Democrats press committee action on health care

[July 30, 2009]  WASHINGTON (AP) -- Congressional Democrats are determined to show progress on health care overhaul by pushing President Barack Obama's top domestic priority through two critically important committees before they head home for their August break.

They're closer, but they're not there yet.

Democratic leaders in the House won agreement from conservatives on the Energy and Commerce Committee that would allow that panel to start voting on legislation as early as Thursday. In the Senate, negotiators on the Finance Committee say they are nearer to a bipartisan compromise that has eluded them for weeks.

The Finance panel and Energy and Commerce panel are seen as pivotal tests of prospects for the legislation because they reflect the broader composition of the Senate and the House. Three other committees that have already passed versions of the legislation are dominated by Democratic liberals.

The earliest that floor votes could occur would be in September.

The House bill and the plan under negotiation in the Senate are designed to meet Obama's goals of spreading health coverage to millions who now lack it, while trying to slow the skyrocketing growth in medical costs. As recently as two weeks ago, Obama was pressing the House and Senate to pass separate bills by the end of July or early August. After Republicans and moderate Democrats objected to the rush, the president said he'd settle for just progress.

Wednesday in the House, Democratic leaders gave in -- at least temporarily -- to numerous demands from rank-and-file rebels from the conservative wing of the party. The so-called Blue Dog Democrats had been blocking the bill's passage in Energy and Commerce.

The House changes, which drew immediate opposition from liberal lawmakers, would steer away from using Medicare as the blueprint for a proposed government insurance option, reduce federal subsidies to help lower-income families afford coverage, and exempt additional businesses from a requirement to offer health insurance to their workers.

Bipartisan Senate negotiators reported progress on legislation that aims to cover 95 percent of Americans without raising federal deficits.

"We're on the edge, we're almost there," said Sen. Charles Grassley of Iowa, the senior Republican involved in the secretive talks, although a fellow GOP participant, Sen. Mike Enzi of Wyoming, dissented strongly.

Sen. Max Baucus, D-Mont., chairman of the Finance Committee, said preliminary estimates from congressional budget experts showed the cost of the emerging Senate plan was below $900 billion and would result in an increase in employer-sponsored insurance -- conclusions that may reassure critics who fear a bloated bill that prompts businesses to abandon the coverage they currently provide.

Congressional officials said Baucus was able to get the cost under $1 trillion because his bill includes only the cost of the first year of a 10-year, $245 billion program to increase doctor fees under Medicare. House Democrats used a similar sleight of hand, excluding the entire $245 billion when claiming their measure wouldn't add to the deficit.

The White House praised the developments in the House. At appearances in North Carolina and Virginia, the president sought to minimize the significance of the slippage in his timetable.

"We did give them a deadline, and sort of we missed that deadline. But that's OK," Obama said. "We don't want to just do it quickly, we want to do it right."

Campaigning for the health care overhaul, Obama stressed that any legislation he signs will include numerous consumer protections, including a ban on insurance company denials of coverage based on pre-existing medical conditions. A White House fact sheet left room for insurers to continue charging higher premiums based on prior health problems.

Rep. Mike Ross of Arkansas, a leader of the Blue Dogs, said the changes agreed to by the leadership in the House bill would cut its cost by about $100 billion over 10 years.

The House deal was worked out over hours of talks that involved not only Democratic leaders but also White House officials eager to advance the bill. Senior congressional aides cast it as a temporary accommodation, saying leaders had not committed to support it once the bill advances to the floor of the House in the fall.

As word of the agreement spread, liberals fired back. "We do not support this," said Rep. Lynn Woolsey, D-Calif., co-chair of the Progressive Caucus. "I think they have no idea how many people are against this. They can't possibly be taking us seriously if they're going to bring this forward."

Plans to convene the Energy and Commerce Committee for a vote slipped until Thursday as leaders sought to allay concerns of liberals.

"We just need to get everybody on board," said Rep. Frank Pallone, D-N.J., who chairs the panel's subcommittee on health.

In the Senate, the pace of negotiations appears to have accelerated in recent days, with lawmakers all but settling on a tax on high-cost insurance plans to help pay for the bill, as well as a new mechanism designed to curtail the growth of Medicare over the next 10 years and beyond.

More problematic from the point of view of most Democrats is a tentative agreement to omit a provision in which the government would sell insurance in competition with private industry. In its place, the group is expected to recommend nonprofit cooperatives that could operate at the state, regional or even national level.

Nor is any bipartisan recommendation likely to include a requirement for large businesses to offer insurance to their workers. Instead, they would have a choice between offering coverage or paying a portion of any government subsidy that noninsured employees would receive.

Like the House bill, the bipartisan proposal under discussion would expand eligibility for Medicaid to 133 percent of the federal poverty level.

It provides for federal subsidies for individuals and families up to 300 percent of poverty, less than the 400 percent in the House measure.

Even if the negotiations succeed before the Senate's vacation, which starts next week, it isn't clear when the Finance Committee would vote.

[Associated Press; By RICARDO ALONSO-ZALDIVAR and ERICA WERNER]

Associated Press writers Liz Sidoti, Alan Fram and David Espo contributed to this report.

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