Top Democrats confirmed Saturday that the House would hold separate votes on the Senate healthcare bill and the reconciliation bill, making fixes to it.
Rep. John Lewis (D-Ga.), one of the chief deputy whips, Rep. Melvin Watt (D-N.C.), and Rep. Eliot Engel (D-N.Y.), all of whom said that Speaker Nancy Pelosi (D-Calif.) won't use the tactic of deem and pass for healthcare reform.
The move effectively kills the "deem and pass" strategy Democrats had been eyeing to make changes to the Senate bill through a rule on the bill, which at the same time would have deemed the original Senate healthcare bill to have passed the House.
The House appears set now to move toward an up-or-down vote on the Senate healthcare bill, as well as a separate, up-or-down vote on the series of changes to that bill. There will still be a vote on the rule, as there always is for a piece of legislation, though it will not package the two bills together.
Democrats moved toward separating the votes after several members, including Rep. Dennis Cardoza (D-Calif.) and Stephen Lynch (D-Mass.), had said they could not support the procedural maneuver.
Cardoza confirmed the change in position by House leadership during a Rules Committee meeting Saturday afternoon.
"I want to thank the House leadership for indicating to a number of us that that's what's going to happen," he said.
Republicans had sought a separate vote on the Senate bill this past week, and tried to force one by offering a series of resolutions to do so, though these efforts were batted aside by House Democrats.
The Senate bill had been seen as a politically dangerous vote, as the Senate bill contains a number of "sweeteners" that had been included to invite Senate support. The reconciliation package would strike many of these deals.
The Democrats’ yearlong health reform push picked up unmistakable momentum Thursday as the votes began to fall into place for a history-making roll call Sunday that could achieve the party’s decadeslong goal of expanding health care.
House Speaker Nancy Pelosi still had plenty of work to do, and no one in leadership was yet saying she has 216 votes in hand. But a series of events Thursday — the president postponing his overseas trip, a solid deficit reading and a handful of members firming up as “yes” votes — all left the impression of a bill gaining ground.
The question now is whether these last-minute conversions will be enough to offset a collection of wavering Democrats who could trade their “yes” votes for “no” votes in the final round of a yearlong fight.
Democrats opened the day on an up note after the Congressional Budget Office unveiled its initial cost estimate for the House-Senate compromise. The government’s official scorekeeper put the cost of subsidies and new programs created by the bill at $940 billion over the next decade and predicted the bill would save the government $138 billion during the same period — a projection that seemed to buoy fiscal conservatives. Democrats also said the bill is fully paid for and would cover 95 percent of all Americans.
Hours later, a pair of Democrats who voted against the House bill — retiring Tennessee Rep. Bart Gordon and first-term Colorado Rep. Betsy Markey — said they would vote yes this time around. That came on the heels of another announcement of support from a frequent critic of the legislation, Illinois Rep. Luis Gutierrez.
“I’ve spent the past week speaking at length with the president and his staff; in fact, I spoke with him again just this morning,” said Gutierrez, who led the protests against Senate language that would bar illegal immigrants from purchasing insurance through the exchange. “After extensive discussions with the president, I believe we have a health care bill I can vote yes for, and I believe we have a commitment to move forward on a comprehensive immigration reform package as soon as possible.”
Adding to the sense of drama, President Barack Obama abruptly postponed until June his planned trip to Indonesia and Australia so that he could be in town for the House vote — and perhaps to sign the House-Senate bill after passage. The Senate is expected to take up a clean-up reconciliation bill as early as Tuesday, if the House passes the bill first.
Obama had been scheduled to leave Sunday — having already once delayed his departure from Friday — but risked being half a world away as the signature legislative goal of his first two years came to the House floor.
But problems remain.
Massachusetts Rep. Stephen Lynch, a former union chief, threatened to vote against the bill for a number of reasons, like the tax on high-end health care plans and his mistrust that the Senate will be able to approve whatever the House does this weekend. He'll met with Obama Thursday, and he told reporters he's not a "lost cause."
Pelosi spent an entire round of votes Thursday afternoon pleading her case to Ohio Rep. Zack Space, a Democrat who has twice voted for health care reform but now seems to be leaning “no.”
“Every vote is a heavy lift,” Pelosi told reporters during an afternoon news conference. “We have great diversity in our caucus. We don’t have a rubber-stamp Congress or rubber-stamp caucus.”
