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Pelosi Sending Three Versions of Health Bill to CBO

By Ben Pershing
Speaker Nancy Pelosi (D-Calif.) said Thursday that she would send three different versions of a health-care bill to the Congressional Budget Office for analysis, bringing the House one step closer to a vote on a combined reform package.

One day after the CBO announced an $829 billion price tag for the Senate Finance Committee's health-care bill, Pelosi asked the office to crunch numbers on her chamber's measure, which combines the work of three different House committees. But while the Senate Finance bill does not include a government-sponsored insurance plan, Pelosi's bill will, and she is asking for a price tag on three different variations of the idea.

"I think it's very clear from our conversations with the members that the votes are there for a public option," Pelosi said. "What I sent to the CBO has a number of versions."

House negotiations on the public option have focused for several weeks on the issue of reimbursement rates for doctors and hospitals. Many liberals want the rates in a government-run insurance plan -- the so-called public option -- to match those currently paid through Medicare, arguing that would help keep costs down and make the plan affordable and competitive compared with private insurance. But some moderate and rural Democrats complain that Medicare reimbursement rates in their districts are far too low, and a public option using the same rates might drive their local hospitals out of business.

Pelosi said Thursday that she would send one bill to the CBO with what she called a "robust public option," that would reimburse health-care providers at 5 percent above Medicare rates. The other two versions would have rates negotiated between the government and providers. "There's no question that the robust public option scores very well," Pelosi said, emphasizing that the first version would cost less but acknowledging that it might not be able to garner the 218 votes needed for passage. (Democrats hold 256 seats in the House.) "It's very close," she said.

Despite that split in her caucus, Pelosi said she felt "we're in a very good place, because we have many good options. ... There will be the votes for a public option. Now it's a question of which one."

After Pelosi gets the CBO's analysis back, Democratic leaders and the House Rules Committee will complete the job of assembling a bill for floor consideration. The leadership has already ruled out bringing a bill to the floor next week, so the week of Oct. 19 would be the earliest time a vote would occur.

Pelosi also acknowledged Thursday that House Democrats, who have been divided on how to pay for their measure, were considering paying for a portion of their package with "a windfall profits tax on income from the insurance companies."

Pelosi said she was waiting to hear back from Ways and Means Chairman Charles Rangel (D-N.Y.) on how much revenue such a tax would yield, and she cautioned that the discussions were "very preliminary." But Pelosi also made clear that she had no qualms asking health-insurance companies to make more sacrifices for reform, because they would be guaranteed millions of new customers.

"We think they can put more on the table," Pelosi said.

By Ben Pershing  |  October 8, 2009; 12:40 PM ET
Categories:  Dem. Leaders , Health Reform , House  
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Comments

"Pelosi said she was waiting to hear back from Ways and Means Chairman Charles Rangel (D-N.Y.) on how much revenue such a tax would yield,"

My God, the Irony.

Posted by: msully25 | October 8, 2009 1:29 PM | Report abuse

msully,

Irony, what irony? Are you specifically referring to U.S. Rep. Rangel's failure to pay certain amounts of back taxes? If so, state the facts. Obtuse comments provide little insight to the essentially uneducated masses. It is important for everyone to understand why Rep. Rangel may be unqualified to chair the Ways and Means Committee but it is proper for Rep. Pelosi to ask the committee itself about potential revenue from a proposed tax. Pelosi's request is correct House procedure, and that is not ironic at all.

irony - a pretense of ignorance and of willingness to learn from another assumed in order to make the other's false conceptions conspicuous by adroit questioning —called also Socratic irony

Posted by: thw2001 | October 8, 2009 1:45 PM | Report abuse

Other Dems sent a letter to her asking her not to do this. Is she single handedly trying to kill reform? She's a loose cannon.

