House Democrats Hail, Question Health Reform Bill

News outlets detailed the House health care reform bill and reaction from members. The Congressional Budget Office estimated its net cost to be $894 billion over 10 years.

The New York Times: "The bill is similar in size and scope to one taking shape in the Senate, where Democrats' control is more tenuous and the outcome less certain." The bill will leave 18 million people uninsured by 2019, the CBO said in its score of the bill. "None of the cost estimates of the bill included provisions to increase Medicare payments to doctors. Those provisions, which would cost more than $200 billion over 10 years, were put into a separate bill, also introduced Thursday" (Pear and Herszenhorn, 10/29).

Roll Call reports that the bill will cover 36 million more people at a cost of $1.055 trillion during the next decade, but will save the deficit by $104 billion over the next decade. "Pelosi (D-Calif.) had touted the bill as costing $894 billion when she released it online earlier in the day, but that number nets out $167 billion in new pay-or-play taxes on individuals and businesses. Pelosi's office had also said the bill would cut the deficit by $30 billion, but the CBO score came in much better" (Dennis, 10/29).

Despite Pelosi's claims that the House bill would not stretch the deficit, Blue Dogs, the conservative Democratic voting bloc, remained skeptical Thursday, The Hill reports. Its leaders "drafted a letter to Congressional Budget Office (CBO) Director Douglas Elmendorf – which the Blue Dogs plan to send Thursday night. In the letter, they ask for additional calculations and explanations about whether the $1.055 billion House bill would reduce federal spending on healthcare and would reduce the deficit, as Pelosi has promised" (Allen and Soraghan, 10/29).

The Washington Post: Of the 36 million new insured: "About 15 million of the poorest children and adults would enroll in Medicaid. An additional 21 million would purchase coverage on a new national insurance exchange, where private plans would compete with a 'public option' backed by the federal government" (Murray and Montgomery, 10/30).

The Christian Science Monitor: "Pelosi and liberal Democrats had originally favored what they termed a 'robust' public option," which would have set payment rates for hospitals and other healthcare providers at Medicare rates plus a 5 percent increase. "But rural Democrats said that those payments would be too low, and hospitals in their districts could not have survived on them." These members, and others from the conservative Blue Dog caucus "were wooed by Pelosi's willingness to accept that the rate should be negotiated by the secretary of the Department of Health and Human Services. It was clear that the Speaker could not find the 218 votes needed to sustain the robust option" (Russell Chaddock, 10/29). 

Even with such concessions, Pelosi potentially may have trouble just getting the bill to the floor, The Hill reports: "Several factions of House Democrats are threatening to block consideration of the bill using procedural moves unless their demands are met." Liberals want an up or down vote on a "robust" public plan, minority lawmakers want the same on allowing legal immigrants to get health care (Allen and Soraghan, 10/29).

Politico reports that some House liberals, who were considered candidates for a rebellion over the powered-down public health insurance plan Pelosi included in the legislation, are not walking away from the legislation. They had sought a more "robust" version of that plan. "But in reality, the bill she unveiled Thursday includes big pieces of what the most liberal members of her party wanted - most likely setting up a serious battle when negotiators try to merge it with the far more moderate Senate" (Brown and O'Connor, 10/30).

But Rep. Bart Stupak, D-Mich., "has long threatened to block the House's healthcare effort unless his party's leadership permits a vote on an amendment that would prevent taxpayer dollars from funding abortions -- a provision, he noted on Thursday, that is still absent from Democrats' recently unveiled bill," The Hill reports separately (Romm, 10/29).

Immigrant care continues to divide lawmakers, Roll Call reports in a second story: "House leaders are struggling with whether to match a tougher Senate approach, developed in response to the (South Carolina Rep. Joe) Wilson episode (where he shouted "You lie" at President Obama when the President was talking about immigrant care at a joint meeting of Congress), that would bar undocumented workers from using their own money to buy insurance in a new health care exchange" (Newmyer, 10/29).

Meanwhile, end-of-life planning - what "Sarah Palin said was tantamount to 'death panels'" - remain in the House proposal, The Associated Press reports. "The provision allows Medicare to pay for voluntary counseling to help beneficiaries deal with the complex and painful decisions families face when a loved one is approaching death" (Alonso-Zaldivar, 10/29).

Separately, Politico notes that "Party leaders would like to start debate on the bill next week and hope to have a final vote before Veteran's Day on Nov. 11." (O'Connor and Frates, 10/29).