US House Dem Leaders Moderate Course On Public Health Option
House leaders spent the last week trying to round up votes for a robust public option, tied to Medicare rates, that is preferred by liberal members of their caucus. In a Friday press conference, they said the robust public option hasn't been ruled out but added what form the public option takes isn't as important as the fact that there is a public option in the bill.
"At the end of the day, we will have a public option in our legislation to keep the insurance companies honest and to provide real competition," said House Speaker Nancy Pelosi, D-Calif.
Pelosi said there is "no philosophical difference" between the robust public option and other versions. She said it is less important now for the House to include a strong public option, than it was several weeks ago when it looked like a Senate health bill might omit the public option all together.
"The atmosphere has changed. When we were dealing with the idea that the Senate had nothing, it was really important, again, to go in with the most muscle for the middle class with a robust public option," Pelosi said at the news conference.
"This is about the endgame now," she said.
She said a robust public option remains her "preferred" version, but "it's not the only way to go."
House Democrats polled their members during a caucus meeting Friday morning, which was attended by about 170 of the 258 House Democrats, according to a Democratic aide. Caucus chairman John Larson, D-Conn., called the roll and asked lawmakers whether they supported the strong public option with Medicare rates or not.
House leaders stressed that their vote counts aren't complete, and there is some hope among liberals that the robust public option might ultimately win enough support.
"They don't have the absolute count," said Rep. Lynn Woolsey, D-Calif. "We've got a lot of undecideds, and we've got to find out where they are."
House aides say a majority of House Democrats support the robust plan but not enough to make a majority of the entire House, or 218 votes.
"People are where they are, and obviously that's a little short of 218, or we wouldn't be in this process right now," said Rep. Earl Pomeroy, D-N.D., who opposes linking the public option to Medicare.
The robust public option is less costly to the government than alternatives, but moderate Democrats prefer a version approved by the House Energy and Commerce Committee under which federal officials would negotiate payment rates with doctors and hospitals.
There are two other alternatives that House leaders are weighing: a so-called trigger that would start with negotiated rates, but could revert to Medicare rates if federal officials determined there wasn't enough competition in the marketplace; and a public option with negotiated rates, while at the same time expanding eligibility for Medicaid to 150% of the federal poverty level.
"From day one, we have had three or four different public options under discussion," House Majority Whip James Clyburn, D-S.C., said.
Pelosi, appearing with AARP Executive Vice President Nancy Leamond, announced that a new version of House legislation would speed up the elimination of the so-called doughnut hole in the Medicare Part D prescription benefit. That's the gap in coverage under which beneficiaries have to pay for drugs between the cost of $2,700 and $6,154 per year.
Under the version of the legislation approved by House committees earlier this year, the coverage gap would be eliminated gradually over the course of 15 years.
Pelosi said Friday that the new version of the legislation would eliminate the gap in only 10 years and that the changes would begin to take effect next year, if the bill is passed into law.
-By Martin Vaughan, Dow Jones Newswires; 202-862-9244; martin.vaughan@dowjones.com
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Publié le 23 octobre 2009 Copyright © 2009 Dowjones
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