House Democratic leaders are preparing to unveil a health care overhaul including a version of the public insurance option favored by moderates that would allow the federal government to negotiate rates with doctors and hospitals, top Democratic aides said.
The development is sure to anger some leading liberals, who have drawn a line in the sand on a public insurance option pegged to Medicare rates. But it comes after leaders determined through a rigorous, weeklong whipping effort that the approach fell far short of gathering the support it needed.
Leaders made no announcements Tuesday, and liberal Members are still rallying for what they have called a robust public option. The Congressional Black Caucus on Tuesday evening announced it would gather Thursday morning — with civil rights groups, former NBA star Dominique Wilkins and others — to announce a “national mobilization effort— aimed at ensuring a robust version is in the final House package.
But there were signs Tuesday that at least some prominent advocates of a left-leaning reform package were ready to deal in the interest of moving a bill. Rep. John Dingell (D-Mich.), who has introduced a measure to create a single-payer universal health care system every Congress since he was elected, pressed a closed-door huddle of House Democrats on the urgency of swift action. “Every day gone increases the prospects of losing this bill,— he said, according to the notes of one person in attendance. “I want single payer, but I’m smart enough to know what we have here is progress.—
After weeks of mulling the issue, and checking and rechecking Member views on it, the schedule indeed may be what forces Democratic leaders’ hand. House Majority Leader Steny Hoyer (D-Md.) said Democrats want to roll out a bill this week. “That would be our objective,— he said, “and it’s our objective because we want to consider this bill next week — and pledged to give 72 hours notice — so we need to roll out the bill this week.—
Leaders are waiting for firmer scores from the Congressional Budget Office on the budget impact of a public insurance option with negotiated rates before presenting the approach to their colleagues, several aides said. Those could come as soon as Wednesday. The plan with negotiated rates saves an estimated $85 billion over 10 years, less than the version linked to Medicare. To help make up some of the difference, the version leaders are pursuing would expand those eligible for Medicaid, a cost-saver according to the CBO.
The House has been scheduled to adjourn for the week of Nov. 9 in observance of Veterans Day on Nov. 11. But Hoyer on Tuesday revised the floor schedule to build in more time to work on the health care package. Per his changes, lawmakers can now expect to report for work the entire week of Nov. 2, possibly the weekend of Nov. 7-8, and the first two days of the next week.
Democratic leaders have plenty of work to do rounding up support for their package. They are still facing nettlesome challenges on two issues of social policy that have crept into the debate — over abortion and immigration. And on the public insurance option, Democratic sources conceded they were not yet sure how many votes they would gain by ditching Medicare rates in favor of negotiated ones. But they said after hitting a wall of resistance on the preferred liberal approach, there was little choice but to change tactics. “The other option is no bill,— one aide said.
Speaker Nancy Pelosi (D-Calif.) has led the charge in leadership of mapping the views of her Caucus on the public option and trying to drum up support for the liberal approach, which she prefers. In the Tuesday meeting, she made another appeal for unity, at one point waving a sheaf of hand-written notes from her one-on-one conversations with Members on the issue over the last several days. Lawmakers said while she has made a concerted push for Medicare rates, she is ultimately hunting for an approach that can gather majority support on the House floor.
“She’s the leader of the 218 caucus,— said Rep. Robert Andrews (D-N.J.).
House Majority Whip James Clyburn (D-S.C.) made the case to liberals in a Tuesday morning meeting before repeating it to the full Caucus, arguing that lawmakers should “not let a perfect bill keep you from supporting a good bill,— according to a Democratic aide. “We should go home this weekend with a good bill on the table that includes the public option and responds to the hopes and wishes of the American people,— he said.
Jennifer Bendery contributed to this report.