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Obama Reveals Trillion Dollar Reboot of Health Care Proposal

WASHINGTON - President Obama took charge of the health care debate on the 399th day of his presidency Monday by proposing a 10-year, $950 billion plan opposed by Republicans and not yet endorsed by Democrats.

White House spokesman Robert Gibbs called it "a starting point" for bipartisan debate at a health care summit Obama will lead on Thursday. But within minutes, Republicans in Congress denounced the plan, which is designed to reduce health care costs and expand coverage to 31 million people.

"The well has been poisoned," said Sen. Judd Gregg, R-N.H. "Mixing two bad bills together doesn't make a good bill."

Less clear is whether Democrats can pass the plan in an election year, even if they impose procedures to prevent Republicans from blocking Senate action. House Speaker Nancy Pelosi, D-Calif., and other leaders sounded positive, but left unclear is whether enough moderate Democrats facing tough re-election races would support it.

"This is sort of the last, best hope for enacting the bill," said Robert Greenstein, executive director of the liberal Center on Budget and Policy Priorities. "It's now about to be a very exciting spectator sport. It is neither a slam dunk, nor is it hopeless."

Obama's plan is a compromise between Democratic bills that narrowly passed the House in November and the Senate on Christmas Eve. Merging the two plans was delayed a month after Republican Scott Brown's upset election to the Senate from Massachusetts, which cost Democrats the 60-vote supermajority they needed to pass the first version of the bill.

"This is the president putting forward what was the emerging consensus when they still had 60 votes," said Diane Rowland of the Kaiser Family Foundation.

Obama's proposal would expand Medicaid for the poor and offer tax credits to middle-income people who would have to buy insurance. It tries to contain costs by taxing expensive health policies and slowing the growth of Medicare. It would prevent insurance companies from denying coverage because of pre-existing conditions.

Some of the changes would increase subsidies to make insurance more affordable, delay the tax on high-cost plans until 2018 and give the government power to block rate increases.

Barring support from Republicans, the White House hopes to use a legislative tactic that would require only 51 votes for passage in the Senate, where Democrats still control 59 votes.

"The president expects and believes the American people deserve an up-or-down vote on health reform," said White House communications director Dan Pfeiffer. "Our proposal is designed to give ourselves maximum flexibility."

Even if Obama can win 51 votes in the Senate, House passage is uncertain. He dropped moderate Democratic Rep. Bart Stupak's provision barring the use of federal subsidies to pay for abortions. He also included more taxes and fees to pay for higher spending.

Democratic Whip James Clyburn said with Obama's changes, "we've got a much better atmosphere in the House to get it more than 218 votes."

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