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Pelosi plays down differences with Senate in health-care debate

By Shailagh Murray
House Speaker Nancy Pelosi, a champion of the public insurance option, pointedly declined Thursday to criticize a pending Senate agreement to drop the idea as Majority Leader Harry M. Reid (Nev.) seeks to unite divided Democrats in his chamber behind health-care reform.

The health-care debate is temporarily on hold in the Senate, as senators turn to the business of completing the annual spending bills, a process likely to extend through the weekend. Consideration of the $848 billion health bill is expected to resume on Monday, Democratic leadership aides said.

Earlier this week, Senate liberal and conservative Democrats produced two coverage alternatives to a government plan; the proposals are now undergoing a cost analysis by the Congressional Budget Office. Pelosi told reporters that she would wait to see the results before taking a position on the Senate's new approach. "As soon as we see something in writing from the Senate, we'll be able to make a judgment about that," she told reporters.

The compromise deal would create a pair of national plans that would be offered by private insurers and regulated by the federal government. It also would allow uninsured individuals age 55 and older to purchase Medicare coverage. The latter idea, long promoted by liberals, already has strong support in the House, Pelosi said.

"There certainly is a great deal of appeal about putting people 55 and older on Medicare," she said. "That's something that people in the House have advocated for years."

But while the national plans appear to be gaining broad support, not all 60 members of the Senate Democratic caucus appear sold on the buy-in idea. Among those who have expressed skepticism are moderates who disliked the public option, including Sens. Joseph I. Lieberman (I-Conn.), Blanche Lincoln (D-Ark.) and Kent Conrad (D-N.D.). Another critic is Sen. Olympia J. Snowe (Maine), the only Republican to have supported Democratic reform efforts.

Democratic leaders said they expected doubts to be erased, once the terms of the program are clear. "They've got to see the details," said Sen. Charles Schumer (D-N.Y.). "All of the problems that people are mentioned, we are mindful of."

Reid is still aiming to complete action on health-care reform before Christmas, but the timing beyond a Senate vote is less clear. A House-Senate conference could take days or weeks, pushing final action on the legislation into January.

"These bills are probably 75 percent compatible," Pelosi told reporters. "But we don't have paper. We haven't seen what they have. So I can't tell you how long it will take."

She ticked off some of the major differences. The House bill provides more generous subsidies for uninsured people. It expands Medicaid more broadly. It provides coverage to an additional 5 million people and becomes law a year earlier, in 2013. It has a public option; the Senate bill likely will not.

The House and Senate also rely on different revenue sources to offset the overall cost of reform. The House would levy a surcharge on taxpayers making more than $1 million a year, while the Senate would impose an excise tax on high-value, so-called "Cadillac" insurance plans.

Many House Democrats strongly oppose the excise tax, because of its potential cost to union households. But some Senate Democrats are also concerned about the tax and are weighing possible alternatives.

Sen. Thomas R. Carper (D-Del.), for instance, is developing a provision that would replace the Cadillac tax with a tax on those health insurance policies whose price tags grow faster than inflation. Carper said his alternative could raise more than $100 billion over the next decade, enough revenue to eliminate the Cadillac tax entirely.

Pelosi said none of the differences seemed irreconcilable. "I think we can find some common ground on those issues," she said.

By Shailagh Murray  |  December 10, 2009; 6:08 PM ET
Categories:  Health Reform , House  
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There's only one man on Capital Hill who could have made this happen. His name is President Obama.

Posted by: TheSimpleTruth | December 10, 2009 7:10 PM | Report abuse

The ultimate public option is Medicare for everybody. That part of this reform is a step in the right direction.

Posted by: tinyjab40 | December 10, 2009 7:16 PM | Report abuse

The objective is to get health insurance coverage for all citizens. It doesn't really matter if the final solution is called a public option or something else. It appears that expanding Medicare and providing a federally supervised plan like Congress has is a way to get to the same end.

Posted by: cdierd1944 | December 10, 2009 7:26 PM | Report abuse

A lot of mischief occurs in conference when no one is watching. The self serving bureaucracy runs the show while Congress fronts with photo ops and hearings on the latest scandal.

Posted by: warrior5 | December 10, 2009 7:36 PM | Report abuse

Pelosi and Reid: Spinelss, gutless, feckless wonders.