During a round of evening votes, the speaker buttonholed Arkansas Rep. Marion Berry, another retiring Democrat who voted for the House bill. He listened to her for about five minutes as he leaned over his cane while she gestured enthusiastically, but then they both got up, and the speaker moved on.
Also Thursday, another group of Democrats — those who initially voted for the House bill — sided with Republicans on a muddled procedural vote that the GOP framed as a bid to force Democrats to abandon the so-called Slaughter Solution, a procedural maneuver that would “deem” the Senate bill passed without a direct vote.
The group of Democrats included New York Rep. Michael Arcuri, Pennsylvania Rep. Kathleen Dahlkemper, Arizona Rep. Gabrielle Giffords and Virginia Rep. Thomas Perriello.
But Lynch voted with his leaders. So, too, did Space, along with his Ohio colleague Rep. Steve Driehaus, another key swing vote. Even Pennsylvania Rep. Jason Altmire, whose well-publicized indecision has become an amusing subplot to some of his colleagues, voted with party leaders.
But the amendment failed — yet another development in a series of breakthroughs for Democrats as they try to build momentum for a final vote on Sunday afternoon.
Other fence-sitters said they’re trying to work through their concerns with the bill in the next three days.
“I want to get to ‘yes,’” said Indiana Rep. Baron Hill, who has voted for the bill twice now — once in the House, once on the Energy and Commerce Committee — but has problems with a 2.9 percent tax on medical-device manufacturers that would hurt companies in his district. “This health care bill is very important.”
Fellow Indiana Rep. Brad Ellsworth, who backed the first version of the bill, said he’s winnowed his problems with the legislation down to its restrictions on federal funding for elective abortions. He said he’s been speaking with people on both sides of the issue and will make a decision based on whether he thinks the legislation meets the existing standards of prohibiting federal funds for abortion.
Ohio Rep. Marcy Kaptur says she and Michigan Rep. Bart Stupak are working to find a way to reaffirm the House position on abortion outside the health care bill.
A big concern at this point is whether Senate Democrats can rebuff any attempts by Republicans — or Democrats — to change the bill through amendments to the reconciliation package. Pelosi has been dismissive of that prospect in her public statements. Her No. 2, House Majority Leader Steny Hoyer, has been more circumspect about the Senate.
Waxman said the Senate will give the House assurances that “those amendments that will be offered will not be successful.” A spokesman for Senate Majority Leader Harry Reid backed up those assertions later in the day.
But Sen. Kent Conrad didn’t do his party any favors by suggesting Republicans would be able to challenge some of the things in the bill — a comment his office later tried to walk back.
Despite that, most members acknowledge the historic import of where they stand and seem to be overcoming their particular problems with the bill.
In a bid to mollify House Democrats, party leaders drastically reduced the tax on high-end health care plans by shielding all but the highest-end coverage and protecting things such as vision and dental care. But those changes resulted in lost tax revenue; the measure now brings in $32 billion compared with the $149 billion the Senate raised in its plan. And the final bill pegs the tax to inflation instead of inflation-plus-1 percent, but that change wasn’t enough to frustrate critics of the tax.
“It’s not enough of a problem that I would object to the compromise,” said Connecticut Rep. Joe Courtney, a principal opponent of the tax.
Gordon, the retiring chairman of the Science Committee who voted against the House bill, applauded the final package for lowering costs for families and businesses, giving people more access to health coverage and lowering the deficit.
“In the end, the question I’m faced with is this: Will this reform be better for Middle Tennessee than the status quo?” Gordon said in a release. “I think it will. That’s why I believe passing meaningful health care reform is essential and why I have made my decision to help ensure health care is affordable for Middle Tennesseans today and for generations to come.”
Markey told a Colorado newspaper that she’s ready to embrace the compromise because it does a better job of lowering costs than the initial House version. Her support earned her praise from the White House, but it gives Republicans a big bull’s-eye for the November election.
As Americans wait for Congress to act on health care, a Fox News poll released Thursday finds 55 percent oppose the reforms being considered, while 35 percent favor them.
In addition, just over half of voters think House Democrats are “changing the rules” to get their bill passed.
About a third of voters (31 percent) think House Speaker Nancy Pelosi and the Democrats are “playing by the rules” to get health care through, while 53 percent think they are “changing the rules.” Looking at the results by political party, 53 percent of Democrats think their party is playing by the rules, about one in four think they are changing the rules (27 percent) and the rest are unsure (19 percent). Varying majorities of Republicans (78 percent) and independents (57 percent) think House Democrats are changing the rules to pass the bill.
