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Health-care negotiations focus on affordability

Updated 5:27 p.m.
By Shailagh Murray
As House and Senate negotiators start writing a final health-care bill, one concern looms above all others: whether Americans will be able to afford the coverage that the legislation would require them to buy.

In a series of meetings this week, including two sessions on Wednesday, Democratic leaders and White House officials combed through the House and Senate versions of the legislation to identify differences and debate compromise provisions. Their aim is to strike a final deal before President Obama delivers his State of the Union address, either in late January or early February.

But for all the individual issues that must be addressed, a broader challenge has emerged -- how to whittle down the bill's potential cost to consumers. As the legislation moves closer to the finish line, Democrats are increasingly wary of imposing an additional financial burden on millions of uninsured people, many of whom have chosen to forgo health coverage because it is too expensive.

"We want to make sure we get it right," said Rep. Chris Van Hollen (D-Md.), a member of the Democratic leadership, after a House negotiating session on Wednesday. "And that's why the affordability piece is so essential."

House Speaker Nancy Pelosi (Calif.) and key House committee chairmen spent two hours huddling with Obama at the White House on Wednesday afternoon, reviewing areas of conflict. But Pelosi played down the differences between the two bills, telling reporters after the meeting, "I think we're very close to reconciliation, respectful of the challenges -- policy and otherwise -- in the House and in the Senate."

One open question is the size of the subsidy for individuals who do not have access to affordable coverage through their employers, and who will purchase plans on new insurance exchanges. The House bill would provide more generous assistance to most of these individuals, through lower premiums and out-of-pocket expenses. But the total value of the House subsidies is estimated at $602 billion over 10 years, compared to $436 billion in the Senate bill.

Whether the new exchanges are organized nationally or by state could translate into a cost difference, Van Hollen said, depending on the number of insurers the new marketplaces attract. The House bill proposes a national exchange, while the Senate would limit this authority to individual states. Obama favors the House approach, senior Democratic aides have said.

The House has not formally agreed to give up a government insurance option, Van Hollen noted, and many of his Democratic colleagues remain convinced that a public option is the best way to guarantee affordability. But negotiators are examining ways to tighten insurance regulations and impose greater oversight of the industry, to keep premium costs in check. "What we cannot allow is consumers to be held hostage by the insurance industry," Van Hollen said.

By Shailagh Murray  |  January 6, 2010; 3:16 PM ET
Categories:  44 The Obama Presidency , Health Care  
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Next: Dust still settling from Democrats' departures


2010 Vote All Democrats Out of Congress.

Posted by: mock1ngb1rd | January 9, 2010 10:59 AM | Report abuse

An arm of the Federal Reserve, then led by now-Treasury Secretary Timothy Geithner, told bailed-out insurance giant AIG to withhold key details from the public about overpayments that put billions of extra tax dollars in the coffers of major Wall Street firms, most notably Goldman Sachs.

The sordid tale unfolds in a series of e-mails between the company and the New York Fed obtained by Rep. Darrell Issa (R-CA), the ranking member of the House Committee on Oversight and Government Reform, and first publicly disclosed by Bloomberg News.

Posted by: lucygirl1 | January 7, 2010 3:53 PM | Report abuse

What makes health care unaffordable is that we have for-profit health insurance companies. They are unnecessary middlemen who add no value but only drain scarce resources from the American people. They pay doctors and hospitals sweatshop wages, charge subscribers over-inflated premiums/deductibles/co-pays so that a few health insurance executives and shareholders can rake in huge, windfall profits from denying care to suffering Americans. At least the drug companies, as much as we may think they charge too much, give us a product we can actually use. No other industrialized nation allows for-profit health plans to play a central role in their health care systems. Countries that allow private health plans require them to be non-profit and heavily regulate them. Germany and Switzerland use that model and they have less "government run" health care than we do. When Taiwan decided to have a national health care system, they sent a commission around the world to evaluate the different models. They decided to model their system on our Medicare system except they made it a complete single payer system for everyone. We will never control costs or continue to have high quality health care if we keep for-profit health plans in our health care system. They need to focus on true commodities like house, auto, life insurance. It is immoral to ration care as we do in the United States based on our ability to pay for it. It is also economically short-sighted. We are only as strong as our weakest link. Our businesses cannot continue to be strong and be responsible for providing for health care benefits. Time to move into the modern era and see health care for all as a smart investment in our national security the way public education, public fire and police departments are.

Posted by: chrzcatt | January 7, 2010 10:38 AM | Report abuse

Attention all Washington Post readers on this subject. I don’t know why there are not more people screaming out about what may happen over the next week or so. We understand that Mr. Obama himself, Senate Leader Harry Reid, House Speaker Nancy Pelosi, and their chosen few are going to meet in secret, and try to hammer out a health care bill that the majority of the American people don’t want.

AND further, it has only gotten this far because of outright bribery to 13 Senators; and the final insult to us all was the blatant and admitted bribery to Senator Nelson of Nebraska to the tune of some $100 Million dollars per year to buy the 60th vote, that none other of the 49 states gets.

Are we here in America going to let that stand? It’s up to us folks. We need to ramp up some serious hard ball rhetoric and hard ball politics here, or we are going to have this thing shoved right in our face. Right now, it’s up to us.

