[JURIST] US President Barack Obama on Monday released the administration's health care reform proposal [text, PDF], four days in advance of a bipartisan summit on the issue. The proposal seeks to reconcile the versions of the bills passed last year by the House of Representatives legislation [HR 3962 materials; JURIST report] and the Senate [text; JURIST report]. The administration has detailed what it considers to be the key points [WH materials] of the proposal, including the creation of a new state insurance exchange to expand health care coverage to Americans who are not provided health care by their employers and a Health Insurance Rate Authority to review rate increases and other unfair insurance practices. The proposal specifies initiatives to make the health care system more affordable while eliminating the Nebraska federal medical assistance percentages (FMAP) [ASPE backgrounder] provision of the House legislation. The provision would have demanded the federal government fund new enrollees in Nebraska's state health care system.

Obama's proposal is the first major step taken this year in an ongoing health care reform debate [JURIST news archive]. In December, 13 state attorneys general threatened legal action [JURIST report] against the Nebraska FMAP provision included in the House bill. The attorneys general argued that the provision is unconstitutional and "antithetical to the legitimate federal interests in the bill" that "the states share with the federal government the cost of providing such care to their citizens" because it exempts Nebraska from such shared cost. The Senate passed its version of the health care reform bill earlier in December in a 60-39 vote [roll call] that split down party lines. Senate Republicans vowed to continue to fight to amend the bill, arguing that it is too expensive and would violate personal rights [NYT report] by compelling people to buy health insurance. The House of Representatives approved its version of the legislation in November. The two bills must be reconciled before legislation can go to the president for signature.