"GOP Struggles For Consensus On Health Care"

ARI SHAPIRO, Host:

This is MORNING EDITION from NPR News. I'm Ari Shapiro.

STEVE INSKEEP, Host:

NPR's Julie Rovner reports.

JULIE ROVNER: Here's Utah Senator Orrin Hatch on CNN's "Late Edition."

(SOUNDBITE OF TV SHOW, "LATE EDITION")

ORRIN HATCH: We'd have to start over. There are a lot of things we can agree on right off the bat.

ROVNER: Over on NBC's "Meet the Press," Senate Republican leader Mitch McConnell had a few examples.

(SOUNDBITE OF TV SHOW, "MEET THE PRESS")

MITCH MCCONNELL: You start with junk lawsuits against doctors and hospitals, interstate competition among insurance companies.

ROVNER: But there is just one problem, says health policy analyst Len Nichols of the non-partisan New America Foundation. If you take most of the ideas that Republicans are shopping around at the moment...

LEN NICHOLS: Then we're back to a policy that, frankly, was rejected by Republicans when they had a majority.

ROVNER: Take medical malpractice reform. Republicans have long advocated for a bill that would cap damages for victim's payments suffering at $250,000. It passed the Republican-led House eight times between 1995 and 2005, but it never even won a majority in the Republican-controlled Senate, despite several attempts. Republicans have long blamed the influence of trial lawyers, but Nichols says there is also just a lack of consensus on the issue.

NICHOLS: What's interesting is, on malpractice, a number of states have different models, some of which some states are very happy with. And what President Bush and now President Obama have both proposed is to encourage states to innovate along those lines and to recognize that states really are the place where malpractice jurisdiction lies, and therefore it's better to have a local medical community in the states to work this out.

ROVNER: Another favorite Republican proposal is selling insurance policies across state lines. That would let people in one state buy cheaper insurance in another state, but the insurance might not cover as much. And the idea has freaked out insurance regulators who'd no longer know who would be in charge of regulating what, says Dave Kendall. He's with the centrist Democratic think tank, Third Way.

DAVE KENDALL: Senator Enzi led an effort to try to do that, and he couldn't even get members of his own party to go along with it.

ROVNER: That would be Mike Enzi of Wyoming. In fact, he was one of several Republicans who spent much of last spring and summer unsuccessfully working to craft a bipartisan bill with Senate Finance Committee Chairman Max Baucus. New Jersey Democratic Senator Robert Menendez said Sunday on CNN he's convinced the current GOP offer is simply another effort to kill the bill.

ROBERT MENENDEZ: When we hear about slow down and start over, it really means don't do anything. Republicans have come to the conclusion that the president's failure - not only in health care, but across the board - is the way to political victory.

ROVNER: Len Nichols, who says he was for bipartisanship in health care before bipartisanship was cool, says he is frustrated at how polarized the sides have become, particularly because the bill now stalled is fundamentally not that liberal.

NICHOLS: I would say that the legislation - both the House and the Senate, frankly - are far closer to the Republican bill in 1993.

ROVNER: That was a bill like the current House and Senate-passed measures that required everyone to have health insurance. It was cosponsored by a dozen and a half Republicans, including several who are still serving.

NICHOLS: It's much closer to that bill than it is to the Clinton plan of that era because it relies much more on markets, much more individual requirements, much more on incentives in the health care system. And to claim that this bill is somehow a left-wing government takeover is just rhetoric of a rather extreme sort. No question about it.

ROVNER: Julie Rovner, NPR News, Washington.