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House Leaders End Night's Negotiations Without Deal

By Paul Kane
After nearly seven hours of closed-door talks on landmark health-care legislation, top House leaders exited with hoarse voices and the need for some "shut eye".

But still no deal.

Pushing to restart the final committee action needed on the more than $1 trillion proposal, White House Chief of Staff Rahm Emanuel spent all afternoon and evening huddled with his former House colleagues in Speaker Nancy Pelosi's Capitol office. House leaders joined the talks with Rep. Henry Waxman (D-Calif.), chairman of the Energy and Commerce Committee, and seven conservative Democrats, the members of Waxman's panel who are blocking final committee consideration of the health-care proposal.

Those Democrats are concerned about plans to have a government-financed "public option" to private insurance, particularly if the government payments to health-care providers are tied to Medicare reimbursement rates, which they allege are skewed toward urban areas. That's just one of about 10 to 12 areas of concern, according to Rep. Mike Ross (D-Ark.), the leader of the Democratic opposition.

When he entered the second round of those talks Tuesday evening, Ross said, "Many of them remain unresolved."

As talks broke up after 9 p.m., Ross and almost every Democrat stuck to the same script: "We're making progress."

Negotiators are expected back at Pelosi's conference room table Wednesday morning, but as critical an issue as the policy parameters of their talks is the calendar. The House has a planned five-week summer break set to begin Friday.

Leadership is no longer demanding a full House vote and instead is focusing on approving a deal with the commerce committee, which would set the legislation up for a post-Labor Day vote. Aides say the planned recess could start on Friday evening, but only if there's a global agreement with Ross and his allies on the committee to reach approval on resuming the legislative markup, which would allow the panel to approve the plan late this week. Otherwise, the House could remain in session over the weekend or into next week.

How close are they to achieving a deal? Depends on who's talking about the state of negotiations.

"They stand as they stood last night," House Majority Leader Steny Hoyer (D-Md.) told reporters Tuesday night, suggesting not much headway had been made since he attended a long session Monday evening of committee Democrats. "Everyone wants to get a little bit of shut-eye."

Ross had a better assessment, sticking to the "progress" line voiced by so many others. Pelosi left with a hoarse voice, barely able to talk. "We're still working," she told reporters.

Emanuel's presence suggests these are the most critical moments. He has played the role of deal closer in every major legislative battle of the Obama White House, from the $787 billion stimulus to the Senate's rejection of ordering a new round of F22 fighter jets.

Aides and lawmakers say Emanuel, a former member of House leadership who was a close ally of Ross's Blue Dog Coalition of conservative Democrats, is there as a mediator. He's been going through the lists of concerns from the Blue Dogs while also trying to find middle ground among the competing offers and counter-offers. Aides, requesting anonymity to speak about the closed-door negotiations, said the two sides are close on most of the key sticking points but still not there yet.

"He's respected by both sides, someone we all consider a close friend," Ross said of Emanuel's presence.

Ross is one of seven Blue Dogs on Waxman's committee refusing to approve the current draft legislation, which numbers more than 1,000 pages. If all seven refuse to back the bill, they would sink it, as there are 36 Democrats and 23 Republicans on the committee.

Ross said Wednesday that all seven are likely to remain a united bloc, either all agreeing or all nixing the final offer.

By Editor  |  July 28, 2009; 10:49 PM ET
Categories:  Health Reform  
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This debate is actually pretty ridiculous on the face of it. Most folks like their health insurance because they're unfamiliar with other plans. Let me compare two plans, one the Tricare plan offered to retired GI's, which is a managed care program, like most HMO's and most commercial policies. The other is Medicare, which I began last year, with Tricare continuing as my backup and prescription drug provider.

GOP threat #1: "The government will stand between you and your doctor." Under Tricare (about $250 per year individual coverage, with $12 dollar co-pays), it's Tricare (a commercial provider) that stands between you and your doctor. As a managed care provider, Tricare decides which doctor and which conditions it will approve for payment.

GOP threat #2: "With a private plan you can go to a specialist without approval." See above. Almost all commercial policies require approval from the carrier for visiting specialists.

