House Leaders Busy Building Coalition To Pass Reform Bill
House Democratic leaders "worked furiously" on Thursday to secure the 218 votes needed to pass the chamber's health reform legislation (HR 3962), which is scheduled for a floor vote Saturday evening, the New York Times reports (Hulse/Herszenhorn, New York Times, 11/6).
The weekend deadline for passing health reform is a "calculated risk" by House leaders that "could backfire if the vote ... fails or must be delayed," according to the Washington Post (Murray/Montgomery, Washington Post, 11/6).
On Thursday, House Speaker Nancy Pelosi (D-Calif.) said that Democratic leaders will have the 218 votes needed for passage by Saturday, subtly acknowledging that House leaders might not have the votes as of yet, according to The Hill (Soraghan, The Hill, 11/5).
House Majority Leader Steny Hoyer (D-Md.) said, "We certainly have well over 218 people who say they want to vote for the bill," adding, "The trick is making sure they have a comfort level with the provisions they are particularly focused on to allow them to do so," which is "what we're in the final stages of trying to get to" (Wall Street Journal, 11/5).
The Post reports that House leaders can afford to lose no more than 40 Democratic votes and that they are working to limit defections to the approximately 25 Democrats considered "hard no" votes.
What To Expect Tomorrow
The House Rules Committee is scheduled to meet Friday to establish the framework of Saturday's vote.
Rules Committee Chair Louise Slaughter (D-N.Y.) said that more than 50 amendments have been filed by both parties and that floor debate could last for five hours. Republican action on the floor could extend debate into Sunday, according to the Post (Washington Post, 11/6).
Lingering Issues
According to CQ Today, abortion is the "greatest threat" facing House leaders, who continue to work on language that would be acceptable to members of their caucus who oppose abortion rights.
Some antiabortion-rights Democrats, led by Rep. Bart Stupak (D-Mich.), have been aggressively lobbying for the restriction of any federal subsidies to health care plans that offer abortion services, even if such subsidies are not used to fund the procedure.
Compromise language by Rep. Brad Ellsworth (D-Ind.), in which private contractors would be hired to handle all funds related to abortion coverage under a public health insurance plan, has been found acceptable by some abortion-rights supporters but is not popular among Democrats who oppose abortion rights.
Stupak has warned that unless stronger language is included, as many as 40 Democrats might vote against the reform bill.
Rep. Diana DeGette (D-Colo.) said that the 190 members of the Pro-Choice Caucus would not accept language that is more restrictive than what Ellsworth has proposed, saying that caucus members are "not going to compromise any further than we already have" (Wayne, CQ Today, 11/5).
According to Politico, House negotiators are working with the U.S. Conference of Catholic Bishops in crafting the final language, as many antiabortion-rights Democrats refuse to support legislation that is not supported by the group (O'Connor, Politico, 11/6).
CMS Score Might Not Be Ready Saturday
In an e-mail sent to the The Hill on Thursday, CMS Chief Actuary Rick Foster said that it is unclear whether the score for the House reform bill will be ready in time for Saturday's scheduled vote.
He wrote, "We're currently working on estimates and analysis for HR 3962. We're trying to have it ready before the House vote, but I don't know if we'll succeed," adding that there are many "new or modified provisions in the bill ... and the legislative language has only been publicly available for a short time."
The Congressional Budget Office's score found that the House bill would cost $894 billion and reduce the deficit by $30 billion over 10 years (Young/Cusack, The Hill, 11/5).
AARP, AMA, ACS Endorse House Bill
The AARP, the American Cancer Society Cancer Action Network and the American Medical Association all separately endorsed the House health reform bill on Thursday, the Los Angeles Times reports (Levey, Los Angeles Times, 11/5).
AARP CEO Barry Rand said, "Under the House plan, quality, affordable health care will never again be based on your luck or your wealth" (Reichard, CQ HealthBeat, 11/5). He said that the legislation "includes critical priorities for seniors" and "ensures quality, affordable health coverage options for all Americans, provides and strengthens Medicare for today's seniors and future generations, and puts us on a path to improving our long-term health system" (Young, The Hill, 11/6).
Nancy LeaMond, AARP's executive vice president, said, "We will be using all of our resources in the coming hours as the House deliberates" (Roth, Roll Call, 11/5).
In announcing AMA's support, President James Rohack said the House legislation "is not the perfect bill, and we will continue to advocate for changes, but it goes a long way toward expanding access to high-quality affordable health coverage for all Americans, and it would make the system better for patients and physicians."
AMA's support comes with the caveat that the House also passed legislation (HR 3961) to overhaul the Medicare physician reimbursement system.
"These two bills were introduced together, and they need to be passed together," Rohack said, adding, "Both are essential to achieving meaningful health system reform this year" (CQ HealthBeat, 11/5). 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.