Dems facing 'serious problems' on healthcare reform bill
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Alert: (The Hill) Congressional Democrats face “serious problems” in getting a healthcare reform bill to the
president’s desk, according to a House panel chairman.
“We’ve got to get a bill that’s more compatible to the House,” Ways and Means Committee Chairman
Charles Rangel (D-N.Y.) said Tuesday. “Forget all the other questions. Two-hundred-eighteen [votes] is the
most important issue we are dealing with… We have serious problems on both sides of the Capitol.
Serious problems.”
Rangel’s comments come a day after Sen. Chris Dodd (D-Conn.) said health reform is “hanging by a
thread.”
While it is clear that Democrats in the House and Senate are jockeying for negotiating power, they also are
openly acknowledging the daunting legislative obstacles in front of them.
The Senate bill attracted 60 votes while the House measure narrowly passed, 220-215. Threading the
needle to craft a conference bill that attracts enough backing in both chambers will be extremely challenging.
Meanwhile, the Democratic Party and union officials are very worried that Republicans could win Sen.
Edward Kennedy’s (D-Mass.) seat in a special election next week. A GOP upset could doom healthcare
reform, Democrats fear.
House Speaker Nancy Pelosi (D-Calif.) said Tuesday that while President Barack Obama wants an excise
tax on so-called Cadillac health plans, she hasn’t yet given up on having a millionaire’s surtax in the final bill.
“I think it’s the best way forward,” Pelosi said of the House-passed millionaire’s tax as she was leaving a
two-hour-plus meeting of members of her leadership team, various committee and subcommittee
chairman, and members who are liaisons to a number or concerned sub-groups within the Democratic
Caucus. “I think it’s the best pay-for that we have so far.”
Tuesday’s leadership meeting came minutes ahead of the first meeting of the entire Caucus, which has not
met as a whole since the House adjourned in December.
Leadership aides were bracing for a potentially "very angry Caucus" meeting on Tuesday night.
Healthcare negotiations between the House, Senate and the White House have been taking place at the
staff level and behind the scenes for days. The pace will pick up on Wednesday when six House Democrats
(Reps. Pelosi, Rangel, Steny Hoyer (Md.), James Clyburn (S.C.), George Miller (Calif.), and Henry Waxman
(Calif.)) join a group of five Democratic senators (Sens. Dodd, Harry Reid (Nev.), Dick Durbin (Ill.), Max
Baucus (Mont.) and Tom Harkin (Iowa)) at the White House.
Few of the many issues dividing the House and Senate remain resolved, and many House Democrats feel
as though they are continuing to lose ground to the upper chamber.
Despite Pelosi’s comments, the Associated Press reported just minutes before the Speaker emerged from
her leadership meeting that Democrats had agreed to drop the surtax on the wealthiest Americans. The
White House quickly disputed the notion that final decisions had been made on the matter.
While making the case for their bill, House leaders stressed that any effort to steamroll the House with the
Senate bill could be disastrous.
Financing the roughly $900 billon cost of the bill stands as possibly the biggest obstacle to final action given
how far apart the House and Senate are. Labor unions and their allies among House Democrats remain
strongly opposed to the excise tax on high-cost health insurance plans. Obama met with labor leaders
Monday and Pelosi sat down with some of the same leaders on Tuesday before gathering her leadership
team and her caucus together to seek a way forward.
Although the House bill eschewed the excise tax and liberals have decried it, the provisions in the Senate bill
appeal to the centrist contingent of the Democratic caucus as an alternative to an income tax increase.
Some health experts say the excise tax will lead to reduced spending on healthcare services.
"I definitely think there’s increasing support in the caucus for some kind of a tax on plans that executives and
wealthy people have," said Rep. Jared Polis (D-Colo.). "This is one of the few cost-containment measures in
the bill," he said, echoing the argument made by Obama and senior Senate Democrats. Polis last year
successfully pushed for the surtax in the House bill to be lifted to the millionaire level.
Despite the dissatisfaction among many House Democrats with Obama's stance in favor of the excise tax, a
solution could be emerging as the president attempts to work out a compromise with organized labor.
Raising the threshold, currently at $8,000 for individuals and $23,000 for families, could be a key component
of a revised version of the policy. In addition, Democrats are looking at other modifications, such as
exempting existing collective bargaining agreements negotiated by unions and other tweaks to prevent a
revolt by labor groups and provide cover to pro-union House Democrats.
Those steps would be an improvement but would not quell all Democrats' concerns about the impact of the
policy on middle-class workers, said Rep. Raúl Grijalva (D-Ariz.), co-chairman of the Congressional
Progressive Caucus. "As much as it is an important gesture to labor, particularly the trades," exempting
existing union agreements would not prevent the tax from applying to the health benefits on non-union
workers and those from "Right to Work" states like Arizona.
But Grijalva did not completely close the door on supporting a bill that includes a scaled back excise tax.
"Many of us would be more inclined" to vote for the bill if the burden for financing it fell more heavily on
wealthy workers, he said.
