The Health Care Overhaul So Far

The president's hopes for swift action on a health care bill faded late in the week, when the Senate announced it would not vote on a plan before senators leave for their August recess in two weeks. A House vote is also uncertain. NPR White House correspondent Scott Horsley brings host Scott Simon up to date on President Obama's drive to overhaul the nation's health care system.

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With talk radio and cable news fixated on police and race relations this week, there was less airtime for President Obama's intended message - that was health care. The president's hope for swift action on the health-care bill faded late in the week when the Senate announced it wouldn't vote on a plan before senators leave for their August recess in two weeks. And the House vote is also uncertain.

NPR's White House correspondent Scott Horsley joins us. Scott, thanks for being with us.

SCOTT HORSLEY: Good to be with you, Scott.

SIMON: Up until Thursday, President Obama insisted he wanted both the House and Senate to vote on health care before they left town. He used the deadline as -I think it's fair to say - an organizing tool, an incentive. How big a setback does this represent?

HORSLEY: Well, you're right, Scott. He said repeatedly that in Washington, nothing gets done without a deadline. In fact, sometimes even when you have a deadline, nothing gets done. Now, he's faced with a challenge of trying to get an overhaul passed in September or October, when there won't be a looming recess to back lawmakers up against.

That said, the White House is downplaying how big a setback this is, saying, you know, they always knew they would have to reconcile House and Senate versions in the fall in any case, and also accentuating the positive, saying, look, three of the five committees in the House and Senate that needed to act on this have voted a bill out positively. It's those other two committees where the big fights are taking place.

SIMON: And of course, we should note it's not just the Republicans who are resisting fast action on the bill because the president's own party members are divided on this.

HORSLEY: That's right. There are real challenges there among Democrats, especially centrist Democrats. And you know, the challenges are these: How are you going to pay to expand health insurance to virtually all Americans? That's a price tag that we estimate at, you know, more than a trillion dollars over the next 10 years.

And none of the ways that are being talked about of financing that are going to appeal to everyone. The president expressed some support this week for a surtax on the wealthiest Americans. And that idea of taxing health benefits is still out there, although he doesn't favor that.

But the second big challenge that he has set out, and which has proven vexing, is how to bend the cost curve down, how to control health care inflation over the long term. And he conceded during his news conference on Wednesday that there really hadn't been enough in the legislation to address that yet.

And so over the last week or so, the administration's been talking a lot about this proposal for an expert panel to recommend changes. But that doesn't necessarily sit well with lawmakers because every one of those cost cuts that's proposed by the experts has a constituency somewhere.

SIMON: I think a lot of people in the administration openly felt that they had to do something before Congress went on August recess because once people get back home, they get bombarded by an awful lot.

HORSLEY: That's right. And that was the fear, that the opponents of the overhaul would use that August recess to pummel whatever's out there. The president says he won't be taking August off, though. In fact, in his radio address this morning, he used the opportunity to talk about the needs of small business. He'll be out there talking all during the break about what he wants to see in terms of health-care reform. No recess for the president.

SIMON: Anything to look for in the few days we have before the recess?

HORSLEY: Well, we do expect the Senate Finance Committee to continue its work. While the full Senate won't vote, we may see something come out of the Finance Committee before they take off in a couple of weeks. It's still up in the air whether the House is going to vote. But the House Energy and Commerce Committee - the third House committee that needs to act - may get something done before they recess at the end of this week.

SIMON: NPR's White House correspondent Scott Horsley, thank you.

HORSLEY: Good to be with you.

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