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Transcript: Health On The Hill, July 27, 2009

Jackie Judd: Good day, I’m Jackie Judd with Health On The Hill. Joining me today to discuss the status of health care reform on Capitol Hill is Mary Agnes Carey of Kaiser Health News. Welcome.

Mary Agnes Carey: Thank you.

JJ: This is the last week that the House is supposed to be in before it breaks for the August recess. What should we expect? A race to the finish?

MAC: Absolutely, there will be lots of negotiations between House Democratic leaders and members of their caucus. There’s a variety of concerns, primarily a group called the Blue Dogs, conservative Democrats, are very concerned about what providers in their rural districts are paid. They are concerned about the growth of Medicare costs, the growth of health care costs overall, and if the bill will do enough to contain that growth.

JJ: This afternoon, Monday afternoon, the House leadership has called a meeting of all Democratic members who wish to attend, for basically a seminar on what’s in this bill, how to understand it, and what to bring back to constituents?

MAC: Exactly. There is a lot of concern about the size of the bill, the complexity of the bill. House Democratic leaders acknowledge that, so they’re going to convene this multi-hour conference where you’ll have staff go through provisions of the bill, section by section. This is also a way for the House Democratic leaders to learn where their caucus stands. Where are the votes? Do they have enough support so they can pass this bill before they leave for the August break?

JJ: And Henry Waxman’s committee, Energy and Commerce, members are supposed to be meeting today, again Monday, to discuss the status of the bill as it stands in their committee. What are the most intractable issues?

MAC: I think again we’re talking about the Blue Dogs, this group of conservative Democrats in the House. They’ve expressed a lot of concerns. Many of them represent rural districts. And in the rural areas perhaps the hospitals and other providers are not paid as much as their urban counterparts. They’re very concerned about Congress’ (they feel) inability to control Medicare costs. Could there be this independent Medicare panel that would take that decision out of Congress’ hands, make recommendations to the President, which Congress would then have to stop. So that has been a big concern, it stopped the markup on the Energy and Commerce Committee and we’ll have to see if they can proceed or if they have to do something called ‘discharge the bill’ where they simply take the bill and go straight to the floor.

JJ: They bypass the vote in the committee.

MAC: Exactly

JJ: Over the weekend, Nancy Pelosi gave a very bullish assessment of where health care reform is. She said “when it comes to the floor, we will have the votes.” Does she think that it is still going to come to the floor this week before they break?

MAC: I think she will do her darndest to make sure that happens. You’ve had a lot of negotiations; you’ve had two other committees in the House mark this up. Whether or not Energy and Commerce, as we noted, can do it is unclear. But I am sure that she and the other Democratic leaders would very much like to get this done before the August break. It would help crystallize, cap off the momentum they’ve had over the last few weeks on health care.

JJ: Now that timetable in the Senate is definitely off the table. The Senate has two more weeks before they break for recess. In Senate Finance, Max Baucus is still moving ahead?

MAC: He’s still trying. The gang of seven he was negotiating with is now down to a gang of six. One of the Republicans, Orrin Hatch of Utah, has left the negotiations. He said perhaps he’ll vote for the final bill, but he doesn’t necessarily like the direction of the talks so far. They’re still talking about how to finance the bill. One discussion is taxing these higher end insurance premiums. Taxing the policies they’re talking about in the level of maybe $20,000 to $25,000. But there’s concern that simply taxing the insurer means that the beneficiary will pay more. So, they’re talking a lot about that and other ways to finance the bill.

JJ: How much money is there?

MAC: Well, it depends on the level they go to. You could get about $100 billion over 10 years if they go this route of putting the tax on the higher end policies.

JJ: And moving on to the White House down Pennsylvania Ave., the President is out again this week touting health care reform. The message from the administration this weekend clearly was “we’re 80 percent of the way there; we only have 20 percent left.” But it’s the 20 percent that’s the toughest.

MAC: It is so tough. It is so tough to figure out the financing. It is so difficult to deal with concerns about will this bill drive up health care costs too much? Will it do enough to control health care costs? These are incredibly difficult things to do when you’re talking about a piece of the economy that is so large in health care. So the President is trying to encourage lawmakers, keep working at it. President Obama wants to keep this in front of the public, but he knows the difficult task ahead

JJ: Thank you very much.