Liveblogging the Health Care Summit
Thu, 02/25/2010 - 9:04am
Today may mark the day that comprehensive health insurance reform lives or dies in the United States, as the President hosts a summit with congressmen from both parties at Blair House starting at 9am CST today to try and work out a bill that will pass both the House and Senate. And we've got it for you here, liveblogged after the jump.
A brief note: this liveblog will be a little different from our typical debate liveblogs. In those, we try to give a complete account of what the candidates are saying, as they're the primary players in question. Here, the primary players are policies, not people. We'll be giving you the rundown on the best talking points on each side, but if there's a good deal of repetition from the members of Congress (which there likely will be), don't expect to see that here.
We should also note that for those of you joining us during the summit, you can view it live online at the MyBarackObama.com web site.
9:00 The summit starts just a little late; a few handshakes on the live feed before President Obama leads off with an opening statement. Notes a "glimpse of bipartisanship" in the recent passing of the jobs bill, and moves on to express the gravity of the health care situation in America. Letters he gets from constituents and other such anecdotes. Premiums will double in the next decade like they did over the previous decade.
Shares some personal anecdotes as well -- of his two children going to the ER, and of his mother dying of ovarian cancer and spending the last six months of her life fighting insurance companies instead of with her family. Wow.
9:15 Not a brief opening statement, it seems. Cites some of the health care plans and ideas from the Republicans in attendance, and notes the overlap. Folks worked "long and hard" to get a bill, but in the end, "politics trumped common sense." He's kept a carefully bipartisan tone throughout.
Not that he's 100% sold on bipartisan agreement -- he notes that there will be some things that they'll walk out of the meeting clearly disagreeing on, but at least they'll have identified their similarities and clarified their differences for the rest of us.
9:22Senator McConnell is tapped for the Republican opening statement, and hands it off to Lamar Alexander. He says he feels their stances on health care represent the American people, and cites the elections in New Jersey, Virginia, and Massachusetts as examples. (I guess we could call those simply badly run races or bad candidates, and point to the majorities we still have in both houses as a counterexample.) He'd like to start from scratch and throw everything done so far out with a bill that would lower costs -- he doesn't like the current bill that lowers costs for paying middle-class Americans, it seems. He calls it "a car that can't be recalled and fixed."
He interestingly also gives an answer for why the Republicans don't have a comprehensive bill. He says "we don't do comprehensive well." Cites as examples the cap-and-trade bill, the immigration reform bill -- funny, I think Democrats would call those pretty good bills. And how about the jobs bill that just passed?
Anyway, he'd rather an incremental, piecemeal approach to the process. (Completely missing, apparently, all the experts that note that drastic change is needed to prevent the system from collapsing under its own weight.)
Ooh. And for the last thing, he requests that before we go on, that Democrats reject the idea of using the "little-used" process of reconciliation to pass the bill. Of course, that's already been refuted, as the Republican Congress under Bush used it far more often than Democrats have. "You may say that it's been used before, and it has, but never for something like this."
9:35 Time for the Democratic delegation's opening statement. Speaker Pelosi and Senator Reid are splitting their time for this. Pelosi notes a much bigger recent bipartisan push in the House recently -- the vote yesterday to remove the antitrust exemption from insurance companies, forcing them to play by the rules in a competitive market. Calls out Congressman Dingell, the dean of the House (its longest-serving member), for gaveling through Medicare -- hey, there's a comprehensive reform package that is still around and that even Republicans don't want to get rid of.
Pelosi's defense of comprehensive health care brings up how it helps the job market -- people hurt from being "job-locked," she says, and having no mobility because of their dependence on their employer-provided health insurance plan; the current bill would immediately create 400,000 jobs.
9:44 Senator Reid starts off by saying he'll be talking about Nevada and the country, and not about what's going on in Washington. Heartwarming anecdote time! A Nevadan with a baby with a cleft palate was refused coverage for the baby's surgery because it was a "pre-existing condition."
Then calls Lamar out -- says he's entitled to his own opinion, but not his own facts. Mentions the recent Kaiser poll that says that 58% of Americans want health care reform this year. Over 60% want to see it happen, period. Also mentions the "donut hole" of Medicare part D coverage, where seniors don't have coverage for a good chunk of their prescription drug bills.
He goes on with the fact-checking with reconciliation. Republicans have used reconciliation more than Democrats have, and for such big projects as the Contract for America, Medicare reform, and the Bush era tax cuts for the rich.
