Then Sen. John Kyl (R-AZ) suggested the fundamental difference in opinion was who should be in charge, states or the federal government. Kyl also said taxes on medical devices and pharmaceutical companies to pay for health reform legislation would eventually be passed on to consumers.

The president countered that Republicans keep criticizing the Senate bill rather than trying to find agreement. He also said that many people such as self-employed persons without coverage or those with high deductible plans, basically buy only for catastrophes, not for preventive or regular care. He again emphasized that the proposed exchanges were not a government takeover, but a means of setting up baselines for coverage and using market principles for competition.


Rep. James Clyburn (D-SC) then recounted stories of people using emergency rooms for primary care even if they had insurance because they could not afford the deductible. He suggested expanding community health centers to help address this problem.

Later in the hour Obama reviewed the areas of agreement: banning rescission of coverage for those policyholders who become sick, extending coverage to dependents, banning annual and lifetime limits; but still disagreeing on protecting those with pre-existing conditions.

In hour three, the talk of insurance reform continued. Rep. Charles Boustany Jr. (R-LA) spurned the proposed exchanges in favor of purchasing insurance across state lines and expanding health savings accounts, as well as creating high-risk pools for those with pre-existing conditions. Rep. George Miller (D-CA) countered that high risk pools would trap those persons within in the most expensive system in the country, without further options.

Sen. John McCain (D-AZ) stated his concern about the special deals in the current bill for the representatives from Nebraska and Louisiana, which was duly noted by the president. Secretary Kathleen Sebelius then weighed in with more problems in high-risk pools. Because the pools had the sickest people, she said, they would also have the highest costs.

After the lunch break, in hour four Sen. Mike Enzi (R-WY) talked-up the benefits of health savings accounts, particularly for younger persons, and then stated he liked the idea of exchanges as a transparent method for consumers to see what is in the market.

Rep. Camp then stated again that Americans do not want to be forced to buy health insurance that they don't want and they can't afford, and that the requirements to buy insurance should be scrapped and reform legislation begun anew.

More Industry Headlines