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Health care decision a week away, say Democrats

Updated 6:45 p.m.
By Shailagh Murray
Democratic leaders are aiming to decide next week about their next move on health care, senior aides said Wednesday.

President Obama is expected to reiterate his call for a comprehensive overhaul in his State of the Union address Wednesday night. But House Speaker Nancy Pelosi (Calif.) and Senate Majority Leader Harry Reid (Nev.) still lack a game plan for moving forward, following the Democrats' surprise loss last week of a Massachusetts Senate seat, costing the party its filibuster-proof supermajority.

One problem the leaders can't seem to overcome is how to pay for whatever bill they are able to produce. Senate Democratic sources said Pelosi continues to protest the excise tax on high value insurance plans that the Senate would adopt to offset the cost of expaning coverage to the uninsured. Pelosi has urged Reid to drop the tax, or at least radically scale it back, leaving the bill with a revenue hole as large as $300 billion over 10 years. Many House Democrats oppose the excise tax because of its potential impact on union households.

Two options are on the table: pushing the Senate bill through the House, along with a companion bill of fixes; and starting from scratch with a smaller bill that includes only the most popular provisions. Reid and Pelosi are in the process of canvassing their caucuses to determine the best approach.

The Democratic leaders still believe they may be able to salvage their original effort, if at least 218 House Democrats agree to approve the Senate version of the bill. But for the House to go along, the Senate would first have to approve a special budget reconciliation bill to makes the changes House Democrats are demanding. This option is theoretically the quickest and surest route to final passage because in the Senate, reconciliation bills are protected from filibusters, meaning they require only a simple majority to pass.

The process would give House Democrats rock-solid assurance that health legislation would not take effect without the fixes they are demanding. But Senate Democratic aides estimate that about seven Democratic senators could oppose reconciliation, for fear of a political backlash.

Sen. Evan Bayh (D-Ind.) told reporters on Tuesday that voters simply do not believe that health care legislation would reduce the deficit and that pushing the package to final through reconciliation would be a fatal political error. "I think reconciliation would be very ill-advised," Bayh said.

Senate Budget Committee chairman Kent Conrad (D-N.D.), warned that Democrats could be forced to delay this year's budget process in order to accommodate reconciliation for health care, since last year's reconciliation instructions expire when a new budget resolution is adopted. Reconciliation remains fraught with other problems in the health care context, Conrad said. For example, any bill would have to cut the deficit by $1 billion over five years, but the changes the House wants to see would cut revenues and increase subsidies.

"I think the role of reconciliation would be quite limited in a health care context," Conrad said.

Other potential problems: Senators can offer unlimited amendments to a reconciliation measure, a recipe for a protracted floor debate. Some of the main flashpoints between the House and Senate bills involve issues like abortion and the design of a new insurance marketplace that may not pass muster with the Senate parliamentarian, who acts as referee during the process. All provisions must have a budgetary impact, and they cannot create new government programs.

Given the uncertainty, some Democratic lawmakers would prefer to focus their efforts on a narrower bill, possibly one that would gain Republican support. Senior Democrats listed some of the provisions that could be included: incentives for small business to offer health coverage; pilot programs that tackle Medicare inefficiencies; and an array of insurance reforms that would prevent egregious abuses and allow young adults to remain on their parents' policies.

The legislation also could include an aggressive Medicaid enrollment campaign that would capture the millions of low income individuals who are eligible for coverage under current law, but haven't signed up for it. That pool alone could include 8 million people, Democrats said.

By Web Politics Editor  |  January 27, 2010; 6:07 PM ET
Categories:  44 The Obama Presidency , Health Care  
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Comments

The history of Health Care Reform from the past to the future. The goals within the plan should be spelled out to the American people, not covered up, stacks of paper no one will read. If Americans had one spokeman for them, to give us the truth, one item at a time, minus the extra words, we too would know if our needs are met. Our elected officials must work with the people, not each other. The togetherness comes at the victory party and joint decisions. Far too many parts of Health Care are overlooked in this bill. I am for health care, but not this one. Let's let the public really understand what it is you are not giving us.

