brief.

12:17 p.m. – Boustany still speaking but the sense in the room is that Obama is letting him talk to counter McConnell’s earlier complaint that Democrats were getting too much time.

12:12 p.m. – Rep. Charles Boustany, Louisiana Republican, is talking, but seems to be reviewing what has already been said more than anything else.

12:07 p.m. – Obama addresses House Minority Leader John Boehner, who he said had shaked his head when the president said people could keep their plans, repeating his point that they will be able to do so.

Kyl responds saying that people could keep their care “for a limited period of time” and that employers would have incentives to drop employees off employer-provided care.

Obama responds by saying, “Anytime the question is phrased as, ‘Does Washington know better?, it’s tipping the scales a little bit,” because, the president says, pretty much everybody is mad at Washington.

“It’s a good talking point,” Obama says.

Obama reviews points of agreement:
-insurers can’t drop people who get sick
-people should be able to stay on their parents insurance until age 25 or 26
-no annual or lifetime limits
-want to end prohibition on preexisting conditions

12:03 p.m. – Rep. Phil Gingrey, Georgia Republican, emails out a fact-check of the president’s argument about the need for baseline protections for consumers. Using the president’s example of the insurance he got for his car, which the president called “Acme Auto insurance,” Gingrey’s staff e-mails out the following:

Obama: “Acme Auto Insurance is not set up to provide insurance, but to meet legal threshold”

Gingrey: FACT: The Democrats bill would do the same thing to health care. It would make owning a federally qualified health insurance plan a legal requirement under penalty of law. Auto insurance is not health insurance. Forcing poor Americans to purchase health insurance is not the way to cover every American. Making it more attractive to all Americans by reducing costs and increasing availability is the way to go. Forcing Americans to purchase health insurance so that they are not treated as criminals by our Federal Government is not the spirit of freedom that our founding fathers intended for their posterity.

11:55 a.m. – Obama takes on GOP arguments about cost. Cites example of self-employed person who can’t get coverage or can only buy high deductible plan to protect from catastrophic situation, and has to pay out of pocket for all regular health care. “But if I get hit by a truck, maybe I don’t go bankrupt.”

Obama says his plan would cost 10 to 13 percent more than that high-deductible plan but would cover regular care.

Obama also takes on the Republican argument that health care should move, overall, toward a high-deductible system, where people put money aside for regular care and only purchase catastrophic care, saying there would be a “riot” in Congress if lawmakers had to sign up for that kind of health care.

Obama says it’s not “a radical idea” that there should be a “baseline” for what kind of care people should have.

He says if there are “no rules” there are “no protections” and an insurer in Nevada can go into New York and “drain from New York all the healthy people who are getting cheaper rates” but all the older, sicker people are in another pool where their rates go up.

“This issue of government regulation … is very different from the way this has been framed … which is government takeover of insurance,” Obama says. He argues “market principles” will shape the way these government exchanges work.

As he finishes talking at 12:01 p.m., an aide walks up and hands the president a note.

11:51 – Sen. John Kyl, the Senate Minority Whip from Arizona, disagrees with Baucus. “There are some fundamental differences between us that we cannot paper over.”

“We do not agree about who should be in charge,” Kyl says, arguing that Obama and Democrats want to put government in charge of too much in their bills.

Kyl goes deep into the numbers on how the government exchanges would require insurers to cover much more than they do now, and says that would drive costs up.

11:47 a.m. Sen. Chuck Schumer, New York Democrat, is the third or fourth Democrat to laud Coburn for talking about fraud, waste and abuse.

11: 38 a.m. – Rep. John Kline, Minnesota Republican, and Rep. Rob Andrews, New Jersey Democrat, get into a debate deep in the weeds about association health plans versus exchanges, and whether it is a semantic difference.

Rep. Paul Ryan jumps in and says the exchanges or associations shouldn’t have to abide by standards set in Washington.

“By mandating exactly how it will work you make it more expensive … we want to decentralize the system … and make insurers compete more,” Ryan says.

McConnell says Democrats have had 52 minutes compared to Republicans 24 minutes so far. Obama contests the assertion.