Posted by: onestring | December 10, 2009 7:40 PM | Report abuse

Whatever bill they finally agree on, I propose this -- that all members of Congress be required to utilize the same health care program that they have written into law. If it's good enough for the American people, it should be good enough for our public servants.

Posted by: Jay31 | December 10, 2009 7:59 PM | Report abuse

Hate to say to the right-wingers who cannot stand the idea, because they oppose anything and ever'thing, but Nancy Pelosi is one heck of a winner. Wait'll ya see what she gets passed! Just gettin' started

Posted by: dudh | December 10, 2009 8:13 PM | Report abuse

actually Jay31, Senator Sherrod Brown has already called the R Senators' bluff and co-sponsored an amendment that does precisely what you propose. Lets say if Senate Rs will blink and can take yes for an answer.

Posted by: leichtman | December 10, 2009 8:14 PM | Report abuse

Pelosi and democratic "negotiators" are likely to kowtow to their counterparts in the senate. The travesty of a health care "reform" bill of the senate to be mostly intact when a bill is sent to the white house.

Posted by: Aprogressiveindependent | December 10, 2009 8:18 PM | Report abuse

Pelosi Cola.

Posted by: IIntgrty | December 10, 2009 8:20 PM | Report abuse

The only effective thing the Radical in the White House and Socialist led Congress has done is awaken the Silent Majority. This is a Conservative Nation. It will not stand for the leftist deceit and irresponsibly that the current Administration and out of control Congress have exhibited. Their actions have ignited the Conservative movement.

2010 & 12 Cannot Come Soon Enough !!

Posted by: jas7751 | December 10, 2009 8:21 PM | Report abuse

this business of droping the age for medicare to 55 ( I thought they plan to make drastic cuts to medicare) so if they keep droping the age .......then we are left with socialized these people think the american people are that stupid ?well we are not !!the veters need to clean house in 2010 and 2012 !

Posted by: cmt138 | December 10, 2009 8:34 PM | Report abuse

Apart from the mandate for people to buy insurance and protecting the profits of the insurance and medical fields there really is no reform in this legislation.

Health insurance stocks are on a tear confirming the above.

Posted by: Maddogg | December 10, 2009 8:36 PM | Report abuse

There is only one true reform. Extend to all American's the same health care benefits members of Congress have on a single-payer basis, funded by a general business tax.

Posted by: Maddogg | December 10, 2009 8:41 PM | Report abuse

On Saturday, November 7, 2009, the House passed H.R. 3962, the Affordable Health Care for America Act, to much celebration by the Democratic party. Healthcare-NOW!’s view, however, is that the House bill is a gift to the insurance industry at the further expense of the people of this nation.

The bill’s advocates claim it will cover an additional 36 million people, subsidize the cost of insurance for families up to 400% above the poverty level, increase Medicaid coverage to 150% above the poverty level, close the Medicare donut hole by 2019, place a surcharge on individuals making more than $500,000 and couples making more than $1,000,000, will end rescissions and pre-existing conditions.

What the Democrats fail to mention is the bill leaves millions of people uninsured, allows medical bankruptcies to persist, criminalizes and fines the uninsured, increases the number of underinsured, does nothing to contain the sky rocketing costs, blocks women from their reproductive rights, transfers massive public funds to private insurance companies strengthening their control over care, protects pharmaceutical companies’ superprofits at patient expense, fails to reclaim the 31% of waste in our system, expands Medicaid without regard to the state budget crises, discriminates based on immigration status and age, and sets up several levels of care covering less for those without the ability to pay. Those who have coverage will increasingly find care unaffordable and will go without. The whole system will inevitably fail from being fiscally unsustainable.

So is the House bill better than nothing?

“I don’t think so,” writes Marcia Angell, M.D., former editor of the New England Journal of Medicine. “It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we’ve tried health reform and it didn’t work. But the real problem will be that we didn’t really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.”

Posted by: ryan_heart | December 10, 2009 9:19 PM | Report abuse

look at the posting by jas7751 above; this is the sickness we are up against. Let's make sure we pass a health care bill for the American people NOW.

