Beyond the Dome

So how will Barack Obama get his ambitious health care plan through Congress, given how badly the last major overhaul attempt failed in 1994?

At a briefing at the Colorado Convention Center this afternoon, Neera Tanden, Obama’s domestic policy director, offered a two-point argument: Conditions have changed since then, and Obama’s version would get through Congress more easily than John McCain’s health care plan.

Tanden didn’t pretend the Obama campaign has a detailed legislative strategy at this point. Everyone is too focused on the election to have thought that far ahead, she said. But the urgency of rising health care costs is convincing lawmakers and business groups that the problem has to be tackled.

“You’ve seen the business community now coming forward in a way that they haven’t in years past, really recognizing that this is an economic competitiveness problem,” Tanden said.

Moreover, of the two candidates’ health care plans, Obama’s would actually be easier to pass because it builds on the employer-based health care system, Tanden said. McCain’s plan would move away from employer-based health care and instead offer a tax credit that would cover only half of what health coverage costs in the individual health insurance market, she said.

“That kind of radical reshaping would have a much more difficult time getting through Congress,” Tanden said.

Not surprisingly, the McCain campaign takes issue with her description of their plan. McCain spokesman Taylor Griffin says the plan wouldn’t end the employer-based health care system at all, since it wouldn’t touch employers’ ability to exclude their health care spending from their taxable income. It’s the employees’ tax exclusion that would be replaced with a $5,000 tax credit, he said, and that would likely make it easier to afford individual coverage that would be too expensive otherwise.

The bigger issue, of course, is that the scope of any major health care overhaul is so broad — requiring a sign-off by several committees before it even gets to the House or Senate floors — that either plan will require detailed negotiations. But it sounds like the Obama team won’t worry about that too much until after the election.

One more side note: Tanden, who was one of Hillary Rodham Clinton’s top advisers before Obama brought her into his campaign, declined to say what role she thought Clinton might want to play in the health care effort if Obama wins. She just repeated Obama’s stock answer: that Clinton, Sen. Edward M. Kennedy of Massachusetts, and other top health care lawmakers will all have a role to play.

“I’ve firmly taken off my Hillary Clinton hat,” Tanden said with a laugh.