Obama says the conversation between Kline, Andrews and Ryan is a “legitimate debate.” He tells a story about trying to get car insurance a long time ago but says the insurer was not honest.

“The general idea has been here that we should set up some minimum standards” for the exchange, Obama says, to protect consumers, so “if your kid got sick they’re actually going to be treated” without a bunch of out of pocket costs.

“The principle of pooling is at the center of both the Senate and the House bill,” Obama says, saying this rebuts the idea that the Democrats’ plans were going to require everyone to sign up for government care.

The real debate, he says, is how much the government should set the rules for insurers who want to compete for pools of new customers.

11:31 a.m. – Rep. Dave Camp begins speaking. Says “responsible lawsuit reform” is missing from Democratic proposals. Says savings could be $239 billion.

Obama, at 11:35, interrupts to say he wants to stay focused on costs, not deficits, which he says he’ll address later.

Camp says “one of our big concerns” is that “all of this is structured around a government-centered exchange which sets the policies … that kind of approach raises costs.”

Again, that is the key Republican point, as detailed here.

11:25 a.m. – Sen. Max Baucus begins speaking. “We basically know what the problems are … the current system is unsustainable. We are actually quite close. There’s not a lot of difference.”

Baucus says it won’t take “a lot of effort” to bridge differences between the two sides.

Says Dem proposals allow selling across state lines but acknowledges it’s not the same system Republicans would want. Here’s a piece I wrote about why Republicans don’t think Dem proposals amount to much.

11:21 a.m. – Obama says Coburn pointed out areas of agreement: fraud and abuse prevention, emphasis on health and wellness.

11:18 a.m. – House Majority Leader Steny Hoyer is now talking. Almost 90 minutes in, there’s little difference between this summit and a congressional hearing. It’s mostly been long statements by lawmakers. One exception: the disagreement on cost containment between Obama and Sen. Lamar Alexander. Obama made a detailed defense of why his proposal would contain costs. Alexander ran away, saying he wanted to give his response in writing.

11:12 a.m. – Reid interrupts Coburn and says he’s filibustering. Coburn had been talking a lot about the over use of tests and technology by physicians afraid of lawsuits.

11:04 a.m. – Sen. Tom Coburn starts a statement about costs. Says large percentage of government spending on health care is eaten up by fraud.

10:59 a.m. – Alexander buts in to disagree with Obama and we have our first wonk slam fest of the day. They are debating whether premiums will go up under the president’s plan.

Obama says he’s taken “every single cost containment” measure “out there” and put it in his proposal. He says portability across state lines is in the bill.

Obama says Alexander’s opening remarks were all about what Republicans didn’t like, and asks him to say what he likes in the president’s proposals.

Alexander says he would like to get back to the president about why the bill would drive up premiums but says he’d like to write his points down “rather than argue with you in public.”

Obama calls him out and says they should settle the issue of cost containment today, “because I’m pretty certain I’m not wrong.”

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10:53 a.m. – Obama doesn’t address Alexander’s request that he “denounce” reconciliation and says the meeting should focus on ideas, not legislative process. But he says a lot of the things Alexander listed are in his proposal and he wants to discuss how the two sides can get to those goals.

10:45 a.m. – Harry Reid goes after Alexander, saying he’s entitled to his own opinion but not his own facts.

On reconciliation, he says, “no one has talked about reconciliation but that’s what you folks have talked about.”

Reid says the procedure “has been used 21 times since 1981” to pass the Contract for America, medicare reform, tax cuts in 2001 and 2003.

10:35 a.m. – Pelosi says the American people “don’t have time for us to start over.”

“I’ve seen grown men cry,” she said.

Pelosi rolls out a line not heard in a while: “Health care reform is entitlement reform.”

Says health care bill will create 4 million jobs.

10:30 a.m. – Sorry for the gap. Website problems. Sen. Alexander called on Obama and the Democrats to “renounce” using the reconciliation process to get a bill through Congress.

“You can say that this process has been used before but it has never been used for anything like this,” Alexander says. “It’s not appropriate.”

Obama stops leaning back and leans forward, leaning on the table.

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10:26 a.m. – Alexander ties health care to the Toyota debacle, saying of the Democrats’ health care bill: “This is a car that can’t be recalled and fixed and we’d like to start over.”

