AP sources: Obama likes national health exchange

Photo by Gerald Herbert

Photo by Gerald Herbert

WASHINGTON -- President Barack Obama has indicated support for a national clearinghouse where consumers could shop for health coverage and an end to the decades-old antitrust exemption enjoyed by insurance companies, Democratic officials said Tuesday.

In signaling his preferences, Obama is siding with House Democrats over their Senate counterparts on issues crucial to negotiations on his health care overhaul.

House Democrats are pressing for both provisions to be included in the final measure, now that their proposal for a government-run insurance option appears dead due to opposition from key Senate moderates. Obama has sided with the Senate to support a new tax on high-value insurance plans opposed in the House.

Obama met with House Democratic leaders last week as they sought support from the president on other priorities. He is now indicating support for creation of a national exchange rather than the state-based structure in the Senate bill, and for revoking the antitrust exemption, which the Senate bill does not do, the officials said.

The officials spoke on condition of anonymity because the negotiations were private.

The maneuvering came as House Democrats returned Tuesday from their holiday break prepared to step up negotiations with the Senate to get a final health overhaul bill to Obama's desk in time for his State of the Union address sometime early next month.

House Speaker Nancy Pelosi, D-Calif., and Senate Majority Leader Harry Reid, D-Nev., planned to meet with Obama at the White House today as the pace of negotiations quickened, officials said.

The legislation passed by both chambers before Christmas is similar in many respects, including expanding the federal-state Medicaid insurance program for the poor and imposing a first-time requirement for almost everyone to purchase insurance. Both bills would extend health coverage to more than 30 million uninsured Americans over the next decade.

But there are important differences that are now the subject of intense closed-door negotiations among House and Senate Democratic leaders and White House officials.

One is the structure of a new insurance marketplace, called an exchange, where uninsured or self-employed Americans and small businesses would go to shop for insurance plans that would have to meet certain standards.

The House bill creates a national exchange regulated by the federal government, and House Democrats contend the national setup and larger pool would yield more competition for consumers and accountability for insurance companies.