Left claims 218 in sight for 'robust' public plan

Liberal tells House Democrats that they have nearly enough votes to pass their preferred version of health insurance reform.

Rep. Lynn Woolsey (D-Calif.), the leader of the Congressional Progressive Caucus, told a closed-door caucus meeting that the group’s “whip count” showed it had 208 of the 218 votes needed to pass what liberals call a “robust” public option. That version would link rates to Medicare plus 5 percent.

Woolsey would not confirm the 208 figure in an interview, but three sources in the meeting said that is the number she cited.

“I said we have the votes to pass a robust plan,” Woolsey said. “This is without leadership stepping up and saying, ‘We’re for this.’ ”

Woolsey declined to provide a list of names to House Majority Whip James Clyburn (D-S.C.), who has been tasked by leadership with keeping track of where the votes are.

Clyburn told Woolsey that his ongoing, informal tally doesn’t show the liberals’ version of the public option having that kind of support.

“That’s not the vote count he has,” said Clyburn spokeswoman Kristie Greco. “We’re not there yet.”

But any momentum liberals sensed early Wednesday was dampened after the Congressional Budget Office (CBO) announced its analysis of Sen. Max Baucus’s (D-Mont.) bill, noting that it would extend coverage to millions of Americans while also cutting the deficit.

Blue Dogs and other Democratic centrist are certain to note the CBO score as proof that the House bill should hew more closely to the Senate Finance Committee legislation.

Some House members, particularly centrists, questioned Woolsey’s 208 figure, noting that last Thursday the Progressive Caucus presented Pelosi with only about 150 names. Centrist Blue Dogs are infuriated by the continued push for a government-run plan they believe the Senate will never agree to.

And another Progressive Caucus source said the liberals’ whip count, begun last week at the behest of Speaker Nancy Pelosi (D-Calif.), found 176 solid “yes” votes, about 15 “leaning yes,” 30 undecided and 23 solid “no” votes.

The angst from the conservative and liberal ends of the caucus is a sign that House negotiations are finally getting serious and Pelosi is preparing to take the bill to the floor for the final push.

“Buckle up,” said Rep. Ron Kind (D-Wis.). “It’s almost game time.”

In the face of unified Republican opposition, Democrats are working to find the 218 votes they need within their 256-member caucus. The public option, which would compete with private companies to drive down costs, has emerged as one of a few key obstacles to getting that number.

Liberals want reimbursement rates for physicians to be equal to Medicare rates plus 5 percent. Centrists, especially Blue Dog Democrats, don’t like the public option, echoing Republican concerns that it will not just lower rates but put private insurers out of business.

Some Blue Dogs have agreed to a modified public option that wouldn’t be tied to Medicare. Instead, federal officials would negotiate rates individually with providers.

Ironically, though the Blue Dogs’ top issue is fiscal responsibility, the liberals’ option saves more money, $115 billion, than the Blue Dogs’ negotiated-rate compromise, which would save $25 billion more than having no government plan, according to the Congressional Budget Office. Centrists say other issues, like ensuring private insurers survive and correcting Medicare underpayments in rural areas, are just as important.

Leaders told members at Wednesday morning’s meeting that they have brought the cost of the bill to $925 billion with negotiated rates, the Blue Dog compromise. They need to find another $25 billion in savings to meet the $900 billion ceiling set by President Barack Obama.

So leaders set out a number of options Wednesday morning to find that savings, such as triggering Medicare-linked rates if negotiated rates don’t bring down premiums, or covering more people with Medicaid.

But the new proposals generated a lot of questions, as well as irritation from the most liberal and conservative members of the caucus. Woolsey asked why leaders wouldn’t just fight for their liberal version, since it saves much more than $25 billion.

Blue Dogs are frustrated that the caucus is still debating the public option, which they don’t expect to be included in the Senate health bill.

“The broader caucus is still spinning its wheels and mired in the public-option debate that many moderate Democrats don’t believe survives in the Senate or conference,” said Blue Dog leader Rep. Stephanie Herseth Sandlin (D-S.D.). “We are not giving the same kind of attention and energy to the other things that really matter in this bill.”

She said Democratic leaders in the House and Senate need to join with the White House to “pre-conference” a bill that can pass both chambers.

On Thursday, the Democratic Caucus is expected to take up the issue of taxes needed to pay for the cost of the bill, mostly premium subsidies for low- and middle-income people.

The Senate Finance Committee is working on a plan that would tax high-cost healthcare plans. But 150 House Democrats have signed a letter opposing such a tax, which is staunchly opposed by organized labor.

Democratic sources say that Pelosi is sticking with a plan for a surtax on individuals making more than $500,000 and families bringing in more than $1 million, possibly coupled with a $20 billion tax on medical devices.

Last week, White House economic adviser Larry Summers and health czar Nancy-Ann DeParle presented a long list of other possible revenue-raising measures to House leaders, such as a fee on brand-name drug makers. Democratic sources said nearly all the ideas were met with some form of opposition, except for limiting the size of health flexible spending accounts.