House Negotiations Heat Up, but Lawmakers Pledge To Soldier On

On Friday, House Majority Leader Steny Hoyer (D-Md.) said that markup would continue on the House reform bill (HR 3200) this week despite heated debate between the fiscally conservative Democratic Blue Dog Coalition and House Energy and Commerce Committee Chair Henry Waxman (D-Calif.), Roll Call reports (Dennis/Drucker, Roll Call, 7/27).

Last Friday, negotiations stalled when Waxman told the Blue Dogs that prior conditions -- granted through tentative agreements earlier in the week -- were off the table.

Waxman accused the Blue Dog Democrats of threatening to vote with Republican members of the committee and derail the legislation.

Rep. Mike Ross (D-Ark.), lead negotiator for the Blue Dogs, had pushed for the creation of a new commission that would set Medicare provider rates, as well as for language to ensure that Medicare payment rates were not the basis for payments under a new public health plan option.

Blue Dogs have criticized regional disparities in payment amounts (Bacon et al., Washington Post, 7/25).

After the Blue Dogs accused Waxman of backing out of deals already reached, Waxman called an emergency, members-only meeting of Energy and Commerce Democrats on Friday afternoon to discuss the bill.

Waxman and Ross emerged together after the meeting and pledged to continue negotiations.

Waxman said, "We've had some rough edges as we try to deal with some of these issues," adding, "But I think that our colleagues have pulled us both back, and said, 'Let's all take a deep breath.'"

Waxman and Ross announced that "everything is back on the table" regarding prior agreements.

Waxman said he hoped to resume the markup on Monday or Tuesday "at the latest" (Roll Call, 7/27).

Grassley Tweets

Meanwhile, Senate Finance Committee ranking member Chuck Grassley (R-Iowa) in a Twitter post on Friday encouraged conservative House Democrats to continue opposing the bill. He called it a government takeover of health care that will not allow U.S. residents to keep their current health coverage (Drucker, Roll Call, 7/24).

A Possible Bypass

Last week, Waxman said that if committee leaders are not able to address all of the Blue Dogs' concerns, he would consider bypassing a committee vote on the bill and moving it to the House floor for a full vote (Hunt/Edney, CongressDaily, 7/24).

Many see a problem with this strategy because the Blue Dogs hold 52 seats in the House, which combined with Republican votes, could provide enough opposition to stop the bill.

On CNN's "State of the Union" Sunday, House Speaker Nancy Pelosi (D-Calif.) said that the Blue Dogs' protests "[a]bsolutely, positively" do not threaten the bill's passage. She said, "When I take this bill to the floor, it will win. ... We will move forward. This will happen" (Bendavid, Wall Street Journal, 7/27).

Pelosi attempted to discredit comparisons between current health reform efforts and failed efforts of 1994 (Zimmermann, The Hill, 7/26). She said that the "American people want us to perform," adding, "They need this. This is urgent" (Kucinich, Roll Call, 7/26).

Although negotiations are set to continue this week between Waxman and the Blue Dogs, Rep. Tom Price (R-Ga.) said he believes Pelosi will move the bill to the House floor by the end of the week. He said, "[Republicans have] witnessed some remarkable conversations and discussions between the speaker and others that leads me to believe she's going to pull a power play" (Weber, Washington Times, 7/24).

Republican Amendments

Republicans plan to offer 86 amendments if the House health reform bill is marked up in the Energy and Commerce Committee this week (CongressDaily, 7/27).

Rep. Joe Barton (R-Texas), the ranking member on the committee, said that Republicans "definitely think there should be a markup ... and we think that we should adopt some of these amendments" (Norman, CQ HealthBeat, 7/24).

One of the amendments would terminate the public plan option if it causes more than 10,000 residents to lose their current health coverage (CongressDaily, 7/27).

Republicans also want to amend a provision of the bill that requires a minimum benefit package for all insurance plans to say that "nothing in this division shall prevent or limit individuals from keeping their current health benefit plan."

In addition, GOP members said their "12-Point Rx for a Healthy America" would:

• Provide ways to disclose publicly the prices of services;
• Stop proposed cuts to the Medicare Advantage program;
• Ensure that states expand high-risk pools;
• Stop insurance companies from canceling coverage;
• Prohibit the public plan option unless the government can certify it would not cause an increase in premiums of private plans;
• Overhaul medical liability; and
• Require that lawmakers enroll in the public plan option if it is approved (CQ HealthBeat, 7/24).

CBO Estimates

On Sunday, the Congressional Budget Office estimated that the House reform bill would lead nine million people to forgo employer-sponsored health coverage to enroll in the government-run public plan option.

The analysis also found that 12 million people who currently do not have employer-sponsored coverage would be able to get it. According to CBO, the measure would result in a net increase of three million people insured through their employers.