Posted by: CommonSense12 | January 7, 2010 9:29 AM | Report abuse

Brian Lamb of C-SPAN to Obama: "You lie"

Posted by: lure1 | January 7, 2010 7:16 AM | Report abuse

Somebody mentioned Currently, a 60-year-old likely would pay five or six times more for private medical insurance than someone in his twenties but it may not be true always check for lower price coverages

Posted by: manuelberk07 | January 6, 2010 11:51 PM | Report abuse

Insurance is counter productive. One of God’s laws is, “That which you fear shall come upon you.” Also, "That which you sow, you shall reap." It requires that you receive (reap) a sickness the insurance will pay.

We have a president who hides his identity papers, a Senate that is not concerned about security over a president that does not qualify as a natural born citizen because of his Kenyan father. They push Health Care Reform without details and giving our national authority over to the United Nations Climate Change agenda. These are big warning signs.....

HEALTH CARE REFORM conforms to: "Psycho-Politics-Address on
Health Care and Control." by LP Beria at Lenin University
(Says only Faith Healing through the Bible can stop
control of the people through health care.) AND

HEALTH CARE REFORM also conforms to "45 Communist Goals For the
Take Over of America." (control of courts, media, education, medical fields.)
See both at

It makes no sense to subsidize the purchase of insurance for multitudes instead of paying the medical bills of those who get sick. Hospitals charge less for uninsured people and charge big dollar amounts when medical insurance covers it. All these things show we are going the wrong way. The whole idea of insurance is corruption and robbery of the masses.

Marie Devine
God has solutions to world problems we created by ignoring His wisdom

Posted by: MarieDevine | January 6, 2010 7:32 PM | Report abuse

Obama and his comrades will agree to ANYTHING to get their scam approved. They don't care about the "components of the plan." All they want is CONTROL. When they achieve control, they’ll do as they please.

Robert Creamer, a CONVICTED FELON and Obama’s ACORN associate, outlined the guidelines for the Obamacare SCAM in his 2007 book, “Stand Up Straight: How Progressives Can Win.”

As per Creamer’s book, the main objective of Obamacare is only to increase the power of "progressives" (Marxists) through the “democratization of wealth” (socialism/Marxim) as per the teachings of Saul Alinsky. They created the health care crisis to enslave us!

Creamer wrote in his 2007 book:

“We need not agree in advance on the components of a plan, but we must foster a process that can ultimately yield consensus.”

As Creamer indicates, Obama and his comrades don't care about the "components of the plan." All they want is CONTROL over our health care, our money, and our lives.

Posted by: AntonioSosa | January 6, 2010 6:20 PM | Report abuse

As we can see, Obamacare is advancing through lies, deception, manipulation, intimidation, coercion and BRIBES (to be paid at our expense). And we can expect Obama and his comrades to use deception, gimmicks, creative accounting, smoke and mirrors to hide the trillions of dollars this scam will cost us.

Legislative Reality vs, Political Reality by Peter Suderman identifies specific tactical maneuvers. One of the strategies entails, for example, shifting an expensive part of a bill to a completely DIFFERENT piece of legislation.

The CBO will then analyze only part of the expenses. Major expenses will be hidden in other bills or shifted to the states. In the end, we'll end up paying for it all!

Posted by: AntonioSosa | January 6, 2010 6:11 PM | Report abuse

They should be able to resolve this issue before President Obama delivers his State of the Union address because all Americans will be watching and listening to every word he'll say.

Tracy, Status Now

Posted by: Statusnow9 | January 6, 2010 5:23 PM | Report abuse

Public support for health care reform fell when the public option was withdrawn. It is clear that republican influence has made the initiative less popular. The more Washington gives in to republican influence, the more public support is withdrawn.
Republicans know the way to the bottom. We don't need to follow them.

Posted by: rooster54 | January 6, 2010 4:38 PM | Report abuse

Makes sense to scuttle the public option for now. Later, when consumers get a taste of the private-insurer exchanges, there'll be a groundswell demanding an affordable, accountable public plan as an alternative to the monopolies. Better to wait for that than to force the issue now.

Posted by: MikeinLA | January 6, 2010 4:04 PM | Report abuse

This bill will do more harm to the low and middle class than people want to believe or understand. Between the cost of the annual premium and deductions to be paid for insurance to kick in, it will put the poor further in the red, while taxing the life out of those who worked hard to achieve their success. Health care should be affordable, but not mandatory. It should be free to choose, not penalize those who don't want to buy it. Those who dont buy and don't pay can be arrested and put in jail. Is this a good bill?
It's clear the answer is "no".
Yet the Democrats in all their arrogance think it's what's best for the USA. It's so good, they themselves want nothing to do with the plan. This is becoming like George Orwell's Animal Farm: "all animals are created equal, but some animals are more equal than others."
November cannot come fast enough to vote these narcissist congressmen and women out of office and put in persons who work to represent the People and their constituents.

Posted by: donaramco | January 6, 2010 4:02 PM | Report abuse

The best news for the White House is that the liberals appear OK with giving up the public option. This could get done by February if that is the case.

Posted by: parkerfl1 | January 6, 2010 3:26 PM | Report abuse

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