The level of public support for the health care overhaul has remained fairly steady since last July -- 35 percent favor it now and 36 percent favored it last summer. The number opposed -- 55 percent -- is up from 51 percent in January, and from 47 percent last July. Opposition hit a high of 57 percent in December.
Among partisans, the president’s party faithful are alone in supporting the proposed reforms. Sixty-six percent of Democrats favor them, while 53 percent of independents and 88 percent of Republicans oppose them.
When the option of starting over from scratch is included, that’s what a plurality of voters want: 46 percent would toss out the current bill and start over, while 30 percent would stick with what is now on the table. One in five (19 percent) would do nothing on health care now.
On several features, proponents of the reforms have failed to convince voters of the benefits. By two-to-one people think the quality of their family’s health care would be worse, rather than better, if the bill passed. In addition, majorities think the reforms would cost them money (66 percent), and increase their taxes (75 percent).
As the main reason for opposition to the current plan, quality issues lead the way (30 percent), followed by cost (22 percent) and an over-ambitious reach (19 percent).
The number one priority for Americans is the economy, and President Obama says reforming health care will improve it. Yet the poll finds around 6 in 10 voters don’t believe that health care reform would create jobs (56 percent) or boost the nation’s economy (64 percent).
If the bill passes -- or fails -- what should happen next?
If it passes, nearly half (45 percent) would like lawmakers repeal it, 29 percent would expand it, and 18 percent say lawmakers should leave it as is.
If the bill fails, most voters want to either start over from scratch (42 percent) or drop it (36 percent). One in five voters would want Congress to keep trying to pass the current plan (19 percent).
The national telephone poll was conducted for Fox News by Opinion Dynamics Corp. among 900 registered voters from March 16 to March 17. For the total sample, the poll has a margin of sampling error of plus or minus 3 percentage points.
How do voters view President Obama’s continued efforts to get health care reform passed?
Views are sharply divided -- nearly half think he is showing leadership (47 percent) and almost as many think he is showing stubbornness (45 percent).
Almost half (48 percent) think the president is only pushing the Democratic agenda and not trying to compromise, while over half (55 percent) think Republicans are only trying to block the president’s agenda rather than looking for middle ground.
Forty-three percent think Obama is truly trying to find middle ground with Republicans, while 31 percent think Republicans are looking for a compromise.
The president’s overall job rating stands at 46 percent approval and 48 percent disapproval, little changed from late February when 47 percent approved and 45 percent disapproved.
This is only the second time more voters have disapproved than approved of the president’s performance. The first was early last month (46 percent approved and 47 percent disapproved).
The president’s ratings among the party faithful are strong. Fully 80 percent of Democrats approve of the job he’s doing today -- down 5 points from when he took office.
It’s a different story among independent voters, who were critical to President Obama’s election. Since taking office his approval has dropped 17 points among this group -- from 64 percent in January 2009 to 47 percent now.
Approval of the president far outdistances that of Congress, which has an 18 percent approval rating, up from 14 percent in late February. Its disapproval rating stands at 76 percent. Even though Democrats control Congress, 63 percent of Democrats disapprove of the job lawmakers are doing.
Ratings of Congress are in line with the portion of voters who think Congress does what the American people want (17 percent), as opposed to whatever it wants (79 percent)
Likewise, 75 percent of voters feel their views are not represented by the federal government right now, including 58 percent of Democrats, 78 percent of independents and a whopping 92 percent of Republicans.
The poll finds 31 percent of voters approve of the job Nancy Pelosi is doing as speaker of the House, and 57 percent disapprove.
House Democrats are pushing to the brink of passage a landmark, $940 billion health care overhaul bill that would simultaneously deliver on President Barack Obama's promise to expand coverage while slashing the deficit, a strategy aimed at winning over the party's fiscal conservatives.
Leaving nothing to chance, the White House announced that Obama has put off his planned trip to Asia for a second time, delaying it until June. Obama was to have left Sunday — when the House is planning to vote.
Said House Speaker Nancy Pelosi: "He wants to be here for the history."
The 10-year plan would provide coverage to 32 million people now uninsured through a combination of tax credits for middle class households and an expansion of the Medicaid program for low income people. Release of the legislation later Thursday sets the stage for a House vote on Sunday, and Democrats have already signaled they plan to go it alone, without Republican support.
The GOP has steadfastly opposed Obama's plan from the outset.
It would restructure one-sixth of the economy, covering 95 percent of eligible Americans, in the biggest expansion of the social safety net since Medicare was created in 1965. It would also impose new obligations on individuals and businesses, requiring for the first time that most Americans carry health insurance and penalizing medium-sized and large companies that don't provide coverage for their workers.