Says Dems plan would work well “in a classroom” but not in real life.

10:24 a.m. – Just got the pool report by USA Today’s David Jackson, who reports that Obama, while walking across the street to Blair House, was asked if he has a Plan B, a smaller bill, as reported this morning.

Obama didn’t at first respond, and walked a few paces. Then, while still walking, he said, “I’ve always got plans.”

10:22 a.m. – Sen. Lamar Alexander, Tennessee Republican, begins opening statement for the minority and gets right to the issue of governors’ views on the health care bill.

Alexander on what should be done: “start over.” He says the focus should be on costs.

In cut shots of the rest of the room, Obama is leaning back against his chair, looking relaxed. Speaker Nancy Pelosi is looking at Alexander. Senate Majority Leader Harry Reid is staring straight ahead, not looking at Alexander.

“We want you to succeed … but we would like respectfully to change the direction you’re going on health care costs,” Alexander tells the president.

10:18 a.m. – Obama now going over basic elements of the proposal he put on the White House website Monday.

He says he wants to talk today about areas of agreement and then move on to areas of disagreement.

“I don’t know that those gaps can be bridged,” Obama says. Says day may end up with disagreements unresolved.

“But I’d like to make sure that this discussion is actually a discussion and not just us trading talking points. I hope that this isn’t just political theater,” Obama says, in a pretty direct rebuke of the vice president’s comments yesterday.

10:13 a.m. – Obama moves to talking about his own family. Tells story about his daughters getting sick and wondering what would have happened if he didn’t have good health insurance. Tells story of his mom haggling with health insurers over coverage at the end of her life.

He then moves on to how the issue of health care reform is bipartisan.

“I think this concern is bipartisan,” Obama says, and namechecks a number of Republicans, saying he has heard many of them agree that reform is necessary.

Obama cites Senate Minority Leader Mitch McConnell’s statement: “The need for reform is not in question.”

“Here’s the bottom line. We all know this is urgent. And unfortunately, over the course of the year … this became a very ideological battle. It became a very partisan battle and politics ended up trumping … practical common sense,” Obama says.

He says, however, there is “overlap” between Democrat and Republican ideas.

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10:09 – You can watch the summit at the Sunlight Foundation page or at

Obama has begun his statement talking about letters he receives from every day Americans telling him about their difficult economic circumstances.

“This is an issue that is affecting everybody … not only those without insurance, but it’s affecting those with insurance,” Obama said.

“The problem is not getting better. It’s getting worse.”

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10:08 – Obama has stared his opening statement. Check out the Sunlight Foundation’s webpage which shows financial donations given to each speaker by their largest donors.

10:04 a.m. – All 38 lawmakers stand as Obama enters the room. He goes around the room to shake each hand. He and Sen. John McCain share a quick handshake. Obama and Sen. Tom Coburn eive each other a full embrace. The two are pretty good friends. For real.

10:01 a.m. – President Obama and Vice President Biden just walked out of the White House across the street to Blair House. Obama didn’t look all that happy for a few moments, raising questions about whether he is steamed about Biden’s comments yesterday that this event “could be pure theater.” But Obama, after a few moments, was smiling and joking with Biden.

10 a.m. – The summit today, with 38 Democrats and Republican lawmakers (21 D’s and 17 R’s – list here) is being held in the Garden Room of The Blair House, a suite of four row houses across Pennsylvania Avenue from the White House. For great background on the Blair House, read this New York Times story from the late 1980’s, when the suite of row houses was renovated and enlarged.

9:50 a.m. – It’s an indication of the expectations for Thursday’s summit that most of the coverage is already looking past it. Politico’s Mike Allen even has what Democrats and Republicans will say after the 6-hour meeting at Blair House in today’s Playbook. The Wall Street Journal has the details of a stripped down plan that Democrats could try to push if a comprehensive bill does not have enough support.

Even Vice President Joe Biden thinks the whole thing is a charade, to use the favored term of House Minority Leader John Boehner, Ohio Republican. Biden told a Delaware newspaper on Wednesday that the summit “could be pure theater.”

“This could end up not being good,” Biden said.