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.
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