The health care bill that came out of Senator Dodd's HELP committee had 150 Republican amendments in its final form. Baucus' bill had significant Republican input as well. And the bill would cut the deficit by over $100 billion over the next decade.
Finishes off by noting that, again, Republicans don't have a plan. I like this "tough" version of Harry Reid -- you can tell he's running a contentious reelection campaign.
9:53 Obama gets in a quick response to Senator Alexander's statements on process -- many ideas he stated were things that Democrats wanted as well, so don't jump to conclusions, there may be more agreement than we thought; let's stick with process here, and we can find out how much agreement we have and how to proceed from there.
Then starts off with costs as a first step. Costs are particularly hurting small businesses. Less than half of businesses with 10 or fewer people offer health insurance. Business premiums are on track to double by the end of the decade. Presents the health care exchange idea as one that can help control that. Senator Alexander says that the CBO says it increases costs -- Obama calls him on it, saying that the CBO says it *decreases* costs so much that people may choose to get better coverage than the underinsured coverage they have now, which could cost up to 10% more, but that costs for comparable plans go down across the board. Republican Myth #1 debunked. Maybe I should keep a running tally?
Obama notes that he's included every cost-control measure that has come up and that has been shown to work. He asks that Republicans name any new cost-control measures they have, and that additionally they should name what things they *do* like about the bill, since it has had so much Republican input. (Which, of course, they won't -- a good way to highlight Republican obstructionism.)
Senator Alexander says that he believes that the President is wrong about costs decreasing, and would like to present his facts. The president, happy to take that on, says that he'd like that clarified today, because he's confident he's not wrong. "We'll be here all afternoon." Alexander punts back to Senator McConnell, who tries to get a not-well-worded barb in on reconciliation before handing it over to Senator Coburn to talk about cost control. He mentions prevention, fraud (20% of the cost of health care, he cites), and tort reform. He's actually pretty good at throwing subtle partisan barbs in there in ways that wouldn't be picked up as overt hackery (things like saying that one side wants "government-based reforms," and he'd prefer "patient-centric, market-centric reforms" -- see how he equates those two? I don't know any patient that has *any* pull in the market compared to even the smallest of health insurance companies, but hey -- he sees a parallel! I'm sure both sides would say they prefer "patient-centric" reforms.) Also throws states' rights in there -- "state mandates" versus "state incentives."
Says the bill has good fraud programs, but lacks the biggest fraud prevention mechanism -- undercover patients. Senator Reed notes that they're once again going way over time, and Senator Coburn says he's finished, noting that one out of three dollars are currently wasted. (It should be noted that the AMA is tentatively against the undercover patient program, saying it could interfere with treatment for real patients. Just throwing that out there.)
President Obama notes that they do have a number of state incentives which Health and Human Services Secretary Kathleen Sebelius has been working on.
10:13 Senator Hoyer goes next. His thing is increasing competition. Calls for an open, transparent market to do so and hopes they can find common ground. Says to Senator Coburn: "We agree with you." One out of three dollars is wasted, and we should wring fraud and abuse out of the system. And we have addressed that thoroughly in the bill. We also have numerous prevention programs like you mentioned, food stamp and school lunch programs like you mentioned. You may have ideas on how to improve those; we'd like to talk about those. Also stop problems with rate discrimination from some having access to large groups, and with pre-existing conditions.
Hoyer also brings up the public option as a significant cost control measure, assuring competition in the marketplace and preventing those rate discrimination problems. Mentioned Senator Baucus would speak with more detail on cost control.
10:21 Hope this keeps up: there was some "harrumph, harrumph" from Republicans chomping at the bit to follow Senator Hoyer, assuredly to say no to yet another idea, but Obama cut them off and asked first who on the Republican side would want to speak on the issues that it seems like they agree on -- like preventive medicine and fraud prevention; Obama notes that they seem in agreement with the exception of the one new idea Senator Coburn has, which Obama says he's interested in talking about and thinks that "conceptually... it shouldn't be a problem." Yet another Republican idea accepted for the bill that so far every Republican Senator has voted against.
10:25 Was that Representative John Kline? I missed the name and am not sure I'm placing the face. He speaks as to how they'd rather deal with providing big insurance pools for small businesses -- he prefers small business associations to a large health exchange.
Senator Baucus follows, and is much more comprehensive with cost control ideas for businesses -- selling insurance across state lines, HSA expansions, et cetera. Specifically on small business solutions, he notes that John Kline's solution is already in the bill in a very similar form -- and that exchanges are actually a Republican idea, and a very good one.
