Some Democrats and industry lobbyists now argue that, in negotiating deals through Mr. Baucus’s panel with powerful health care interests, the White House was tacitly signaling as early as last spring that it might end up accepting something more modest than the government insurer the president has said he prefers.
The Finance Committee, for example, appears to be coalescing around the idea of nonprofit insurance cooperatives instead of a government-run plan. It is a proposal the health care industry prefers, but many liberal Democrats oppose, in both cases because cooperatives are likely to have less leverage over health care prices.
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Industry lobbyists and moderate Democrats in both chambers, though, argue that the White House’s actions behind the scenes show a recognition that the finance panel’s anticipated compromise is the most likely template for any final legislation.
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Lobbyists for the drug and hospital industries say that, as early as June, White House officials directed them to work out cost-saving deals with Mr. Baucus’s committee. Drug industry lobbyists said they negotiated a deal to contribute $80 billion over 10 years toward the cost of an overhaul with Mr. Baucus, under White House supervision, before taking it to the president for final approval. House lawmakers have said they were caught by surprise when it was announced.
Hospital industry lobbyists, speaking on the condition of anonymity for fear of alienating the White House, say they negotiated their $155 billion in concessions with Mr. Baucus and the administration in tandem. House staff members were present, including for at least one White House meeting, but their role was peripheral, the lobbyists said.
Several hospital lobbyists involved in the White House deals said it was understood as a condition of their support that the final legislation would not include a government-run health plan paying Medicare rates — generally 80 percent of private sector rates — or controlled by the secretary of health and human services.
“We have an agreement with the White House that I’m very confident will be seen all the way through conference,” a lobbyist, Chip Kahn, director of the Federation of American Hospitals, told a Capitol Hill newsletter.
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Still, industry lobbyists say they are not worried. “We trust the White House,” Mr. Kahn said. “We are confident that the Senate Finance Committee will produce a bill we fully can endorse.”
http://www.nytimes.com/2009/08/13/health/policy/13health.html?hp
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