Posted by: words444 | February 3, 2010 10:36 AM | Report abuse

This system and this reform effort must be more understandable to Americans.

What would be missing with an effort that:

1. Required everyone to purchase health insurance, like the auto insurance model.
2. Required all health insurance companies to offer a "basic" plan with a government-mandated set of features. (Again, the auto-insurance model). They could then create and compete on additional products beyond this one.
3. Subsidized low income people, on a sliding scale.

I truly welcome responses.

Posted by: pat93401 | February 2, 2010 12:10 PM | Report abuse

This so called health care bill by Democrats is a give away to the Big pharma, Big insurance, and the Rich; proving yet again that just like Republican lunatics most Dems are agents of Big corporations (Big Pharma, Big insurance, etc.) too.

Kill this bill and make the next election to be a referendum about Universal Nationalized Single Payer Health Care as they have in ALL European countries, Canada, Israel, etc. vs the for profit health insurance we have in US.

Let the Republican lunatics and the Republican Dems (i.e., Liberman, Nelson, etc.) run against Universal Nationalized Health Care and prove what lunatics they are, what enemy of the American (middle class) they are, given the FACT that under Universal Nationalized Single Payer Health Care every one wins except those who are getting paid $40Mill per year in salaries and flying in $50Mill corporate Jets and who are funding lying slime bags like Limbaugh, Beck, Fix news, Wall Street Journal, etc. to LIE and LIE to American people.

To be exact here are the incredible benefits of Universal Nationalized Single Payer Health Care:
http://anoox.com/blog/UHC.37605

Posted by: RealNews1 | February 2, 2010 11:52 AM | Report abuse

The President said:

Still, this is a complex issue [Health Care Reform], and the longer it was debated, the more skeptical people became. I take my share of the blame for not explaining it more clearly to the American people.

Not at all, Mr. President, not at all; you explained it just fine. We just decided we don't want Health Care Reform right now.

Posted by: Soloflexerus | January 29, 2010 1:08 AM | Report abuse

Soloflexerus,

The problem with your belief and the other Americans that oppose helath care reform is this. Health care reform is a moral issue not a political issue. I understand those that oppose the public option. However, I do not and never will understand those that want no changes at all. It is just morally wrong on every level for the insurance industry to have the right to decline health care coverage to those that can afford it due to a pre-existing condition. The status quo is telling these individuals to just shut up and die or just lessen the surface population as good old Scrooge said. Further, it is also wrong to allow the health isurance industry to continue raping the self-employed and small business community with rates such as $800.00 per month for a family of three. That is not an affordable rate unless you are very affluent. The answer everyone usually gives is that they are a business which is exactly the problem and why the public option is offered as a solution. Health care should be about people first, not profits first.

Posted by: croftonpost | February 1, 2010 11:48 AM | Report abuse

I am from Illinois.(Currently embarrassed to say that) I have tried to contact both of our
senators...Mr. Durbin and Mr. Burris. The only thing I received was a generic form email. (That I am sure every one that takes the time to write...pleading or trying to have hope that our Rep. in Washington hear us). I AM NOW CONVINCED, they do not and really just do what they want. I hope the people of my State see how politics is really done. Once elected..."The People" mean NOTHING to them. When the time comes...WE NEED to vote for Representatives that still care about, "The People." They need to know that...THEY WORK FOR US!!!!!

As far as the Health care bill currently and in the state it is written today....would only awaken a much frustrated and angry group of Americans. If all the countries Senators and President goes forward on the current bill....
They will lose big time. (Any support they may have had)...OPEN YOUR EYES WIDE! Today it is heath care.. tomorrow who knows.....What I do know is that Washington has sent a message LOUD AND CLEAR....
"We The People." Only matter to them when they are trying to be re-elected. I vote to clean all the corruption in Washington and especially for Term limits. If a Senator is in office too long....They forget about the people that got them there. Wake up Washington and take notice....The majority of Americans do not want the Health Bill you spent a whole year on! (While we were losing our jobs and the economy was in the toilet!!!) Start over and DO IT RIGHT! (Jobs and economy first though) We need Jobs if you expect Middle America to pay for the rest of America! Government employees should be stuck with the same S@#T American every day citizens are stuck with!!!!
Why are they special??????? THEY ARE NOT! If the American citizen is stuck with a health Bill forced down our throats...Government employees including Representatives and Senators...Should be made to have exactly the same SH$T....They voted for!!!!!! Otherwise...UNFAIR!!!!!

