Skip to main content

Obama embraces earlier state flexibility on health care reform

By Alan Silverleib and Tom Cohen, CNN
Click to play
Obama flexible on health care overhaul
  • NEW: Republican governor continues to reject the health care reform law
  • Waivers would allow alternatives to the individual mandate opposed in lawsuits
  • Obama supports allowing states to apply earlier for waivers for health care alternatives
  • State alternatives for some parts of health care reform must provide the same outcomes

Washington (CNN) -- President Barack Obama tried to seize the political middle in the continuing fight over health care reform Monday, telling a group of governors that he's willing to give states earlier flexibility in how they implement the overhaul signed into law last year.

Specifically, the president embraced a bipartisan proposal that would allow states to apply for "innovation waivers" starting in 2014, three years earlier than originally scheduled in the health care reform bill pushed through by Democrats.

Under the terms of such waivers, states would be exempt from a number of requirements in the law if they come up with their own way to adequately expand coverage without increasing the deficit.

For example, a state could seek an exemption waiver beginning in 2014 if it comes up with an alternative for the provision requiring everyone to obtain health coverage unless they can't afford it, senior administration officials told reporters in a conference call later Monday.

The so-called "individual mandate" is the focus of multiple lawsuits by states that contend it is unconstitutional. While the proposal Obama backed Monday is unlikely to affect those lawsuits, it offers states the chance to devise an alternative to the most opposed provision so far.

The senior administration officials, speaking on background, explained that for any state alternatives to be eligible for a waiver, they must meet four criteria:

-- Provide coverage plans at least as comprehensive as would have been available under health insurance exchanges in the bill;

-- Provide coverage at least as affordable as would have been available under the bill;

-- Provide coverage for as many people as would have been covered under the bill; and,

-- Budget neutrality, meaning they cannot increase the federal deficit.

In his remarks, Obama slammed the door on conservative calls for a repeal of the overhaul, declaring that he is "not open to refighting the battles of the last two years."

He knows he hasn't made everyone "a member of the Affordable Care Act fan club," Obama told the governors during a meeting at the White House. But the overhaul has "done more to rein in rising costs ... than we've seen in years."

However, Republican Governor Sam Brownback of Kansas said most of his GOP colleagues had fundamental philosophical objections to the health care law that will be difficult to overcome, no matter what compromises the White House puts forward.

"This offers a little bit of flexibility, which I think is a positive thing, but it doesn't change the overall objection to the bill," Brownback said of the waiver proposal.

Obama also alluded to the growing controversy over public-sector union collective bargaining rights, asserting that while "everybody should be prepared to give up something" in the face of new budget realities, "I don't think it does anybody any good when public employees are vilified" or their rights are infringed upon.

Wisconsin Governor Scott Walker, a first-term Republican, has encountered fierce opposition from state Democratic leaders and public-sector union representatives over his plan to strip the unions of the bulk of their collective bargaining rights. Similar fights have started to erupt in other states grappling with the exploding costs of public pensions, health care and other benefits.

The president appeared to be searching for the political center on broader budgetary issues as well, telling the governors that the country "can't afford to kick the can down the road any longer" on festering fiscal problems relating to Medicare and Medicaid. Nevertheless, he argued, new spending is required on priorities such as infrastructure modernization.

"We're committed to funding only those things that work," the president asserted.

The White House and congressional Republicans are in a political standoff over how best to fund the federal government for the remainder of the current fiscal year. The GOP-controlled House of Representatives recently passed a measure that would cut $61 billion in funding for the rest of the year largely by imposing cuts in domestic discretionary spending that Democrats insist are too severe.

Obama noted Monday that such spending accounts for only 12% of the entire budget.

Congress and the White House appear to be closing in on a two-week extension of federal funding that would avoid a government shutdown after Friday. The proposal would trim spending in areas agreed to by leaders from both political parties.

White House Press Secretary Jay Carney warned earlier Monday, however, that continued short-term funding bills could create a climate of uncertainty and hamper prospects for a stronger economic recovery.

CNN's Peter Hamby contributed to this report