President Obama to Lay Out Final Push for Health Care Reform Legislation

With the clock once again ticking on health care reform legislation, President Obama today will launch his final push to get a bill passed and will indicate that he is willing to work with Republicans on some issues. But the president will suggest that if it is necessary, Democrats will use the controversial "reconciliation" rules to send a bill to his desk.

That parliamentary procedure would allow Democrats to pass the legislation with just 51 votes, as opposed to the 60 votes needed to stop a filibuster and proceed to a vote.

Lawmakers on Capitol Hill have been waiting for direction from the president on how health care reform will proceed. In remarks scheduled for 1:45 p.m. ET at the White House, Obama will urge Congress to "move swiftly" toward votes on health care, a White House official said on Tuesday.

The White House's outline for the path to getting a bill passed includes having the House of Representatives pass the health care reform legislation passed by the Senate on Christmas Eve, as well as a second bill containing "fixes" to that legislation.

Obama will call for an up or down vote on health care reform, as has happened in the past, and though he won't use the word "reconciliation," he'll make it clear that if an up or down vote is not possible, Democrats will use the reconciliation rules as Republicans have done in the past.

Republicans have been grousing for weeks about the use of reconciliation, saying it shortcuts the process and should not be used for a bill of such importance.

White House officials said the president will make the argument these rules are perfectly appropriate for several reasons: first, the procedure is not being used for the whole bill, just for some fixes; second, reconciliation rules are traditionally used for deficit reduction and health care reform will reduce the deficit; and third, the reconciliation process has been used many times by Republicans for larger legislation such as the tax cuts pushed by President George W. Bush.

While this will sound like partisanship to Republicans, Obama is expected to note that his proposal brings together "the best ideas from both parties."

The president will show a willingness to work with Republicans to incorporate some of the ideas they brought to the table at last week's bipartisan health care summit.

On Tuesday Obama sent a letter to congressional leadership from both parties that said he would be open to including $50 million for state grants for demonstration projects to explore alternatives to medical malpractice cases, and a crackdown on Medicaid and Medicare fraud as proposed by Sen. Tom Coburn, R-Okla.

Obama will also herald the removal of extraneous provisions in the bill such as the so-called "Cornhusker Kickback," a deal to secure the support of Sen. Ben Nelson, D-Neb., in which the federal government would pay for Nebraska's Medicaid expansion; and "Gator-aid," the provision to shield Florida seniors from cuts to the Medicare Advantage program, secured by Sen. Bill Nelson, D-Fla.

The Republicans responded with a letter that essentially said, "Thanks but no thanks."

Senate Minority Leader Mitch McConnell, R-Ky., wrote to the president to say that the Republicans were "surprised and disappointed with your latest proposal to simply paper a few of these commonsense proposals over an unsalvageable bill."

"The American people are asking us for step-by-step reforms that target cost and expand access, not a couple of commonsense ideas layered over a rewrite of one-sixth of the economy, a massive expansion of the federal government's role in their daily lives, and higher taxes and cuts to Medicare to pay for it," he wrote.

The president will be joined in the East Room by health care professionals from around the country and Secretary of Health and Human Services Kathleen Sebelius.

To stress the urgency of the task at hand for members of Congress, Obama will "reiterate why reform is so crucial and what it will mean for American families and businesses: they'll have more control over their own health care, they'll see lower costs , and they'll see an end to insurance company abuses," according to a White House official.

The president will paint a picture of what he will say will happen without a health care reform bill – skyrocketing premiums, everyone at the mercy of the insurance industry, as recently seen with the 39 percent premium increases proposed by Anthem Blue Cross in California.

He is expected to note that that the "fixed" bill will include the proposal for a new "Health Insurance Rate Authority" to set guidelines for reasonable rate increases. If proposed premium increases are not justifiable per those Health Insurance Rate Authority guidelines, the Health and Human Services Secretary or state regulators could block them.

Obama will say that he will be working on exact legislative language in the next few days. Republicans can join him and Democratic congressional leaders of the House and Senate to make these changes and to pass the bill, but either way the bill will be moving forward.

The White House said on Tuesday that the health care debate moves into its "final act" after the president's remarks and that he will "continue the role he's played throughout this process."

"He will obviously be very involved in whatever happens next," White House spokesman Robert Gibbs said. "We wouldn't be where we are without the president's involvement and we'll leave process to after the president's announcement."