WAKE UP SENATORS!!! AMERICA IS DEFINITELY PAYING ATTENTION AND WE DON"T FORGET!!!! 2010/2012.

Posted by: Intuition1010 | January 30, 2010 2:35 AM | Report abuse

The President said:

"Still, this is a complex issue [Health Care Reform], and the longer it was debated, the more skeptical people became."

With all due respect, Mr. President, that is how it should work.

Americans' representatives talk about an issue, debate the merits of different solutions, then propose an answer to us taxpayers and voters.

In this case, we are telling our representatives we dislike their ideas; please return to the debate until you come up with something better, which may be nothing at all.

Posted by: Soloflexerus | January 29, 2010 1:15 AM | Report abuse

The President said:

Still, this is a complex issue [Health Care Reform], and the longer it was debated, the more skeptical people became. I take my share of the blame for not explaining it more clearly to the American people.

Not at all, Mr. President, not at all; you explained it just fine. We just decided we don't want Health Care Reform right now.

Posted by: Soloflexerus | January 29, 2010 1:08 AM | Report abuse

The President said:

Still, this is a complex issue [Health Care Reform], and the longer it was debated, the more skeptical people became. I take my share of the blame for not explaining it more clearly to the American people. And I know that with all the lobbying and horse-trading, the process left most Americans wondering, "What's in it for me?"

Actually it was Senator Ben Nelson who asked, "What's in it for me?"

Posted by: Soloflexerus | January 29, 2010 1:04 AM | Report abuse

Someone said that Health Care Reform was on life support. Where is Dr. Kevorkian when we need him?

Posted by: Soloflexerus | January 29, 2010 12:53 AM | Report abuse

I've been trying to understand Obama.

It seems to me as if the "health coverage" mandate that he wants - at the expense of our entire country's financial future - is steeped in his GUILT and REFUSAL to accept the truth about his mother.

My theory: Obama refuses to accept the fact that his mother...who was so focused on making a name for herself by working the all-elusive PhD...was irresponsible.

She allowed herself to be caught without insurance and without a job. Like most Americans - if that happens - we know we are SCREWED.

Yet for all of his ranting...she got the best medical care available in the U.S. - Sloan Kettering in New York and the Straub Clinic in Hawaii. I don't know about you, but I would be hard-pressed to travel several thousand miles for treatment - even with insurance.

So when he says that she was denied treatment - HE LIES. Whether she had insurance is unknown...but he says that he watched with anguish as she paid the bills and dealt with insurance claims. Well, who hasn't? That's part of WHAT YOU DO.

HIS problem was that he was so busy publishing his first book, and working as Chairman of the Chicago Annenberg Challenge - managing almost 50 MILLION dollars of grant money - that he simply didn't get around to seeing his mother before she died.

He was just too busy.

So - my theory is that this "health insurance" fiasco...is just Obama trying to come to terms with the death of his mother...and his regret for choosing to chase his own fame over choosing to see his dying mother. So deal with it, Obama.

His mother made a CHOICE to chase her PhD. rather than holding a regular job that paid benefits. It was her CHOICE. She lived and died with the choices that she made.

I can live with that. Now, Obama, can you?

We can't afford this "health insurance reform" - which we all know it is nothing of the kind. President Obama and Congress will have to solve the Social Security, Medicare, and Medicaid deficit WITHOUT brining us to our knees.

STAND UP AND BE HEARD, AMERICANS!

