Judd Gregg has an idea for a bipartisan HCR deal, but given his history with the administration--accepting and then rejecting the Commerce Secretary post, then trashing the administration regularly on budget issues--is it one Dems should even consider?
In a letter to Obama released late Tuesday, Gregg welcomed the meeting as a chance for “constructive dialogue” and is promoting his own lower-cost approach focused on preventive care and guaranteed catastrophic coverage for all families.
His letter warns the president that the House- and Senate-passed health care bills can’t be the sole basis for the discussions. But in a series of interviews with POLITICO, Gregg has been open to specific deficit-reduction and cost-containment steps that could be taken to win Republicans’ support for health reform....
Gregg has yet to reduce his ideas to formal legislation but bundles them under the catchy title CPR: coverage, prevention and reform.
The centerpiece is his plan to begin reform by first guaranteeing access to a low-premium policy that protects against catastrophic costs but also expressly allows preventive benefits and disease management under the deductible. He would modify the existing Health Insurance Portability and Accessibility Act to allow employers greater freedom to reward workers who participate in wellness programs, such as giving up smoking or losing weight. And given his New Hampshire roots, he subscribes to a host of the so-called Dartmouth reforms to promote accountable care organizations and incentivize “shared decision making” between physicians and elderly patients about treatment options.
His approach is sure to face criticism for being too late and too small bore. But Gregg’s already shown a willingness to work with Democrats on a compromise related to the HIPAA changes he wants. Having a true catastrophic, major medical option for people being mandated to buy insurance fits his mode of “middle working out.”
“We can all agree that no American should lose their life savings or their home because of illness or injury and that the rising cost of health care severely burdens individuals, families and businesses,” Gregg wrote in his letter to Obama this week. “Report after report also confirms that health care costs are a systemic risk to the long-term fiscal health of our nation.”
The theory is that because he's retiring, he wants to burnish his legacy. The big question is whether any other Republican would be willing to help with his legacy when the orders from leadership are to obstruct. And, of course, if Democrats who have spent the last year sweating to make this effort meaningful would be willing to throw it out the window for such a scaled-down approach. The House already finds the scope and lack of affordability in the Senate bill unacceptable. How would this get through?
Accepting this proposal would basically be what Obama has ruled out, starting over from scratch. His "CPR" elements are already in the plan. What's missing, in this summary anyway, is access--how to make it affordable through Medicaid expansion or subsidies.