Health Insurance (Legislation)
Working day and night, House Democrats advanced major health care legislation through two committees on Friday and struggled to line up the votes necessary to prevail in a third.
But the sense of urgency diminished in the Senate, where bipartisan negotiators ended talks for the week with no indication a deal was imminent and a different group of six Democrats and Republicans announced its opposition to "timelines which prevent us from achieving the best result."
The White House and Senate Majority Leader Harry Reid are pushing for legislation to clear both houses by August, but the letter said, "we believe that taking additional time to achieve a bipartisan result is critical."
The letter was signed by Democratic Sens. Ben Nelson of Nebraska; Ron Wyden of Oregon and Mary Landrieu of Louisiana; as well as Maine Republican Sens. Susan Collins and Olympia Snowe and independent Sen. Joe Lieberman of Connecticut.
Separately, the White House urged Speaker Nancy Pelosi to toughen the emerging bill so it will hold down the future increases in Medicare payments to doctors, hospitals and other providers. The request, in a letter from Budget Director Peter Orszag, came one day after Congress' top budget official warned that as drafted, the legislation fails to slow the growth in health care costs nationally.
The Ways and Means Committee was the first panel to act in the House, voting after midnight to slap a new 10-year tax increase of $544 billion on the wealthy to help finance legislation.
The committee vote was 23 to 18, with three Democrats joining all Republicans in opposition.
In a nearby committee room, the Education and Labor Committee met throughout the night, then took a brief break around dawn before returning to work and approving its portion of the bill on a vote of 26-22.
Republicans failed in numerous attempts in both committees to knock out central portions of the bill, including the tax increases and a requirement for the government to sell insurance in competition with private companies.
Separately, the Energy and Commerce Committee met to consider its part of the bill.
There, Rep. Henry Waxman, D-Calif., confronted a pivotal group of moderate to conservative members of the rank-and-file demanding changes, and claiming the votes to block the measure unless they get them.
Speaker Nancy Pelosi, D-Calif., has vowed to pass health care legislation in the House by the end of the month.
That task grew more demanding on Thursday, though, when the director of the Congressional Budget Office, Douglas Elmendorf, said of the legislation so far, "We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health care costs."
Slowing the rate of growth for health care spending is one of Obama's twin goals for health care, alongside expanding health care to the millions who now lack it.
At its core, the effort involves a requirement for insurance companies to offer policies to all willing buyers, and bars them from charging higher premiums on the basis of pre-existing medical conditions. Legislation would rely on government subsidies to make insurance more available for lower-income individuals and families, and use tax increases as well as cuts in Medicare and Medicaid to pick up the cost.
"I will not defend the status quo," the president said Thursday in New Jersey, where he used a political fundraising appearance for Gov. Jon Corzine to make his latest plea for congressional action.
The Senate Health, Education, Labor and Pensions Committee approved its portion of the legislation on a party-line vote earlier in the week.
But Baucus' Senate Finance Committee is days overdue for a promised public drafting session, with no date set to begin.
Baucus has been negotiating for days with Republicans in hopes of achieving a bipartisan compromise. But time clearly is running short, given Obama's personal request for him to deliver a bill by the end of the week.
Baucus and other negotiators ended talks for the week without agreement. "I think it would be prudent for the president to be patient," said Sen. Olympia Snowe, R-Maine, urging Obama to abandon his call for legislation to pass both houses by early August.
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