Posted by: FLvet | October 8, 2009 1:52 PM | Report abuse

Nancy Pelosi aka The Great Mother of All Wing-Nuts is the gift that keeps giving to the massive losses in Democratic seats in government in 2010. As the economy goes down in flames, over 500,000 people lose their jobs every month and these morons keep trying to find more ways to spend. Enough. Our government is delusional and incompetent. Red or Blue vote for fiscal responsibility in 2010. We cannot afford anymore debt, nor are we going to spend our way out of this by printing more money. No to any more debt on health care, not to cap and trade. Enough.

Posted by: Bubbette1 | October 8, 2009 2:17 PM | Report abuse

Did Nancy even bother to read them?

Posted by: arby1 | October 8, 2009 2:19 PM | Report abuse

Perhaps you already believe that Ms. Pelosi is a problem for Democrats. If not, I believe the next few weeks will clearly show that this woman, ironically designated 'Speaker of the House' yet consistently unable to string coherent sentences together in front of a TV camera, will prove without a doubt that she is the GREATEST obstacle the Democrats,the President and the American people face. Watch and learn.
NEVER, NEVER, NEVER VOTE FOR AN INCUMBENT...EVER.

Posted by: bgreen2224 | October 8, 2009 2:19 PM | Report abuse

VOTE ALL INCUMBENTS OUT IN 2010! IT'S TIME FOR REAL CHANGE.

Posted by: arby1 | October 8, 2009 2:30 PM | Report abuse

Will the new bill(s) cover Botox injections?

Posted by: arby1 | October 8, 2009 2:44 PM | Report abuse

Three versions? Why of course! A girl's got to have options! Just like shoes and handbags!

If there were ever a clearer indication that Pelosi is unfit to lead, this is it. Which one do you support Nancy? "All or none," she replied. What a joke.

Posted by: flintston | October 8, 2009 3:21 PM | Report abuse

Boy,thats a joke especially coming from Pelosi,a known liar which was proven on more than one ocassion.Pelosi wouldnt know a health care plan if it hit her in the head.As far as her views on the rrepubs,both party's are suppose to be trying to work together but with idiots like her messing things up all the time i don't see how they can.She much like the whole admin including Obooboo all need to be replaced and sooner not later

Posted by: charles0390 | October 8, 2009 3:29 PM | Report abuse

I love hearing all the "wait till 2010" or "wait till 2012" rhetoric from those who hate the Democrats, it reeks of present day desperation. Although the Dems will probably lose their 60 seat majority, it's unlikely that they will lose control of the house or senate in 2010. People who hate Obama have thrown the kitchen sink at him, and he still has above 50% approval rating. The more people preach about 2010 and 2012, the more crushed they are going to be when they don't win; it's music to my ears.

Posted by: paulflorez | October 8, 2009 3:33 PM | Report abuse

I hope Nancy Pelosi sticks to her guns and makes sure the public option stays in the bill. She is our only hope! Baucus can shove his bill down the toilet.

Posted by: sandnsmith | October 8, 2009 3:41 PM | Report abuse

A good prescription drug plan could save Nancy Pelosi .. a small fortune..

Posted by: newbeeboy | October 8, 2009 4:20 PM | Report abuse

“””I love hearing all the "wait till 2010" or "wait till 2012" rhetoric from those who hate the Democrats, it reeks of present day desperation. Although the Dems will probably lose their 60 seat majority, it's unlikely that they will lose control of the house or senate in 2010. People who hate Obama have thrown the kitchen sink at him, and he still has above 50% approval rating. The more people preach about 2010 and 2012, the more crushed they are going to be when they don't win; it's music to my ears. Posted by: paulflorez”””
==========================
Paul, Rassmussen Poll Thursday shows -
29% of the nation's voters Strongly Approve of the way that Barack Obama is performing his role as President. 36% Strongly Disapprove giving Obama a Presidential Approval Index rating of -7.

Overall, 48% of voters say they at least somewhat approve of the President's performance. Fifty-one percent now (51%) disapprove.