10:32 Republican congressmen have always been the most reliable sources of rote party-line argument, and Rep.Dave Camp is no exception. At least their senators sound like they are listening to what everyone else said. This guy complains about the "trillion dollar" bill, and then goes on to nitpick on how much he dislikes details of ideas that Republicans came up with in the first place. I'm not kidding here -- he's dissing the health savings account improvements. Then he starts talking about the governmental cost of all these programs, and government spending and deficits.
Ooh -- Obama redresses the guy, pointing out that what he's talking about isn't related to const control for families, and further, that if everybody "on one side" is just giving lists of what they don't like, they aren't really working toward common ground.
Rep. Robert Andrews goes back to trying to find common ground -- smart! He addresses association plans versus the health exchanges in the current bill, noting that the difference is mostly semantic. He says that there is one substantive difference, but that if they can find agreement on that matter, they'd likely be able to agree on the plan itself. The difference is assuring consumer protections in the health exchanges, which are not in the association plan that Rep. Paul Ryan presented. Andrews points out that Ryan calls for those same minimum protections in the roadmap he had presented in Congress previously; Ryan says he does support those, but at the state, not national, level.
A quick interlude from Mitch McConnell: he complains that Democrats have gotten 52 minutes, and Republicans only 24. Obama notes that that includes his opening statement, and he wasn't including that because, well, he's the president. ZING!
Schumer again notes similarities. Seems to like the "undercover patients" idea. He also takes a little time to shoot down Republican complaints on Medicare cuts: everyone so far has said they're in favor of cutting waste and fraud, but the supposed Medicare "cuts" Republicans have complained about are specifically cost reductions due to reducing waste and fraud.
Then John Kyl throws down the Republican gauntlet: there are philosophical differences "we can't paper over." Considering how everything that's come out so far is nearly identical, he really just looks like he's trying to pick a fight.
Senator Coburn, last to speak before the afternoon break, has two points: First, he says that a missing aspect is strengthening primary care -- a large part of emergency room cost is due to patients coming in not for emergency care, but for primary care, and so we should strengthen community health centers. He does note that's already in the bill, and it's a key cost-cutting measure. Second, he brings up that the employees of the small businesses in question in this debate on exchanges don't get to have a say in the quality of their plan. He wasn't too clear about it, but it seems like he was defending universal minimums of consumer protections in these plans so that those employees wouldn't get shortchanged by the small business owner looking for the most economic option, no matter what.
Obama gets to answer some of Kyl's concerns -- Kyl and Obama spar for a bit about whether costs go up or down with the -- Republicans say insurance mandates, Democrats say consumer protections -- in place in the current bill. Obama, in closing, says that we agree on certain things -- one being lack of rescission (being dropped from your insurance without warning), which he notes is in agreement with John Kyl's bill and leads to an amusing camera moment as Kyl can be seen frantically flipping through his bill in front of him to find where he made the mistake of agreeing with a Democrat.
11:12 Oh -- I guess there's another speaker before the break. Don't know who the guy is, but he's going straight back to political talking points. Booooring. He even reiterates the "plan costs go up" false argument, even though Obama went out of his way earlier (after Kyl's statement on that) to explain in practically little-kid talk that if you pay one price for an apple, and another for an orange, that doesn't mean your costs are going up -- it means you're buying something different. (Myself, I would have used "an apple" and "an apple and a half," but what do I know?) He also thinks that risk pools and reinsurance are *more* assured ways of making sure people are covered for pre-existing conditions than explicitly prohibiting pre-existing conditions. Huh?
11:19 Yeah, turns out we have plenty of speakers left. Rep. George Miller again sticks with the Democratic approach of trying to point out similarities. When he gets to a difference, it's with the pre-existing conditions clause that was just brought up. He goes back to Pelosi's point of being locked into a job and not having the flexibility to move jobs or start their own small business -- the driver of the American economy -- because they wouldn't be able to get insurance. He noted that business groups actually signed off on the changes in the bill.
11:26 McCain's up, and he wants to talk process. It's a little sad how he's turned from a man with a mind of his own to one that would spend time delineated specifically for issues to instead hammer on partisan points. He talks about the process by which the bill was developed -- kickbacks to states, concessions to PhRMA, etc. I don't really know how he can lay blame for that at the president's feet, but it can probably be argued that the Democrats' PR arm was asleep at the wheel when those things came out.