Posted by: easttxisfreaky | January 28, 2010 7:58 PM | Report abuse

I am so disgusted with those who are so hateful in their postings regarding this president and the Democrats. It would be interesting to know how many of them belong to the so-called Tea Party. I am sure of one thing. They will not find any good in anything the Democrats try to do in Congress. I was so proud to be an American when our people showed compassion to those poor people in Haiti who had lost everything in the earthquake. However, that compassion is missing when these conservatives show their lack of concern for fellow Americans who need the reform in order to survive. It would be interesting to know how many of them belong to the infamous Tea Party - only wanting to deny others the same benefits they have.

Posted by: kmaupin7 | January 28, 2010 4:07 PM | Report abuse

Nancy Pelosi looked like a jack in the box last night. First she says that Health Care is on hold, now she is gong ho again. When will you people get the message that we do not want the Health Care Plan. And now if this is passed it will be a mix match of issues. We want to take care of our own insurances NOT THE GOVERNMENT. STAY OUT OF OUR BUSINESS. You had the audacity to take a raise while creating havoc with the system.

Posted by: newt856 | January 28, 2010 2:10 PM | Report abuse

If these Democrats try to push this horrific health care debacle they will be creamed in the coming elections. No one wants this collage of back room deals and bribes that does nothing to cut costs but creates 110 new government agencies we all know will be a cesspool of waste and fraud. Nothing has made our family this angry. We promise you this, if you push this garbage on us, we will not soon forget. Your political hides are toast. Obama showed our children that it is not what you do that is important but what you say. He blamed the Republicans for his failure to pass this garbage of a bill and yet he had control of Congress. Could it be the American people are just too smart to buy this terrible bill? Could it be they do not like it? Well, I guess it really does not matter to these arrogant deaf politicians? It won't until they get elected out. It cannot happen too soon for me.

Posted by: greatgran1 | January 28, 2010 12:45 PM | Report abuse

What Arrogance. Maybe if Obama had spoken slower and used smaller words – “We the People” would have gotten how the bribes to Unions, Pharma, Docs, and the States of Nebraska & Louisiana were necessary for us peasants. When will we learn he and the Dems elite know better than the rest of us. So long Dem majority – November can’t come soon enough….

Posted by: johngallagher1 | January 28, 2010 10:23 AM | Report abuse

The time has come for Pelosi to circle the troops and take what there is available. To push this issue as they are, risks losing it all. Many of us feel the Senate bill is too weak, but changing it in any way that will cost more is a kiss of death.

We are already pumping too much debt into the markets and the cost of that debt will soon be the biggest part of our cost of governance. We can't continue to do that. This bill reduces debt. Combine it with real spending limits and get us back on the path toward no national debt. That path includes reducing the war activity that sucks billions out of us every year.

Posted by: ronjeske | January 28, 2010 10:19 AM | Report abuse

These days it is only the Democrats who believe in Democracy - the Congress elected for the People, voted in by the People, for the benefit of the People. The Republicans got used to 8 years of government of the People for the benefit of Wall St by the mouthpieces of Big Money and really think that this is how democracies are supposed to work - NO! There is no evidence that any Republicans are negotiating in good faith with the Democrats and I can't understand why the Majority leaders continue to bother. The Republican bloc will never support anything progressive that comes from the Democrats, even if they agree with it, and are merely seeking to delay and exhaust the Democrats. They would prefer to destroy a Presidency that they can't control, regardless of any past commitments to the democratic process - because that's what Big Business demands. The Republicans passed on an economy in ruins, a foreign policy in shambles and a long list of overdue domestic reforms, it's astonishing that so many Americans even bother listening to their divisiveness.

Posted by: ianf46 | January 27, 2010 9:29 PM | Report abuse

I hope with every fiber of my being they pass this bill with all of the dirty tricks available to them. It will be the death knell of the "liberal" wing of the democrat party for generations. I personally want to thank every partisan progressive for being the impetus for the growing states rights movement. Their incessant need to use the violence of government to force their ideology on the rest of us has awoken a slumbering giant. It's about time.