Scaling back the excise tax, however, would require the White House and congressional Democratic leaders
to come up with another revenue source, particularly since the millionaire's tax has scant appeal in the
Senate.
The Senate-passed bill would increase the Medicare payroll tax on high-income earners. The final measure
could further increase that tax or even apply it to non-wage income, such as investment earnings, for the first
time. Polis noted that an increase in the size and scope of the Medicare tax also would not negatively affect
small-business owners the way the millionaire's tax could.
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Last chance to KILL THE BILL - Stop Obama Care
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Alert: The Associated Press Reports that President Barack Obama and top Democrats began trying to
shape a final health overhaul bill on Wednesday in a White House meeting that underscored their desire to
strike a quick deal on the administration's top domestic priority.
The president was meeting with House Speaker Nancy Pelosi, D-Calif., Senate Majority Leader Harry Reid,
D-Nev., and other Democratic leaders to narrow differences between the House and Senate over the
massive legislation. Congressional aides said the session was expected to last hours — the latest
indications that Democrats want the health drive, which began when Obama took office a year ago, to bear
fruit before his State of the Union address, perhaps in early February.
Among the pressures they faced was a special election next Tuesday in Massachusetts to replace the late
Democratic Sen. Edward Kennedy — an unexpectedly close race that could cost Democrats the pivotal 60th
vote they need to push the measure through the Senate.
With polls showing public support for Obama's healthcare effort slowly drooping, House Republican leader
John Boehner of Ohio told GOP lawmakers that they could still sink the legislation. Republican leaders said
they believed dozens of House Democrats who supported the initial bill might feel pressure to abandon the
final version because of potential changes in provisions on abortion, Medicare cuts and federal Medicaid aid
to states.
"The bottom line is, I believe we can beat this bill," Boehner told House Republicans in a closed-door
meeting, according to his aides. "The American people are with us."
Lower-level negotiators from the White House and the two chambers have already been holding closed-
door meetings and trying to make decisions. They seem likely to abandon a House-approved surtax on the
wealthy even as they consider extending the Medicare payroll tax to investment income of high earners,
Democratic officials said.
"I have so much faith in the president of the United States and his ability to be persuasive," House Ways and
Means Committee Chairman Charles Rangel, D-N.Y., said Tuesday.
On another major difference between the two chambers, bargainers are considering a combination of the
national insurance exchange the House approved and the Senate's preference for letting each state
establish its own exchange, Democratic officials said. The exchanges in effect would be marketplaces
where consumers could compare competing health care policies before purchasing them.
The officials spoke on condition of anonymity, saying they were not free to disclose details of the
negotiations.
The House returned from its year-end break on Tuesday, and Democrats met immediately to get an update
from their leaders. Lawmakers left that session expressing a mix of resolve to craft a compromise and
defiance of Senate Democrats, who passed their version of the bill on Christmas Eve without a vote to
spare. House passage in November was also a nail-biter, 220-215.
"A lot of people think we have a gun to our head and don't like it very much," said Rep. Anthony Weiner, D-N.
Y., referring to senators' insistence that their bill can't be changed much without risking anew the 60 votes
they need for passage. He said there was a "squeal like pigs" coming from the Senate about the difficulties
of retaining those 60 votes.
After letting Congress provide most of the legislation's details last year, Obama in recent days has spelled
out his preferences on two measures aimed at curbing healthcare costs. He has told lawmakers he wants
at least a pared-down tax on high-cost insurance plans, which is opposed by labor and House Democrats,
and favors a commission with power to order cuts to Medicare spending in some circumstances.
Among the remaining House-Senate disputes are restrictions each chamber approved on federal financing
of abortions. The House voted for the stricter version of the two, and some anti-abortion and abortion-rights
Democrats have threatened to abandon the final package unless the language is to their liking.
Rep. Bart Stupak, D-Mich., who led the successful fight last month for the House bill's tight anti-abortion
language, said in an interview Tuesday that he has had two broad discussions with House leaders about
that issue. He said he believes his provision — or something very close to it — has popular support but did
not rule out striking a compromise.
"How we work that out I guess remains to be seen, but I think in the long run it can be worked out," he said.
In dealing the remaining issues described by Democratic officials, negotiators:
* Are considering extending the Medicare payroll tax, which now applies only to wages, to some of the
investment earnings of couples making more than $250,000 a year and individuals earning more than
$200,000.
* Seem likely to drop the House-passed income tax boost on individuals making more than $500,000 a year
and couples making over $1 million.
* Might jettison a House-approved requirement for large businesses to provide health coverage for their
workers.
* Could include more federal money to help states pay for an expansion of the federal-state Medicaid
insurance program for the poor. That issue flared after Sen. Ben Nelson, D-Neb., the critical 60th vote for the
health care bill in the Senate, got a deal for the federal government to pay the full cost of Medicaid expansion
in his state permanently, while other states would have to pick up part of the tab after a few years.
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