The president answers: "We're not campaigning anymore. The election's over." He notes that we've had months and months of floor discussion and committee debate, but that we're not here to argue process and try to gain political points in doing so.
11:33 HHS Secretary Kathleen Sebelius gets to talk about the efforts that would be made on the executive side to cut costs for middle-class Americans. She talks about health exchanges, and notes that state associations have uniformly opposed cross-border health insurance offerings on the whole, *not* because they're against national health insurance, but because there are no across-the-board consumer protections, and therefore there's no ability to assure that the insurance available to people in their state conforms to some common-sense standards. That pretty much directly refutes Rep. Ryan's argument for small business associations with state-level as opposed to nationally defined consumer protections.
11:39 Rep. Cantor starts off pretty well -- he's doing less of the standard Republican talking points and a little more straight shooting. "There's a reason we all voted no" -- philosophical differences, and Washington defining the baseline consumer protections and benefits. He says if we were to try, costs would go up, and some people would not be able to keep the coverage they have now.
Obama answers by noting that it's not that they wouldn't be able to keep their coverage -- the CBO says it's that they'd actually find the deals in the exchange to be better and would switch.
Then he answers his underlying question, on the philosophical differences. "We could reduce food costs... by eliminating all meat inspectors." We make a fundamental decision to assure a baseline standard to avoid abuses in industry, as an appropriate application of government. It's not a Washington thing -- most states have stricter restrictions than anything that the federal government has.
And further -- Republicans *agree* that some regulation is necessary. They have already agreed to preventing denials from pre-existing conditions. Well, without a law for that, you can bet that they won't be prevented. It happens already. So you *have* to have all those spelled out, and you *have* to have that 2400-page bill to do that for all the aspects that they've agreed on -- a very large chunk of that to establish mutually agreed-upon fraud controls, for example.
So he basically notes that the "philosophical difference" is neither feasible nor honestly adhered to by the Republicans.
11:52 Have I mentioned lately that I love Joe Biden? He lays it down short, sweet, and simple: there is no huge "philosophical difference." Either you think that government has no place doing any of this stuff, or you acknowledge that government can and must regulate certain things -- and Republicans have already acknowledged that in calling for reforms to rescission and preexisting conditions. We're just arguing where the line is. The idea of this "philosophical difference" is a scapegoat. Heck, he may have actually explained that *faster* than I just did.
Cantor goes back to the idea that we can't afford the bill as it's currently structured. I'm wondering where the Democratic counterargument that we actually would see net savings -- that the cost would be more than offset by the savings. Haven't heard that in a little while.
11:54 Rep. Slaughter does the straight-shooting thing too. We have to get rid of preexisting conditions; they are cruel and unfair. The system's broken. We have to get this stuff passed.
Aaaaand an emergency break for a scheduled House vote. We'll be back at 12:45 CST for the continuation
1:00 Again, starting out a little late. Apparently, adjournment will be at 3:15 CST.
Senator Mike Enzi thinks that part of the piecemeal Republican effort can be fixing Medicaid. Funny how we haven't been able to pull that off before. But mostly he just complains about process some more.
Senator Harkin follows, and notes again the similarities between what Republicans and Democrats are asking for. 9 of the 10 items in the Republican proposal in the House are already in the Democratic Senate bill. We've spent a ton of time on this bill, and included a ton of Republican amendments. And again, we don't have the time to do this piecemeal -- Americans are already hurting. Considers current risk pools "segregation by health."
1:22 Representative Camp keeps railing against the individual mandate, and against setting of standards by the HHS secretary. Obama notes that the current solution they have is just setting up a high-risk pool, which basically locks them into ludicrously high rates. 21 states already do it, and only 200,000 people are in and they pay the highest rates in the nation. Apparently he likes the "segregation by health" line, by the way..
Rep. Camp wants to avoid the mandate, but does not give any explanation as to how they would get the broad coverage
1:30 Senator Rockefeller is up next. The problem is that health care should not be for-profit -- they're more concerned with the bottom line than with providing a public service. A public option would therefore help keep prices fair in the system, but that's not going to happen. And states clearly aren't controlling for that themselves. So we should assure by law that the medical loss ratio (the percentage of premiums that actually go to care) is always between 80 and 85 percent, and the HHS should get rate review.
Marsha Blackburn sticks with talking points. We need to start with a blank sheet of paper, and put in things like shopping for insurance across state lines -- which of course is in the current bill.
Obama defends the mandate again -- everyone gets cheaper insurance if they're in one big pool. If we don't do that, we get cost shifting. And the insured are already subsidizing the health care of the uninsured, and the mandate fixes that too.