Hospitals and doctors, drug companies and insurers would gain millions of new paying customers, but they would also have to adjust to major changes. Medicare cuts would force hospitals to operate more efficiently or risk going out of business, but seniors would see the coverage gap in their prescription benefits gradually eliminated.
Insurance companies would face unprecendented federal regulation. Health care industries would be hit with new federal taxes. Upper-income households would face a new tax on investment earnings.
The Congressional Budget Office estimated the legislation would reduce the federal deficit by $138 billion over its first 10 years, and continue to drive down the red ink thereafter. Democratic leaders said the deficit would be cut $1.2 trillion in the second decade — and Obama called it the biggest reduction since the 1990s, when President Bill Clinton put the federal budget on a path to surplus.
"This is but one virtue of a reform that would bring accountability to the insurance industry and bring greater economic security to all Americans," Obama said. "So I urge every member of Congress to consider this as they prepare for their important vote this weekend."
The Democrats' drive took on a growing sense of inevitability, picking up endorsements Wednesday from a longtime liberal holdout and from a retired Roman Catholic bishop and nuns who broke with church leaders over the bill's abortion provisions. Leaders appeared increasingly confident of getting the 216 votes they need to pass the bill.
But House Republican Leader John Boehner of Ohio said his party's lawmakers will "do everything that we can do to make sure this bill never, ever, ever passes."
The legislation would be vulnerable to attack after it passes, since the biggest changes would be phased in slowly. The major expansion of coverage would not come until 2014, when new health insurance marketplaces open for business.
In the meantime, the legislation calls for a series of new consumer benefits. Starting this year, insurers could not deny coverage to children because of an pre-existing health problem, nor could they place lifetime dollar caps on the amount of coverage. A high-risk health insurance pool would provide coverage to uninsured people who can't get private coverage because of health problems.
Democrats are following a complicated two-track legislative strategy for passing the bill. First, the House will have to approve a Senate bill that many of its Democratic members object to. Then both chambers will quickly pass a package of fixes agreed to in negotiations with the White House.
Since the House will vote first, Democratic leaders are seeking assurances from their Senate counterparts that they have enough votes to pass the follow-up measure as well.
Democrats are promising 72 hours for lawmakers and the public to review the legislation once it's released, so that would push a House vote on the bill until Sunday at the earliest — "during daylight hours," said Rep. Henry Waxman, D-Calif.
Much of the legislation's longterm deficit reduction came from two key changes Democrats made in recent days, the budget office said. Starting in 2019, the bill would slow annual inflation increases in new federal tax credits available to help people pay health insurance premiums. Beginning in 2020, it would accelerate the impact of a tax on high cost insurance plan by indexing it to the general rate of inflation.
Labor unions earlier succeeded in easing other features of the insurance, and Thursday the AFL-CIO's executive council voted virtually unanimously to support the plan.
The long-anticipated measure is actually the second of two bills that Obama hopes lawmakers will send him in coming days, more than a year after he urged Congress to remake the U.S. health care system. The first cleared the Senate late last year but went no further because House Democrats demanded significant changes — the very types of revisions now being packaged into the second bill.
After heavy lobbying from Obama, liberal Rep. Dennis Kucinich, D-Ohio, announced his support Wednesday, becoming the first Democrat to declare he would vote in favor of the legislation after opposing an earlier version. Shortly after Kucinich's announcement, a letter was released from 60 leaders of religious orders urging lawmakers to vote for the legislation.
The endorsement reflected a division within the Catholic Church. The U.S. Conference of Catholic Bishops opposes the Senate-passed legislation, contending it would permit the use of federal funds for elective abortions.
Late Wednesday, however, retired Bishop John E. McCarthy of Austin, Texas, told The Associated Press he was urging approval of the legislation.
Reflecting growing opposition among states to the health care bill, Idaho Gov. C.L. "Butch" Otter, a Republican, signed a measure Wednesday requiring the state attorney general to sue the federal government if residents are forced to buy health insurance. Similar legislation is pending in 37 other states.
The President looks back to the bipartisan Patient's Bill of Rights, a bill that was defeated in Congress at the hands of special interests and their supporters, and notes that health insurance reform covers the same ground and much more in terms of giving the consumers the upper hand over their insurance companies. He calls on the Senate to allow an up-or-down vote, and for those opposing reform to stop using parliamentary maneuvers to drag it out.
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