Obama backs Brown’s bill tempering health care rule

President Obama told governors that the change in the health law would give states flexibility. President Obama told governors that the change in the health law would give states flexibility. (Ron Sachs/ Getty Images)
By Theo Emery
Globe Staff / March 1, 2011

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WASHINGTON — President Obama said yesterday he is willing to relax the new health care law’s requirement that nearly all Americans obtain health insurance starting in 2014, but only in states that can show they have an alternative plan to gain near-universal coverage.

Displaying his willingness to compromise on one of the most controversial aspects of the overhaul, the president’s move appeared on its face to give states far more freedom to shape the law to their own needs. Obama was endorsing a concept that has been proposed by Senator Scott Brown, Republican of Massachusetts, in a bipartisan bill filed with Democrat Ron Wyden of Oregon.

But conservative critics of the president said that a variety of other requirements in the law also should be eliminated, and they said the president’s announcement, made in an address to the nation’s governors, could prove to be an empty gesture.

To receive the exemption, states must demonstrate they could find other ways to cover as many people as the original law would — something Massachusetts has accomplished — and do so without adding to the federal deficit. Moreover, insurance couldn’t cost more than under the federal plan, and it would have to provide at least the same level of benefits.

Many of the act’s central provisions, such as the individual mandate to buy insurance, take effect in 2014, the year states could seek an exemption under the Brown bill. The law currently allows such exemptions only starting in 2017.

Such a change would give states flexibility, Obama said. “Alabama is not going to have exactly the same needs of Massachusetts or California or North Dakota,’’ he said. “We believe in that flexibility.’’

Brown’s legislation, if approved, would not significantly affect Massachusetts. The state’s own health care law has served as the model for the national plan and has many of same core tenets, including the insurance mandate.

But the legislation might accelerate the process of allowing other states to follow Massachusetts’ lead in establishing their own brand of near-universal health care coverage.

Although the endorsement should boost the prospects of Brown’s bill in the Senate, the GOP-controlled House has shown little interest in any change in the law short of wholesale repeal.

Some of the law’s detractors suggested yesterday that the president’s shift could allow the White House to open a back door to even more expansive state plans, such as a single payer system under consideration in Vermont.

“What the White House and Washington Democrats call flexibility seems more like a back-room deal to push more government into everyone’s health care,’’ said Tory Mazzola, spokesman of the National Republican Congressional Committee, which aids Republicans in their campaigns for the House.

Tom Miller, a visiting fellow at the American Enterprise Institute, rejected the notion that Brown’s legislation would afford a great amount of flexibility to states. Rather, the several requirements necessary to receive an exemption do little to release them from the law’s mandates, he said.

“When you put that all together, you don’t have many alternatives, but it makes it look like they’re being reasonable,’’ he said. “It’s just a faint gesture.’’

Obama’s support of the change, however, would probably boost Brown’s standing as a centrist lawmaker willing to cross the aisle on issues that could benefit Massachusetts. While previously calling for the repeal of the health care overhaul, Brown has shown a willingness to work within the existing rules to reshape the law.

A Brown spokesman, Colin Reed, said the senator was pleased with the president’s support for the bill, but remained adamant in his opposition to the national health care law.

“Senator Brown believes that individual states should have the flexibility to opt out of provisions of the federal health care reform bill. He strongly opposes the federal health care law, and believes states should have the ability to implement their own plans that provide quality care for all their citizens,’’ he said.

Health care has been a central topic of the National Governors Association’s meetings in Washington over the weekend.

Governor Deval Patrick of Massachusetts has been one of the president’s most ardent supporters on the subject, while promoting the state’s own efforts to make sure each citizen has access to health care. He is scheduled to testify today before the House Energy and Commerce Committee about the impacts of the federal law.

A spokesman for Patrick, Brendan Ryan, said that the governor discussed Brown’s bill with White House staff, but not with the president. Patrick met with Brown yesterday, but both offices declined to reveal what they discussed. Patrick is scheduled to meet members of the Bay State’s House delegation today.

JudyAnn Bigby, the Massachusetts secretary of health and human services, said that the state is aggressively implementing the national law. Although the federal law and the state law are similar in many respects, some differences need to be reconciled, such as the size of fines to businesses that don’t insure their employees, and the mechanism that triggers those fines.

Bigby did not rule out the possibility that Massachusetts would consider seeking a waiver from some of the requirements in the federal law.

“We certainly would want to be able to look at [the Brown-Wyden] bill if it passes and make an assessment about whether there were any reason to pursue something,’’ she said.

Brown’s legislation — and the president’s endorsement — won’t help him win back support from Tea Party movement conservatives, who helped him to victory in 2009 but ferociously denounce the health care law as an overreach of federal power. Rather, he’s trying to earn support from moderates, showing that “I’m a pragmatic guy looking for political answers that don’t fit into the political grain,’’ Miller said.

“In that posture and with that profile, he’s trying to say, ‘Here I am working with a Democratic senator — a political moderate — and we’re not like everybody else yelling at each other,’ ’’ Miller said.

Although the bipartisan nature of the bill may earn it passage in the Senate, the Republican-controlled House, with its restive Tea Party freshman class, is almost certain to block it. Within hours of the president’s announcement, majority leader Eric Cantor of Virginia said the law has an “unworkable structure’’ and that House leaders would work to scrap it altogether.

“We will continue at the committee level, as well as through floor action, over the course of the next several months to not only look to defund and delay the implementation of that law, but to produce an alternative so we can replace it,’’ he said.

Theo Emery can be reached at