Posted by: AmericanSharecropper | January 27, 2010 8:51 PM | Report abuse

All the American people want is affordable and efficient health care. All the first world nations have this, why doesn't the US? If our politicians persist in having their heads where the sun never shines I think after the next election they will be out of jobs and going home in descriss.

Posted by: OldCoot1 | January 27, 2010 8:22 PM | Report abuse

When Dick Cheney said Obama was dithering on Afghanistan he should have referred to teh Hosue Dems. I am a proud progressive but it seems when the Dems have the majority they cannot rule. The republicans would have had a bill passed with a smaller majority, for better or worse, porbably worse since they always start helath reform with tort reform. Tell that too a person who lost their insurance or sitting in an ER. The Senate bill is not perfect but teh Dems need to do the tough, right thing, not be shils for insurance companies who cover doctor for malpratcice and charge them obscene rates to be covered or having to make money on sick and hurting people. Pass the bill and stop dithering Dems. Make the tough choices, that was what you were elected to do.

Posted by: Brainny | January 27, 2010 8:20 PM | Report abuse

Please ram it down our throats. It would be the end of the dems for 50 years. Is that Taps I hear playing in the background?

Posted by: Straightline | January 27, 2010 8:19 PM | Report abuse

Jobs are the number one priority issue. As Bob Herbert recently wrote in the NY Times, They don't get it. If the administration persists in healthcare reform cramdown with a majority of the American voting public in opposition, the Obama administration will become only a caretaker presidency. The 2010 elections will eliminate their congressional majority and this administration at the end of the day will be historically ranked with Hoover's.

Posted by: ctw46 | January 27, 2010 7:43 PM | Report abuse

If the this bill is eventually pushed through I'm going to for the first time vote down the line Republican. President Obama won't be getting my vote either as well.

The funny part is my Republican Representative in Congress Rep Lincoln Diaz Balart voted against the bill, but Bill Nelson my Democratic Senator voted for it! He says on his website, "While the bill by Senator Reid isn't perfect, there are many good elements." Total disconnect from the will of the American people!

I hope for their sakes AND especially mine they choose well.

Posted by: moebius22 | January 27, 2010 7:13 PM | Report abuse

Senate democrats: the republicans are not going to agree on anything meaningful. Wake up and vote to make the rule that 51 votes are necessary. What the country is upset about is your inaction in a time of crisis. Get stuff passed and you will show the country what punks the republicans are, otherwise all incumbants will lose.

Posted by: Bowerbird | January 27, 2010 7:11 PM | Report abuse

Dims still do not get it. Barry campaigned for Obamacare in Massachusetts, and lost when Scott Brown defeated Marcia Coakley for Senate.

Paul Kirk you impostor, vacate Senator Brown's seat at once.

Posted by: screwjob2 | January 27, 2010 6:54 PM | Report abuse

Dims still do not get it. Barry campaigned for Obamacare in Massachusetts, and lost when Scott Brown defeated Marcia Coakley for Senate.

Paul Kirk you impostor, vacate Senator Brown's seat at once.

Posted by: screwjob2 | January 27, 2010 6:54 PM | Report abuse

The Democrats are freaking crazy. An NBC/WSJ poll released today shows that only 7% of the American Public feel that passing health care reform is a priority this year, while 86% feel that the president and Congress should focus their attention on the economy and jobs. If even one of the Democrats wants to get re-elected this year, they will totally shelve Obamacare.

Posted by: mike85 | January 27, 2010 6:48 PM | Report abuse

The Democrats are freaking crazy. An NBC/WSJ poll released today shows that only 7% of the American Public feel that passing health care reform is a priority this year, while 86% feel that the president and Congress should focus their attention on the economy and jobs. If even one of the Democrats wants to get re-elected this year, they will totally shelve Obamacare.

Posted by: mike85 | January 27, 2010 6:47 PM | Report abuse

There is not going to be any GOP support for anything, period. Any Democratic staffer that floats that idea should be fired on the spot.

Posted by: hoos3014 | January 27, 2010 6:45 PM | Report abuse

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