House reform plan finalized
Compromise with Senate health care bill poised for Sunday approval
WASHINGTON – Buoyed by estimates that their health care overhaul would cut the deficit by $138 billion over the next decade, congressional Democrats unveiled their final blueprint Thursday and set the stage for a dramatic House vote Sunday.
House approval of the package, which will include the health care bill passed by the Senate last year along with a series of changes sought by House Democrats, would allow President Barack Obama to sign the Senate bill this weekend.
“This is history, and this is progress,” House Speaker Nancy Pelosi said Thursday, referring to the cost and savings estimates for the bill that were released Thursday by the nonpartisan Congressional Budget Office. For weeks, the CBO has been evaluating the evolving versions of the overhaul legislation.
“We told (our members) we would stick with this bill until we had the savings that were necessary. And it took some time. But we are very pleased,” said Pelosi, D-Calif.
The Senate, using the budget reconciliation process to avoid a Republican filibuster, could complete action by the end of next week by approving changes sought by House Democrats, bringing to a close one of the most intense legislative battles in decades.
Underscoring the urgency Obama attaches to hitting that target, the White House announced that he would postpone until June a trip to Asia that was to have started Sunday.
Republican lawmakers, who say the legislation is too costly and the Democratic push to pass a bill is too rushed, repeated their pledge Thursday to work to block votes in both the House and Senate.
“It’s pretty clear that Democrat leaders here in Congress and the president aren’t listening to the American people,” said House Minority Leader John Boehner, R-Ohio.
Boehner and other GOP leaders have focused their criticism in recent days on Democratic plans to use a parliamentary maneuver in the House that would allow House Democrats to pass the Senate bill with a procedural vote.
A coalition of business groups, led by the U.S. Chamber of Commerce, Thursday announced a new ad campaign urging Democrats to stop the health care push. Many business leaders have criticized the legislation for doing too little to contain costs while placing new mandates on employers.
In the Senate, Republicans plan to try to force changes to the reconciliation package. If they succeed, the House would have to take yet another health care vote, possibly after Easter.
Democratic officials believe that can be avoided, however. And with legislation that boosts coverage without adding to the deficit, Democrats are growing increasingly confident that they will be able to complete work on their health care overhaul soon and sell it to a skeptical electorate.
The combined package that Democrats outlined Thursday would cover an addition 32 million Americans by 2019, according to a preliminary CBO estimate. That would mean 95 percent of non-elderly Americans would have health coverage in 2019, compared with 83 percent today. (Virtually all elderly Americans are already covered by Medicare.)
The boost will not be cheap, according to budget analysts, who estimated that the coverage expansion will cost $940 billion over the next decade.
Because the new spending is offset with a series of new taxes and cuts in federal Medicare spending over the next decade, the CBO concluded that the legislation will actually reduce the deficit. The budget analysts estimated that deficit reduction could be even higher over the next two decades, hitting as much as $1.3 trillion by 2029.
Obama highlighted those numbers while speaking at the White House on Thursday, saying the health care bill represented “the most significant effort to reduce deficits” since the ’90s.
Privately, the president also kept up his effort to convince wavering House Democrats to rally behind the health care package, meeting and talking with several rank-and-file lawmakers at the White House.
Party leaders are closing in on the 216 votes they will need Sunday and appeared to pick up more support from conservative Democrats on Thursday, thanks to the CBO cost estimates.
Reps. Betsy Markey, D-Colo., and Bart Gordon, D-Tenn., announced they would back the bill. Both voted against the more costly House health care legislation last year.
Rep. Baron Hill, D-Ind., who has expressed skepticism about the health care legislation, said Thursday he was moving closer to supporting the bill. “I’m pretty happy about the numbers,” Hill said.
And fellow Indiana Rep. Brad Ellsworth, who has been concerned that the Senate bill places too few restrictions on federal funding for abortion, said, “It’s not a perfect bill, but there are great things in the bill,” he said.
A host of leading medical groups, consumer advocates and labor unions also rallied behind the legislative package.
“It is no exaggeration to say that this is the last opportunity in our generation to bring about durable reform,” Federation of American Hospitals President Charles N. Kahn III wrote lawmakers. Seventeen years ago, Kahn, a former GOP staffer, helped lead opposition to the health overhaul sought by then-President Bill Clinton.
The 153-page reconciliation package preserves the basic structure of the Senate health bill by placing new restrictions on insurers’ ability to deny coverage and creating a series of regulated insurance marketplaces where people who do not get coverage at work will be able to shop for plans.
But it would boost federal subsidies to help low- and moderate-income Americans buy a plan in the new insurance exchanges and reduce the penalties on people who do not buy insurance. The health care legislation will for the first time mandate that most Americans buy coverage.