1:45 Vice President Biden leads off the third major subject, on how the bill affects the deficit. Again, on message -- puts out a list of points of agreement. Costs are doubling every ten years, there is tons of waste, and we're already paying a heavy tax burden for the current system in covering the uninsured -- 35 cents out of every dollar. The Republican plan cuts the projected deficit by 300 billion dollars over the next 20 years; the current Senate bill cuts it by 2 trillion. (We win.) And, again, the "cuts" in Medicare are savings from cutting waste, not cutting services. Exhibit A: Medicaid Advantage. We assumed that private insurance would manage costs better than public insurance, so we subsidized private insurance entering the program. Except it turned out that they managed costs *worse*, not better. And now we want to end that program and bring that back to the public sector, and Republicans are calling that a "cut" -- though no services are being taken away. Republicans are the ones making Medicaid suffocate the country in debt.
1:53 Representative Ryan is back. Says the president promised not to raise the deficit in the campaign -- come on, that was before the economic collapse. Even so -- the CBO says it doesn't raise the deficit, and Ryan says it does. It's ten years of cuts for six years of funding on the bill, he says -- "smoke and mirrors." (No, Representative -- the CBO also gave estimates for 20 years out -- and the savings just get bigger.) Says he doesn't want this stuff decided by the government -- he wants it by the people. Wow. If the government isn't the people, what is? Does he really think insurance corporations setting their own rules is better -- that somehow they represent the people better than the government does? And doesn't that directly contradict the corporate profit motive? Good partisan soundbite, I guess, but it doesn't make any sense. (Keep in mind that this is the guy that wants to get rid of Medicare and Medicaid altogether.)
2:00 The president again points to Medicaid Advantage -- an $18 billion program that experts agree doesn't actually make anyone healthier. Privatization doesn't work. Wants to spend that money on closing the donut hole.
McCain again starts talking process -- he's really committed to making this a partisan points war. Obama shuts him down by saying he agrees. Touche! That's really the only right answer right now: yes, those concessions were bad ideas, and that's why we took them out. Acknowledge, transition, and then back to the message. That's some Damage Control 101 for you there.
Representative Becerra up next -- he asks Rep. Ryan if he believes that the (nonpartisan) CBO is a legitimate source for these numbers, seeing as he was saying that they were inaccurate now but he'd been perfectly willing to use CBO numbers in the past. Wow -- major fail on Ryan's part. Believes the CBO, but not "the reality of their numbers." That's like saying that I'm a big fan of Republicans -- I just think all their policies stink.
2:09 Senator Grassley is coming across as a little senile. Says that 75% of Medicaid Advantage dollars go to benefits and 25% to the government. The President says that's not really possible, because it's a private subsidy -- at least *some* of that percentage by definition goes to insurance companies. Then Grassley rambles about the CBO counting dollars twice (trust me, Senator, they know what they're doing better than you do), about the individual mandate being unconstitutional, and how we can't cut Medicaid Advantage. The president basically calls him on being chicken -- everyone across the spectrum agrees it's not helping anyone and it's expensive. If we can't get rid of any entitlements, ever, we're in really big trouble.
Senator Conrad is down with fixing Medicare. Says half the costs of Medicare are taken up by 5% of the people on it.
John Boehner is almost painfully predictable. It's like he didn't hear -- or didn't want to hear -- anything about keeping this related to substance. Government takeover this, we're funding abortion that. He's a fact-checker's dream. Obama basically laughs at him for being so transparently partisan -- his facts are false, the CBO says so, and he should stick to substance and not bomb-throwing.
2:40 Representative Cooper wails on Republicans a little. Republicans talk tough, but they don't act. They shot down the bill for a bipartisan fiscal commission that would force them to reduce the deficit. And they want to punt on Medicare, which everyone agrees needs to be fixed now. Medicare Advantage added $8 trillion to the debt. Quit talking and act.
Jeez, is McCain consistent or what? He and Boehner win the Partisan Hack crown. Gets up and talks about starting from scratch, medical malpractice, and how reconciliation is apparently the new "nuclear option."
The president notes that most Americans don't *care* about process junk like reconciliation -- dead true -- and that a majority vote makes intrinsic sense to them. And he'd be willing to look at tort reform -- but he smacks McCain and Boehner down for making that the cornerstone of their "savings" when that won't come even close to covering the costs of their plan. Then he turns the tables on all the reconciliation talk -- hey, none of it would be necessary if they wouldn't abuse the filibuster by applying it to everything that goes through the Senate. Hey, Republicans -- we won't go through reconciliation if you don't filibuster! Even stevens! I bet I know who wins that one.
