Blue Dog Democrats Reach Deal on Reform With House Leaders
House Democratic leaders, the White House and four Blue Dog Coalition members on the House Energy and Commerce Committee reached a deal on Wednesday that would cut more than $100 billion from the chamber's $1 trillion health reform bill (HR 3200) and increase the number of small businesses that would be exempt from an employer contribution mandate, Roll Call reports.
The deal also assures that lawmakers will not proceed with a full vote on the House floor until after the August recess, which will give lawmakers time to study the entire bill (Dennis, Roll Call, 7/29).
The four Blue Dogs who agreed to the deal are Democratic Reps. Bart Gordon (Tenn.), Baron Hill (Ind.), Mike Ross (Ark.) and Zack Space (Ohio) and (AP/Washington Times, 7/29).
Ross, head of the Blue Dog Health Care Task Force, said the deal would prevent the public plan option from basing reimbursements on Medicare rates. The fiscally conservative Democrats say Medicare payments to rural hospitals are disproportionately lower than payments to hospitals in urban areas (Kane, "Capitol Briefing," Washington Post, 7/29).
The new proposal would require the HHS secretary to negotiate rates with hospitals and physicians, which is how private insurers often set rates (Kane/Murray, Washington Post, 7/30).
In addition, the agreement would allow states to create not-for-profit health insurance cooperatives where individuals, families and small businesses could purchase coverage (Pear/Herszenhorn, New York Times, 7/30).
According to the agreement, companies with less than $500,000 in annual payroll that do not offer coverage to workers would be exempt from a tax penalty.
Previously, the measure would have exempted businesses with total payroll under $250,000 (Washington Post, 7/30). Businesses with $500,000 to $750,000 in annual payroll would be subject to a sliding-scale tax if they do not offer coverage, and companies with payrolls greater than $750,000 would pay 8% of total payroll if they do not offer coverage to workers.
The agreement also would ensure that individuals whose health insurance costs comprise at least 12% of their income would be eligible for government-sponsored subsidies, a 1% increase from current legislation.
In addition, the proposal would require states to pay 7% of the cost of additional Medicaid coverage, a provision that would be phased in over an unspecified period of time.
According to CongressDaily, the Congressional Budget Office has not yet scored the new proposal.
Ross said the final score would be available before the full House votes on the measure. He indicated that he would oppose the bill if the cost estimate is not below $1 trillion.
Other Blue Dogs React
The remaining Blue Dogs on the Energy and Commerce panel -- Reps. John Barrow (D-Ga.), Jim Matheson (D-Utah) and Charlie Melancon (D-La.) -- did not approve the new deal.
Melancon said that the changes were positive but that they do not go "far enough" (Hunt, CongressDaily, 7/29). Still, he indicated he might still vote for the legislation if it is subject to "additional reform." He added that the decision by four Blue Dogs to accept the deal does not signal a division in the group (Haberkorn, Washington Times, 7/29).
Rep. Allen Boyd (D-Fla.), a Blue Dog leader, said that he thinks "the bulk" of the 52-member Blue Dog Coalition ultimately could oppose the legislation, despite the latest agreement (Levey/Hook, Los Angeles Times, 7/30).
After the agreement was reached, President Obama said that he was grateful that lawmakers "are working so hard to find common ground." He added, "Those efforts are extraordinarily constructive in strengthening this legislation and bringing down its cost" (Smith/Frank, Reuters/Yahoo! News, 7/30).
Other Democrats React
Other lawmakers criticized the deal, saying that attempts to appease conservative Democrats go against what the majority of the party pushed for before the bill was drafted.
The White House and Democratic leaders immediately tried to address concerns from the party's more progressive members.
House Speaker Nancy Pelosi (D-Calif.) met with groups of liberals on Wednesday, while House Energy and Commerce Chair Waxman (D-Calif.) held a caucus meeting to answer House members' questions (Soraghan et al., The Hill, 7/29).
Liberal lawmakers are particularly concerned about the plan's treatment of the public plan option.
Rep. Eliot Engel (D-N.Y.) said many Democrats are concerned that forcing the public plan to negotiate rates with physicians, hospitals and other providers would "erode" the option (Armstrong/Wayne, CQ Today, 7/29).
Rep. Jerrold Nadler (D-N.Y.) said, "We signed a pledge to reject any plan that doesn't include a robust public plan option, and this plan doesn't have" one. He added, "Waxman made a deal that is unacceptable" (Thrush, Politico, 7/29).
According to The Hill, Democrats in the 83-member Progressive Caucus are circulating a letter protesting the agreement. They hope to gather at least 50 signatures to make it clear they have the votes to defeat the legislation.
Progressive Caucus Co-Chair Raul Grijalva (D-Ariz.) said, "Fifty is our threshold," adding, "That'll kill anything" (Soraghan , The Hill, 7/29).
Waxman said he would ask Democratic leadership and the Blue Dogs to restore cuts to subsidies for low-income individuals. However, he said if the Blue Dogs do not agree to the changes, he still stands by the deal.
Waxman said he would proceed with the Energy and Commerce Committee markup of the bill on Thursday.
Some House members who oppose the deal still support moving forward with the bill.
Rep. G.K. Butterfield (D-N.C.) said, "We don't like [the deal], but the political reality is we need to move something out of committee" (Dennis et al., Roll Call, 7/29).
Waxman said that despite objections by liberals, he thinks the bill has enough votes to pass the committee (Soraghan , The Hill, 7/29).
PBS' "NewsHour with Jim Lehrer" reported on progress made in the House on reform legislation and obstacles that remain before full chamber approval of the bill. The segment included comments from Ross (Bowser, "NewsHour with Jim Lehrer," PBS, 7/29).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.