Posted by: dudh | December 10, 2009 9:21 PM | Report abuse

Many different variables might push health plans into "Cadillac" territory, including geographic location, plan demographics, and other characteristics of the insured population. More at

Posted by: JEngdahlJ | December 11, 2009 11:56 AM | Report abuse

Anyone who thinks this bill has ANYTHING to do with heathcare is dillusional - it is nothing more than a power grab by the Democrats - I think that if the republicans ever get back in control, the first order of business will be to rescind this affront to our personal freedom.
Of course, I'll bet the system is rigged so that a conservative will never see another house or senate seat. Look how Franken was elected - they chose which votes would be counted, then made up enough until he had won.Total fraud

Posted by: rknapp0205 | December 11, 2009 1:19 PM | Report abuse

Yeah, yeah, rknapp, and the moon landing never happened, there are alien cadavers in Area 51, and there WAS someone on the grassy knoll in Dallas.

The Repubs lost because the majority of voters don't agree with their platform and because they ran the economy into the ground by allowing the free market to run without any enforcement of regulations.

Predictions of the outcome of the 2010 elections are premature. Not a single one of you prognosticators is equipped with the ability to see what the next 10 months will bring, and your posturing and fuming makes you look ridiculous.

Posted by: notation | December 12, 2009 1:36 PM | Report abuse

A sign of things to come.

Why should I believe...

I'm a retired veteran; I have coverage from Aetna, the VA, and Medicare.

I was diagnosed with Leukemia when I was 40, Aetna paid for all of my care, VA claimed that I had to go to a civilian cancer care center because they didn't have the proper facilities to treat me.

So I went to the University of Louisville James Graham Brown Cancer center, in Louisville KY. The care was first rate, the government payment was far from it.

Aetna paid all costs, except the co-pays, TRICARE paid a small percentage, and I paid the rest out of pocket. Then TRICARE billed their portion to AETNA, so the government paid nothing.

On the advice of a hospital Social Worker I signed up for Social Security Disability (SSD). I was on SSD for 26 months. At my 25th month of SSD, Medicare informed me that because I had been on SSD for more than 24 months that the law required I go on Medicare. This was after my cancer was cured. Since Medicare Part A (which covers nothing other than hospital stays) was what I was enrolled in, I was faced with the choice of enrolling in Part B, which I had to pay for, or having no insurance to cover my copays. TRICARE was revoked even though I am a veteran, because when a veteran, any veteran is enrolled into any part of Medicare they lose their veterans promised health care coverage, as it is replaced by Medicare.

For the next 36 months, Medicare charged me 90.00 a month for coverage, but since the law places Medicare at the end of the line of payers, Aetna carried the ball and I paid Medicare 90.00 a month only to have them deny every charge. Like Obama-care, there is no "Opt-out" of the Medicare trap.

As for TRICARE and VA, when I retired I was 40% disabled but it took them a year to figure that out and get a disability letter done. Then I was informed that I had to register with the local VA clinic, which required that I meet with a VA doctor. The Doctor I was assigned is Pakistani and barely speaks English. It took me 18 months to get an appointment for my initial consult, and I was not allowed to get any VA treatments until the consult was complete. The first thing my Pakistani doctor said to me was "I'm tired of all of you people faking your injuries to get disability." This was before she even began the exam. Yet, my retirement physical of 18 months earlier, had already confirmed my disabilities.

NOW....Why should I believe that any new healthcare bill will be any different than the current debacle?

Based on my experience, I have begun informing High School aged people in my area about the poor quality of service I recieved and cautioning them against military service.

Posted by: jonweiss1 | December 12, 2009 3:17 PM | Report abuse


You are totally correct with your assertion that a "fix" is beiung rigged by the Dems, they are rigging the system by using your tax money to pay for healthcare, and after they get it in place, all of the crap they claim is not in the bill, will be inserted, abortion coverage for illegal aliens, etc, and after the 12 million illegals are given healthcare, they will also be given the right to vote, and since the Dems have already bribed them, they will be expected to vote for the Dems who have already bought their votes with your money, the Constitution not withstanding.

Posted by: jonweiss1 | December 12, 2009 3:22 PM | Report abuse


If you think that medicare is such a great deal be careful, you may get what you ask for.

Posted by: jonweiss1 | December 12, 2009 3:33 PM | Report abuse

jonweiss1, if you think Medicare is so bad, be sure you don't apply for it when you are of age. Most of the people on it are happy with their coverage. But you go right ahead with your case of paranoia; the rest of us actually have a grip on reality.

Posted by: notation | December 12, 2009 8:09 PM | Report abuse

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