The machinations leading up to the Blair House summit have resembled a chess match in which one side – the Democrats — can't decide who gets to move the pieces on its side of the board. Both the House and Senate passed health-care bills about two months ago, yet President Obama's plan, released earlier this week, did not have the support of either chamber's Democrats when it was released. In fact, congressional Democrats had been asking to see an advance version of the plan but were rebuffed by the White House. In addition, as the New York Times reported, the main reason that President Obama had to — finally — release a White House plan is that the Democrats in the House and Senate could not come to an agreement, and the president had promised that he would post a Democratic proposal 72 hours before the summit. As a result of this new, third proposal, we now have even less Democratic unity than we had before Obama stepped in. When the summit takes place, this could lead to the awkward spectacle of Obama arguing for his plan, Reid and his Democratic colleagues arguing for the Senate bill, and Pelosi's people arguing for the House bill.
Another problem with the president's proposal is Congressional Budget Office's inability to score it before the summit. CBO's explanation for this was pretty devastating: They said that the proposal did not have enough detail to be scored, and even if there had been enough detail, they did not have enough time to come up with a score. Given that we have known the summit was coming for about a month, this appears to be inexcusable. Yet the White House may have waited so long because they feared the score they were going to get. Budget experts I have talked to think CBO is likely to find that the president's proposal will cost considerably more than the $950 billion the White House claimed, likely over a trillion dollars. It is not clear why "under a trillion dollars" has become a Democratic standard for frugality, but that appears to be the standard President Obama has set, and not having a CBO score in time for the summit avoids potential awkwardness on that front.
On the political side, Democrats and their allies have been arguing that reconciliation is a perfectly legitimate legislative approach, but it was not long ago that they were arguing, in somewhat hysterical tones, that reconciliation represented the end of democracy as we know it. According to this video on the Breitbart site, then-Senator Biden said that procedures that circumvent the 60-vote hurdle are "ultimately an example of the arrogance of power," adding that he prayed that "when the Democrats take back control we don't make the kind of naked power grab you are doing." Even though Democrats will conveniently manage to swallow their cognitive dissonance on this issue, reconciliation still presents significant procedural and political hurdles. On the procedural side, the Senate parliamentarian would need to decide if various provisions are germane to budgetary questions, a standard that only some of the Democratic health-overhaul provisions will be likely to meet. On the political side, it is not clear if the Democratic leaders in the House or the Senate have the votes to pass their bills under the reconciliation mechanism. Furthermore, as we get later and later into 2010, supporting an unpopular health overhaul will get harder and harder for vulnerable Democrats.
Which brings us to the summit itself. The best way for the president to bring grumbling and nervous Democrats together is to unite them against a common enemy, and it looks like the president wants Republicans to play the role of Snidely Whiplash. The president will claim that he has adopted the Senate proposal's structure, along with some of the bigger giveaways from the House approach, to show that he has split the differences between the two. Then he will turn his fire on the Republicans for being obstructionist and callous to the problems of health care in this country. In response, the Republicans will need to be polite — no Joe Wilson moments — but firm. On defense, the Republicans need to show that the Democrats have failed to pass something thus far for two reasons: because their ideas are unpopular, and because Democrats — who have large majorities in both houses — have been unable to agree amongst themselves. On offense, the Republicans need to show that they have a variety of CBO-scored ideas that will increase access and reduce costs, including high-risk pools, purchasing insurance across state lines, and real medical-malpractice reform. The may decide not to bring in a single, official Republican proposal, à la the small bill, but they certainly can bring in a variety of useful ideas that most Republicans agree on.
Republicans have been afraid of Obama's rhetorical gifts in the past, but events of the last year showed that the president, while talented, is not unbeatable. The trick for Republicans in the summit will be to highlight the considerable differences among the Democrats and the deficiencies of their bills, demonstrate that Republicans care about health care and have ideas for fixing it, and show that they are willing to work with Democrats on a new bill that starts from scratch. The stakes are high, but the task is eminently doable.