WASHINGTON — President Barack Obama and Republicans sparred over health care in a historic faceoff Thursday, punctuated by a pointed exchange between Obama and the man he defeated in 2008 for the presidency, Arizona Sen. John McCain.
McCain criticized Obama for leading a Democratic effort to overhaul health care marked by secret negotiations, legislative payoffs to key senators, and a popular backlash against a system he called unsavory.
He chided Obama that the two of them had both promised to change the way Washington works when they ran in 2008, and that Obama had failed to deliver.
"We're not campaigning any more," Obama told McCain. "The election is over."
Obama brushed aside McCain's criticism, saying "we can have a debate about process or we can have a debate about how we're actually going to help the American people at this point. And I think that's — the latter debate is the one that they care about a little bit more."
The personal confrontation was one of several in the six-hour session between Obama, top members of his administration, and 38 members of Congress from both parties.
They met at Blair House, across the street from the White House. Obama called the meeting to try to hammer out a compromise with Republicans that would allow the Congress to enact proposals to expand health insurance to many of the nation's uninsured, curb soaring health insurance costs, and add protections such as requiring insurance coverage for people with pre-existing conditions.
Democrats want a sweeping overhaul but may not have enough support in their own ranks to push the plan through the Congress. Republicans support some of the ideas - such as requiring coverage for pre-existing conditions - but would spend far less to extend coverage to fewer uninsured. They also flatly oppose greater government control over health insurance and costlier plans to expand coverage.
"We all know this is urgent," Obama said. "And unfortunately over the course of the year... this became a very ideological battle. It became a very partisan battle. And politics I think ended up trumping practical common sense."
He said he didn't know if the two parties could agree on a final plan.
"I don't know that those gaps can be bridged," he said. "And it may be that at the end of the day we come out of here and everybody says, well, you know, we have some honest disagreements; people are sincere in wanting to help, but they've got different ideas about how to do it, and we can't bridge the gap between Democrats and Republicans on this."
Laying out the broad views of Republicans, Sen. Lamar Alexander, R-Tenn., said his party reflects popular opinion that the Democratic proposal is too big and too costly.
"We believe that our views represent the views of a great number of the American people who have tried to say in every way they know how — through town meetings, through surveys, through elections in Virginia and New Jersey and Massachusetts — that they oppose the health care bill that passed the Senate on Christmas Eve," Alexander said.
"We want you to succeed, because if you succeed our country succeeds. But we would like, respectfully, to change the direction you're going on health care costs," Alexander said. "We believe we have a better idea."
He likened Obama's proposal, unveiled on Monday merging ideas from bills passed last year by the House of Representatives and Senate, to a new car at an auto show that looks just like a model from the year before.
"Our view, with all respect, is that this is a car that can't be recalled and fixed, and that we ought to start over," Alexander said.
Alexander and other Republicans also pressed Obama to rule out the use of the Senate's "reconciliation" rules to push through its plan on a simple majority, rather than the 60-vote supermajority that would require at least one Republican vote.
"Mr. President, renounce this idea of going back to the Congress and jamming through on a ... partisan vote through a little-used process we call reconciliation, your version of the bill," he told Obama.
"If we don't, then the rest of what we do today will not be relevant. The only thing bipartisan will be the opposition to the bill."
Sen. Harry Reid, D-Nev., reacted angrily.
"No one has talked about reconciliation but that's what you folks have talked about ever since that came out, as if it's something that has never been done before," Reid said.
"But remember, since 1981 reconciliation has been used 21 times. Most of it has been used by Republicans, for major things, like much of the Contract for America, Medicare reform, the tax cuts for rich people in America. So reconciliation isn't something that's never been done before."
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