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House Health Care Deal Reached, but Problems Loom

Updated: 4:48 p.m.House leaders broke a logjam over their health care overhaul on Wednesday, reaching a deal with four Blue Dog Democrats to set the stage for clearing a bill out of the Energy and Commerce Committee, but not a floor vote, before the August recess.Energy and Commerce had been expected to resume a markup of the measure this afternoon, but Chairman Henry Waxman (D-Calif.) postponed it in the face of Caucus opposition. The House was scheduled to adjourn for the August break by the end of the week.But the deal was immediately under fire from the Congressional Progressive Caucus. Progressive Members were meeting with Speaker Nancy Pelosi (D-Calif.) on Wednesday afternoon to discuss the agreement.Rep. Mike Ross (D-Ark.), the head of the Blue Dog health care task force who helped hatch the deal, said the terms call for cutting more than $100 billion from the Democratic health bill, increasing exemptions for small businesses and preventing the public insurance option from basing reimbursements on Medicare rates. The proposal also includes a promise from Democratic leaders to hold off on a floor vote until September.House leaders, White House Chief of Staff Rahm Emanuel, the Blue Dogs and Waxman had been huddling for days to try to reach a deal on the package, with marathon talks stretching throughout Tuesday. At times the talks devolved into name-calling and appeared all but dead, only to be resurrected again. Four of the seven Blue Dogs on Energy and Commerce who had been holding up the bill — Ross, Blue Dog Co-Chairman Baron Hill (Ind.), Rep. Zack Space (Ohio) and Rep. Bart Gordon (Tenn.) — have agreed to Wednesday’s package.Ross said the quartet received significant concessions in return for agreeing to back the bill in committee.Small businesses with less than $500,000 in payroll will now be exempt from an employer mandate that they provide health insurance, which Ross said will exempt 86 percent of small businesses.The final cost of the bill will come in at less than $1 trillion over a decade, Ross said.The agreement not to base the public insurance option on Medicare rates would save rural hospitals that might otherwise have to shutter, Ross said. The public plan will have to negotiate rates with providers just like private insurance companies do, ensuring a level playing field, Ross said.That provision angered liberals, however.Rep. Lynn Woolsey (D-Calif.), co-chairwoman of the 83-member Progressive Caucus, gave the deal a thumbs-down. Woolsey said negotiated rates under the public plan would prove too expensive, effectively killing it. She said she will rally her group against any package that fails to offer a “robust— public insurance option.“They can’t possibly be taking us seriously if they’re going to bring this forward,— she said.But the deal appeared to have the blessing of President Barack Obama, who thanked the Blue Dogs for their support.“I’m especially grateful that so many Members, including some Blue Dogs on the Energy and Commerce Committee, are working so hard to find common ground,— he said. “Those efforts are extraordinarily constructive in strengthening this legislation and bringing down its cost.—People who don’t want health care reform will say the Blue Dogs caved, Ross said, but the fiscal conservative group’s biggest concerns were addressed.“I’ve made it very clear from the beginning that we were never about stopping health care reform,— Ross said. “We wanted to play a constructive role.—He also praised the involvement of the White House, which included numerous hours with Emanuel.“They’ve worked with us to help bring down the cost of this bill,— Ross said.House Majority Leader Steny Hoyer (D-Md.) said Ways and Means Chairman Charlie Rangel (D-N.Y.) and Education and Labor Chairman George Miller (D-Calif.) had not yet agreed to the compromise but that he was about to brief them on it and expected “they’re going to be fine with it.—Tory Newmyer contributed to this report.

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