Congress Shows Little Appetite for Bush's Health-Care Agenda

By Jay Newton-Small

April 12 (Bloomberg) -- President George W. Bush's health- care initiatives, which he showcased as his top domestic priorities in the Jan. 31 State of the Union address, are stalled in Congress, with little chance for passage.

While the Senate is scheduled to spend the first week of May focusing on health care, Republicans say there is little hope any legislation will be passed in this election year. Bush had outlined four proposals: allowing small companies to pool health insurance, expanding health savings accounts, overhauling medical liability laws and small cuts to Medicare.

``The agenda this year is small and it may not even be achievable at that,'' said Senator Trent Lott, a Mississippi Republican.

Bush's health-care agenda may join other key domestic initiatives that he has been unable to get through a reluctant Republican-controlled Congress. Bush's Social Security overhaul plan died last year, he has put off a restructuring of the tax code until at least next year and his proposal for changing U.S. immigration law was dealt a setback by senators last week.

``I think his whole domestic agenda has been submerged by Iraq,'' said Darrell West, a political science professor at Brown University in Providence, Rhode Island.

Bush has repeatedly presented health-care overhaul as an essential component in keeping the U.S. competitive in the global economy. U.S. expenditures on health care reached almost $1.9 trillion in 2004, more than two and a half times the $717 billion spent in 1990, and more than seven times the $255 billion spent in 1980, according to the Kaiser Family Foundation, a non-profit organization in Washington that studies health trends.

`Available and Affordable'

``How does the United States of America remain the preeminent economic leader in the world?'' Bush said April 5 as he promoted his policies in Bridgeport, Connecticut. ``You make sure you've got an environment where small businesses can thrive, where people can feel comfortable in having health care that's available and affordable.''

Bush is touting his health-care plans to the public in a series of speeches across the country this week and last. Yesterday, however, at an event in Jefferson City, Missouri, Bush made no mention of his proposals, focusing instead on urging people to enroll in the Medicare program expanding coverage for prescription drugs, which was enacted in 2003.

`Priorities'

``We view all these things as issues that we will continue to work with Congress to forward,'' said Ken Lisaius, a White House spokesman. ``We don't view this as stalled, we view this as a healthy discussion on health-care priorities and a continuing conversation with members on the Hill about these priorities.''

Most public-opinion polls show that health care is the most urgent issue for voters, though they have shown little confidence that the Bush administration or Republicans in Congress will be able to fix the problem.

In a Harris Interactive Inc. poll published March 6 by the Wall Street Journal, large majorities of respondents said they weren't confident Bush could reduce the percentage of uninsured Americans, cut out-of-pocket costs for care and insurance, and slow the increase in health-care costs overall.

A Bloomberg/Los Angeles Times poll published Jan. 27, days before the State of the Union address, found that only 25 percent of respondents believed that Bush could do a better job than congressional Democrats in handling health-care issues.

Perhaps as a result of this public sentiment, Republicans in Congress have so far shown little interest in acting on Bush's proposals.

Medicare Cuts

In March, the Senate passed a budget for the 2007 fiscal year that omitted Bush's plan to cut Medicare spending over the next five years. A House committee removed a provision containing the cuts last week.

``It's an election year and everyone is a little touchy about doing anything that actually might be used against them,'' said Senate Budget Committee Chairman Judd Gregg, a New Hampshire Republican.

Democrats are almost unanimous in their opposition to Bush's proposal to expand tax incentives for health savings plans, which are already offered to 3 million Americans. Democrats say the plans, which provide tax advantages for health expenditures, only benefit the young and healthy.

`No Hope'

In February, Senate Finance Committee Chairman Charles Grassley, an Iowa Republican, said ``there's probably no hope to get done what we'd like to get done on HSAs.'' There's no indication things have changed since then.

The Senate Health, Education, Labor and Pensions Committee last month passed Bush's proposal to preempt state laws to allow small businesses to pool health insurance across state lines. To lure Democrats, the committee's chairman, Michael Enzi, a Wyoming Republican, included a provision requiring insurers to include at least one plan offered to government employees in the five most populous states: Florida, Illinois, New York, California and Texas.

Democrats said the provision would only further spur the use of HSAs because one of Florida's plans is to create such accounts with a $5,000 deductible.

Enzi has since said it ``won't be easy'' getting the Senate to approve the measure. ``I'll need all the help I can get to overcome very strong opposition,'' he told reporters on March 28.

While the House has twice approved measures overhauling medical liability laws, the legislation has been stuck in the Senate. Senator John Ensign of Nevada, the Republican spokesman for health care initiatives this year, said his party will try again in May to pass the legislation.

``We're pretty pessimistic about being able to pass it but we're going to continue to drive this as an issue out there because it is not going away and it is going to continue to get worse,'' Ensign said April 5.

To contact the reporter on this story: Jay Newton-Small in Washington at jnewtonsmall@bloomberg.net

Last Updated: April 12, 2006 00:13 EDT

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