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Transcript: Health On The Hill for Week of August 3

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Jackie Judd: Good Day, I’m JJ with Health On The Hill. Joining me today to discuss the status of health care legislation on Capitol Hill, is Eric Pianin of Kaiser Health News. Thanks again for joining us.

Eric Pianin: My pleasure.

JJ: The House left town Friday night, the Senate is going to leave town towards the end of this week, so give us the big picture – where do things stand?

EP: Well, the House Energy and Commerce Committee finally finished its markup of its section of the health care reform package Friday night, after days and days of very intense behind-the-scenes negotiating, lots of compromises and deals were cut all over the place before the conservative and more liberal members of the Democratic Caucus could finally vote in relative unity to get the package moved out of committee. That is the third House Committee to act on

JJ: Third and final.

EP: Third and final! To act on the bill. Ways and Means, and Education and Labor have also voted on it, so now during the recess the House leadership has to essentially stitch together that bill and get it into some kind of shape so that it can be presented to the entire House when Congress comes back after the recess.

Meanwhile, across the Capitol, the Senate Finance Committee negotiators – six of them, three Republicans, three Democrats led by (Chairman) Max Baucus – continue to try to find a consensus on a package that everybody that is looking to as sort of a guidepost for what the ultimate shape of the bill likely will be.

JJ: And there will be no vote this week.

EP: No vote this week. Its not likely they will have even a compromise to show anybody until Congress comes back in September. Over the August recess, there maybe some ongoing conversations, some teleconferences and the like, but I think we’re going to have to wait until early fall to get an idea of where they’re coming down.

JJ: And the Senate HELP Committee – Health, Education, Labor and Pensions – they already voted out their draft of the bill. So, four of the five committees have voted, Senate Finance is the last.

EP: Exactly.

JJ: If you step back from this, from the past couple of months of negotiations, where do you see the areas of consensus on health care reform.

EP: I think there’s probably a handful of areas where there’s general consensus on how we should proceed. Clearly, everyone is in agreement that we have to do something about helping the nearly fifty million Americans who have no health care insurance. There’s a lot of suffering, bankruptcy, family angst, and concerns out there about rising health care costs and the inability of many Americans to cover the costs of their medical treatments. So, I think that there’s general agreement that we have to move forward, not necessarily universal coverage, but to cover maybe as many as ninety-five percent of the uninsured.

I think that there’s also considerable interest in insurance reform. A lot of people are concerned about insurance company policies that would deny coverage to people with preexisting medical problems, that might impose exorbitant premiums on older Americans — there’s a feeling that this whole area needs to be explored and addressed — and its clear that the White House, and Nancy Pelosi, the House Speaker, and others are hammering away at the need for these changes and reforms.

I think everybody agrees that we’re spending far too much on health care. And that the government spending on health care is rising at exorbitant rates. The cliché is that we have to “bend the curve” of spending, and I think that there are a lot of initiatives for doing that, some of them would have short term impact, a lot of them are much longer term in nature, and you might have to wait ten or fifteen years to see the effects of those.

JJ: But there is a consensus that you can’t squeeze out so much from the system to pay for this intially, without taxes of some sort, right?

EP: I think that’s true. And I think both the House and the Senate Committees are looking at substantial tax increases, but the two chambers are coming at it in very different ways. The House Ways and Means Committee approved a plan that would slap a fairly stiff surtax on income of the wealthiest Americans, and that’s how they would raise most of the money to help pay for this plan. The Senate Finance Committee negotiators are looking at a number of alternatives, including the possibility of taxing high-end insurance policies, taxing the insurance industry if you will, and I think this is one area where there’s going to be a lot of intense negotiating in the fall.

JJ: You covered politics for many, many years for the Washington Post. So, as Congress breaks for the August recess, there’s going to be town meetings, lobbying efforts, T.V. campaigns, etc. What clues will you be looking for through August to try to figure out what’s going to happen – what the temperature’s going to be when they get back in September?

EP: Well, I mean, one thing that we’ll be looking at, obviously, is the polling, and public sentiment about Obama’s leadership in this area, and the emerging outlines of the plan. There’s a lot of controversy around several key elements of the proposal, and one of them is the plan to create a public option – a public insurance entity that could compete with the private sector and could provide lower cost insurance policies, much more competitive with the private industry. The insurance industry is fighting this, a lot of Republicans are fighting this – they say that its really the first step toward a single payer government insurance program. They don’t want it, they’re fighting it. There will be a lot of T.V. and radio commercials, internet advertising, some fairly nasty stuff which we’re already beginning to see on some of the more conservative talk shows, going after elements of the plan. And so, I think you’ll see a real “battle royal,” if you will, over the next five weeks as the two parties try to get their messages across, play to their bases, and basically see what kind of pressure that they can put on the administration, and the leadership coming back early next month.

JJ: And this is exactly why the Obama Administration had wanted health care reform to pretty much be locked down before they left for the August recess.

EP: I think that’s right. I think that the initial hope expectation was that both the House and the Senate would approve their versions of the health care bill before the August recess, and then, when Congress came back, conferees from the two chambers could sit down and iron out differences. Well, that’s not going to happen. This is going to be a tough slog, everybody knows it now. Obama no longer is talking about action by early this fall, he’ll be happy if he can get something by the end of the year. And one thing to keep in mind is that he is the ultimate pragmatist, and this is so important to his agenda, that he’s got to come away with something. So, I think you’re going to see some fairly substantial compromising – the public option could be one of those bargaining chips that they’re going to have to throw down at the last minute.

JJ: Alright. Thank you very much Eric Pianin of Kaiser Health News, and thank you for joining us. I’m Jackie Judd.

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