Health Care Bill Debate Resumes Tomorrow...Pelosi's Caving In

Health Care Debate Resumes With WH Meet


The health care debate resumes in earnest on Tuesday after more than a week of quiet following Senate passage of its landmark bill on Christmas Eve.

The four relevant House chairmen will meet with Speaker Nancy Pelosi and her leadership team at 1 o'clock in the speaker's Capitol office to start setting the parameters for negotiations with the Senate.

Then, Pelosi and House Majority Leader Steny Hoyer (D-Nev.) will head to the White House for an early-evening meeting with President Barack Obama to discuss the final bill, according to Democratic officials. Senate Majority Leader Harry Reid (D-Nev.) and party Whip Dick Durbin (D-Ill.) will participate in the meeting via conference call because neither has returned to Washington from the holiday break.

House negotiators have their work cut out for them because Reid – and his wavering moderates – will be reluctant to make any changes that would upset the fragile accords that paved the way for last month's historic, hard-fought, party-line vote to approve the Senate bill. This spells trouble for the public option, but there are plenty of other substantive differences between the two bills that could give House leaders a foothold to make other changes.

Democrats in the House are expected to push for increased subsidies for the lowest-income Americans who don't qualify for Medicaid. On the eve of the Senate vote, Democratic aides in the House also suggested they would push for a blend of new taxes to help pay for the subsidies and new programs created by the bill. That could include a tax on high-end insurance plans at a higher threshold organized labor could accept along with a tax on the wealthiest Americans.





But House aides acknowledge they don't have much room to maneuver. For starters, congressional negotiators need to keep the final 10-year price tag below $900 billion, forcing Democrats to pick priorities, since the House bill costs more than $1 trillion compared with a Senate measure that would cost an estimated $871 billion over the next decade.

House leaders also want the Senate to adopt a national insurance exchange, instead of the state-by-state exchanges established under the Senate bill, and add tougher mandates for employers and individuals. And, of course, Democrats get another chance to spar over the public option, coverage for abortion and whether illegal immigrants can purchase insurance through the exchanges.

Other issues are sure to pop up. For example, Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) wants to squeeze more money from drugmakers by reimbursing them at a lower rate for seniors who qualify for both Medicare and Medicaid, and a pair of senators is pushing to include more money for the state-run Children's Health Insurance Program, while the House bill would fold it into the new exchange program.

Congressional Democrats are embarking on an abbreviated negotiation to save Reid the hassle of overcoming more procedural hurdles, but that means the resulting negotiations will be held behind closed-doors as the various stakeholders push for final changes. Liberal Democrats in the House have taken exception with the revised process, but most aides argue a drawn-out conference negotiation would give Senate Republicans too many opportunities to derail the process.

The White House is expected to take a very active role in melding the two bills after keeping quiet publicly during negotiations in the House and Senate. Obama's top aides took a much more hands-on role crafting the Senate bill, so it includes administration priorities that the House bill lacks, like the tax on high-end health care plans and language giving an outside panel the authority to increase efficiency and advocate cost-containment under Medicare.

They also want to make sure congressional negotiators wrap up work as quickly as possible so the administration and its congressional allies can turn their attention to the economy and job creation. That means bartering with lawmakers on other issues. According to TalkingPointsMemo, the Congressional Hispanic Caucus might relent in their push to let undocumented immigrants buy insurance on the exchange if the president pushes a comprehensive overhaul of the country's immigration laws – one that grants immigrants who seek a path to citizenship the right to purchase this insurance.

During the Tuesday session, the speaker is expected to set loose parameters for the abbreviated conference negotiations with the four chairmen with jurisdiction over the final legislation, Waxman, Education and Labor Chairman George Miller (D-Calif.), Rules Chairwoman Louise Slaugher (D-N.Y.) and Ways and Means Chairman Charlie Rangel (D-N.Y.).

Democrats are also scheduled to hold a caucus meeting on Thursday at noon in the Capitol. But since few lawmakers are expected to be in town to attend, party leaders are setting up a conference call that will give every member a chance to participate in the dialogue and hear how the process will work. Aides suggested Pelosi might even walk her members through some of her early priorities for the final bill. The speaker also wants to hear from her members frequently as the process moves along.