Now let's examine the idea of a "public" plan, like Medicare (which, for a variety of reasons, would be the model for a true public plan).

Medicare is just a few dollars short of a hundred dollars a month, with no co-pays for doctor visits, and NO REQUIREMENT for prior approval before seeing a specialist (or any other doctor).

The only drawback to Medicare is prescriptions. And the current public drug plan sucks. In my case, I rely on Tricare, and pay nine bucks per prescription on medicines for high blood pressure, high cholesterol, congestive heart failure,PAD and COPD. If I buy these through a commercial drug store, they cost Tricare about a hundred fifty bucks per script. But drug costs are no longer a major problem since Walmart's drug program went into effect. Every single drug I take (or their generic equivalent) is available at Walmart for just ten bucks for a ninety day supply. Even if you hate Walmart (and I do), you can't beat their prices on prescriptions.

To be plain, if you're paying more than a hundred dollars per person per month under your current coverage, with managed care, you'd have to be an idiot to prefer that coverage to a public plan similar to Medicare, offering coverage for about a hundred bucks a month for each person covered, with the right to visit any doctor you choose any time you choose.

Unfortunately, there are too many idiots amongst us, and most of them are stupidly fighting for the right to pay more for their health insurance than they have to, much to the delight of the private companies. Though they'll spout the line about government getting between you and your doctor, the truth is that most of the recalcitrants are simply putting their political allegiance ahead of their own best interests and those of their families and friends.

Posted by: thedr8 | July 29, 2009 2:06 AM | Report abuse

therdr8 Wrote:

Medicare is just a few dollars short of a hundred dollars a month, with no co-pays for doctor visits, and NO REQUIREMENT for prior approval before seeing a specialist (or any other doctor).
While Medicare is a few dollars short of a hundred dollars you did get a few of you fact incorrect. There are co-pays for doctor visits. While these co-pays are reasonable and affordable they have gone up significantly in the last few years. Also, while there may not be any requirements of prior approval for a specialist, there are a lot of things that Medicare will not pay for and most doctors won't accept a patient that is on Medicare because of the low reimbursement rates of Medicare.

While overall Medicare is a pretty good program and is better than much the private insurance you had written about, and although it would not be acceptable to everyone, it would work for most people. While I think reform is much needed in this country, and if Medicare is an example of how well the government can run health insurance, if it can improve on what it has done in Medicare then I think it would have something that would be a workable solution to the problem of health care. Even if everyone would not be happy with something similar to Medicare, most people would be happy with such a plan.

Posted by: KingDavidRetired | July 29, 2009 2:37 AM | Report abuse

I have a bad feeling that when they get done there will be goodies for the health care industry and nothing for the people except another bill.

Posted by: SarahBB | July 29, 2009 6:12 AM | Report abuse

Corporate Greed and sold-out politicians shall rule the day.......

An Independent

Posted by: aeaustin | July 29, 2009 6:50 AM | Report abuse

What neither of you get, is that all of that gets thrown out the window. Not only will those rates go up, you will pay a sh** load of more taxes to cover it. There is no way around it, 2+2 equals 4, but 4-5 still equals -1. There is no other way to pay for it and America no longer has the credit line to finance it.

Posted by: akmzrazor | July 29, 2009 7:31 AM | Report abuse

The final package of the healthcare reform proposal must include the Public Option as well as private insurance coverage. Competition of these coverage programs will lower and contain healthcare costs over time. Furthermore, employers must be required to provide healthcare insurance to their employees or pay into the public insurance system. I would propose that if individuals do not enroll in either a private or public plan, they will be automatically enrolled in the public plan.

Posted by: abishop2 | July 29, 2009 1:37 PM | Report abuse

baucus $2.8M, grassley $2.7M, demint $1.3M
mcconnell$3.3M, boehner $1.6M,hatch $2.9M

Follow the Money: Link

Call Congress and demand, Single-Payer Health Care for All Now!

Sign Single-Payer Petition: Link


Posted by: NAVDOC3rdMAR | July 29, 2009 2:42 PM | Report abuse

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