Posted by: annlawler26 | October 9, 2009 12:52 AM | Report abuse

"Pelosi said she was waiting to hear back from Ways and Means Chairman Charles Rangel (D-N.Y.) on how much revenue such a tax would yield,"
===========
My God, the Irony.
Posted by: msully25
===========
HaHa!! msully25, You got that right!!

Posted by: annlawler26 | October 9, 2009 12:54 AM | Report abuse

Well if she is send three different versions of the House Bill it is an exercise in futility. The REAL COST of the health care bill that will be voted on has to be a COMBINED SENATE/HOUSE BILL THAT IS IN LEGISLATIVE LANGUAGE. Then the CBO can do the cost analysis. This is a wasted effort for the most part and it really does not mean anything until the bills are combined and a true analysis has been made.

More Pelosi grandstanding; she's learned quickly from Mr. O. However, she didn't look too happy on TV yesterday when she was standing at the news conference with her co-hort Harry R. Liked the eye roll!!

Posted by: nancycrichton | October 9, 2009 1:28 PM | Report abuse

A windfall tax on insurance companies ought to really help the economy. That way more people can lose their jobs becuase of lost revenue. Makes a lot of sense, no?

Posted by: nancycrichton | October 9, 2009 1:29 PM | Report abuse

CBO issues of health bill costs are a distraction from the key issues of concern in the proposals of Mr. Obama, Mr. Baucus and Ms. Pelosi.

The current proposal in Congress does not address any of the most meaningful issues in health care:

1) The need for single-payer insurance

Multi-payer systems inflate health care costs and give 8-12% of total health system costs to private insurers in system waste

2) True universality of coverage in a plan that doesn't create a second-class citizenry of the insured

Congressional plans still leave 10-15% of our country insured and create a second-class system of the poor insured that will place them below Medicaid recipients with respect to stigma and prioritization of care

3) The crisis of doctor shortages and primary care deficits in American medical care

Doctors are retiring at record rates and they are only being replaced at 75-85% rate because of a monopoly and market-control of the MD control by the AMA. Also, we have a 2/3 primary care / specialist ratio and 40% less per-capita doctors than the best European and Scandinavian countries. We have plenty of dermatologists and radiologists but not enough doctors to complete basic screenings and offer fundamental preventative care

4) Tax shortages for the Federal government and a lack of funding for the Medicare (and Social Security) trust funds

With a $13 trillion deficit and annual budget deficits of greater than $500B, our country and our entitlement programs are heading for bankruptcy without a 7% across the board tax cut. The idea of providing greater benefits without tax hikes is a myth impossible through policy

5) Tort reform and the end of defensive medicine

The featured research section of my website discusses the true costs of defensive medicine, which are high and staggering. Most studies that indicate these costs are 0.5% of total system costs are flawed econometric studies that poorly measure true indirect effects on health care costs within our American system


My website addresses these issues, and many more, as they related to health policy, comparative health systems and public health. I encourage you to all check the site out and appreciate your visits. Every visit also raises money that goes 100% to charity to fight disease.

The url is:

www.satvathealthcare.com

Thanks,

Amir Satvat

Amir Satvat
www.satvathealthcare.com
MBA in Health Care Management, The Wharton School
MPA in Health Policy and Management, New York University
Former Health Care Investment Banker, Goldman Sachs

Posted by: bsatvat | October 11, 2009 1:38 PM | Report abuse

Too bad the WP has not shown an ability to report the details of the bills before Congress. Hopefully this is a decision made to hold off until a bill is cobbled together in each chamber that would actually be voted on. The WP has done a decent job in reviewing the proposals of the VA gubernatorial campaign - reviewing in detail plans (where the exist) of each candidate and noting gaps in those plans, including as they did today noting where assumptions used are unrealistic. The POST should use its resources to do a similar review of the healthcare bills - not just a printing or linking of the CBO reports as they can be convoluted and difficult to digest.

Posted by: sagedutch | October 11, 2009 11:56 PM | Report abuse

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