Sources: Politico, MSNBC, The Ed Show, Youtube

The Health Care Reform Debate...Who's Leading It?

MSNBC----


Sen. Chris Dodd (D)(Conn.) - With Sen. Edward Kennedy, D-Mass., sidelined by illness, Dodd is leading the Senate health committee's effort to design its overhaul legislation. It is inevitably going to be a slow process, Dodd (who's up for re-election) told colleagues, saying, "I never suggested this was going to be warp speed."

Sen. Max Baucus (D)(Mont.) - Baucus is the chairman of the Senate Finance Committee and architect of one of the bills that, with some modifications, is most likely to arrive on the president's desk. He has stressed paying for extending health coverage to the uninsured by taxing some workers' health insurance and by forcing hospitals and providers to become more
cost-effective.

House Speaker Nancy Pelosi,(D)(Calif.) -
Pelosi's clout with her 256 Democratic members may prove to be essential in getting a compromise bill passed in the House. She favors a "public option," a government-sponsored plan that would compete with private-sector insurers. "I have every confidence we will have a public option coming out of the House of Representatives. It will be a level playing field. For us to have substantial health care reform, this has to be part of it," she said.

Sen. Charles Grassley (R)(Iowa) - The senior Republican on the Finance Committee, Grassley (who's up for re-election) has worked closely with Baucus to design a bill that would gain some Republican support. He is not a fan of Obama's plan to let government plans compete with private ones. "There's a lot of us that feel that the government is an unfair competitor," Grassley said. "We have to keep what we have now strong, and make it stronger."

Sen. Kent Conrad,(D)(N.D.) - Chairman of the Senate Budget Committee, Conrad is the sponsor of a proposal to use a series of regional co-operatives, somewhat like farmer co-ops, as non-profit rivals for profit-friendly insurance companies. Conrad told the Washington Post it was necessary to get 60 votes in the Senate to pass any health insurance overhaul. He has warned about a government-sponsored insurance plan. "Virtually all Republicans are against the public option and some Democrats are," he said. "So how do you get to 60?"

Sen. Ben Nelson,(D)(Neb.) - A crucial Senate centrist who along with about six other like-minded Democrats may supply the votes to pass a bill, or might kill it by voting "no." A critic of the "public option," a government plan competing with private-sector insurers, Nelson has also said he might be open to some form of public option which would be "triggered in the event that there's no market available on the private side."

Sen. Olympia Snowe, (R)(Maine) - Snowe is a critical GOP centrist who often votes with the Democrats on significant legislation. She has voiced worries that high-cost areas of the nation, including her home state, would suffer disproportionately if Congress decided to tax employer-provided health insurance.

Peter Orszag, Office of Management and Budget - Head of the Office of Management and Budget, Orszag is largely responsible for making sure the Obama administration accepts the design of any insurance overhaul. Orszag said the resulting plan "must be deficit-neutral," and must require some real, quantifiable savings to offset the new federal spending that will be needed to cover the uninsured.

Douglas Elmendorf, Congressional Budget Office - As director of the Congressional Budget Office, the non-partisan budget scorekeeper for Congress, Elmendorf is in charge of the analysts who'll figure out whether the numbers in the health insurance blueprint add up. "Without meaningful reforms, the substantial costs of many current proposals ... would be much more likely to worsen the long-run budget outlook than to improve it," he said.

Karen Ignagni, America's Health Insurance Plans - Ignagni is president of America's Health Insurance Plans, the group that represents nearly 1,300 companies providing health insurance coverage to more than 200 million Americans. AHIP supports making all uninsured Americans living in poverty eligible for the Medicaid program -- which currently has wide coverage gaps in it. AHIP opposes a government-run plan for the non-poor, which it says would dismantle employer-based coverage and cost taxpayers too much money.

Richard Kirsch of Health Care for America Now - Kirsch is the leader of a Democratic-affiliated advocacy group Health Care for America Now -- a coalition of labor unions and others, including ACORN, the AFL-CIO, and MoveOn.org. The group calls for a federal health insurance plan that guarantees coverage without a private insurer involvement. It attacks the private-sector insurance industry as "beholden to Wall Street" and says it "puts corporate profits before people's health."

Sources: MSNBC, Politico, Reuters, Flickr, Huffington Post, Zimbio