Senator Durbin follows up with hard numbers on tort reform -- it would cover only 1/5 of 1% of the ten-year cost, and decrease accountability in the system and lead to more deaths. Also knocks down McCain's ideas of it being some rampant problem by noting that cases and awards have both actually gone down by half in the past ten years. And when Boehner talked about this all ruining "the best health care in the world" -- right now only people like us Congressmen get the best health care; the rest can't afford it. It should be available to all Americans.
I hope all this tort reform stuff ends up in a sound bite somewhere -- it destroys both the argument for it and any remaining shred of legitimacy the Republican "plan" had.
2:50 Now to expanding coverage. Obama noted that Boehner's plan covered 3 million additional people, and his covered 30 million. So are we going to agree that we do need to cover more Americans? And if we're going to do that, we're going to have to pay for it.
Thank you, Representative Barrasso, for representing the loony right wing of the Republican Party. Barrasso apparently only wants catastrophic coverage available to people. We have a name for those people -- the underinsured. Obama asks if he would support a plan cutting all Congress' benefits and only providing them catastrophic coverage, and he says yes. Let's start with his! After all, Republicans prefer a slow, piecemeal approach to things... Oh, and apparently the premier of Newfoundland came here to get heart surgery. Obama points out that premiers who can afford their own care aren't the guys he's trying to help.
Senator Waxman then asks if he also supports cutting all Medicare benefits except for catastrophic coverage. ZING! There's yet another one for the sound bites -- put that in an ad and see how fast senior citizens abdicate the Republican Party that wants to cut their Medicare.
3:09 Representative Roskam is back on message: "entitlement expansion" and starting from scratch. Obama gets back to the question: do Republicans support covering more people? Better to do it through the exchange than through Medicaid, he says.
Dodd then points out that expanding coverage is a fiscal concern too -- stuff like cutting costs and the plan's hit on the deficit requires that we include as many people as possible.
Representative Joe Barton makes up some numbers in talking about the same point of having to start all over. But he still wants tort reform and competition across state lines -- but no mandates, without which competition across state lines doesn't work. Clearly he wasn't listening when we hashed this out half an hour ago.
Representative Wyden says that the only real divide is that Democrats want comprehensive reform and Republicans want incremental reform, but studies show that incremental reform only ends up costing more in the long run. McConnell mentions that Americans don't support this bill. Obama counters that they don't know what's in it, and they actually majority support many measures within it. (True.) Senator Coburn talks about connecting purchase and payment, to give people reasons to buy better insurance. (Wonky!) Representative Charlie Rangel doesn't think Americans care about reconciliation; they don't get the 60-vote requirement, and a majority vote makes sense to them; and he doesn't think they care about the size of the bill either, as long as it works.
Representative Dingell says that purchasing insurance across state borders without mandated minimums for coverage would cause a "race to the bottom" of providing low-quality health insurance services. He also thinks that the Senate shouldn't be so "fussy" about helping Americans through a 51-vote majority.
3:56 Pelosi makes a brief closing -- she wanted a public option but settled for the Republican exchange plan; hey, Sen. Coburn, we have things in the bill that deal with encouraging quality insurance; hey, Sen. Boehner, we already refuse to pay for abortions with federal dollars AND your thing about cutting Medicare for seniors is a flat-out lie.
And Obama with some final talking points: hey, Republicans, which insurance reforms in the bill should Americans *not* get? Exchanges aren't a "government takeover" -- they're market-driven, just like they should be. Purchasing across straight lines is a Republican idea, and it's already in the bill -- but it doesn't work without the consumer protections piece. Government does consumer protections all the time, and they have been very successful at it. Without them, you get the "race to the bottom," just like you got with the credit card industry.
Republicans came up with the exchange idea and were big fans of it until Obama embraced it -- they're playing just for political points. Obama tells them they should look through and find something they agree on. They should use market-based ideas, like the Democrats have; there might not be any consensus to be had on whether or not to cover 30 million more people and that bipartisan support might be hard for Republicans to come up with, though starting over is pointless because everyone agrees on what the issues are. Hopefully, the Republicans will find some common ground; otherwise, "decisions will have to be made" and elections will decide who's right in the end.
Aaaaand, over an hour over schedule, it's finally over! Let us know what you think in the comments.