By Jared Allen and Mike Soraghan - 10/29/09 03:46 PM EDT
Speaker Nancy Pelosi (D-Calif.) rolled out her long-awaited healthcare reform bill Thursday, but she may have some problems getting it to the House floor.
factions of House Democrats are threatening to block consideration of
the bill using procedural moves unless their demands are met.
“We don’t want to challenge the rule, but
the need for an up- or-down vote … is something members want,’ said
Rep. Raúl Grijalva (D-Ariz.), co-chairman of the Congressional
It’s not clear how many liberals might
join Grijalva in trying to block the bill, but Rep. Bart Stupak
(D-Mich.) said he already has enough anti-abortion Democrats to, in the
parlance of the House, “take down the rule.” Stupak wants a more
complete ban on taxpayer money funding abortions, which House leaders
appear unwilling to grant.
And members of the Congressional
Hispanic and Asian-Pacific caucuses may also demand their own
up-or-down votes on an amendment to repeal the constraints placed on
legal, documented immigrants wanting to sign up for
government-subsidized health insurance.
Asked how leaders know they can pass the new bill, a senior House aide said, “Because we have to.”
the threats show that House Democrats remain divided on key issues,
both liberal and centrist Democrats emerged from a morning caucus
meeting ebullient that a healthcare bill finally seems within reach.
is the best, most historic healthcare bill we’re going to get,” said
Rep. James McGovern (D-Mass.), one of 60 liberals who’d signed a bill
pledging to vote against a letter without a “robust,” Medicare-based
public option. “At the end of the day, we have to pass something.”
lawmakers, including Blue Dog Democrats, were celebrating Pelosi’s
decision to go with a public option in which the government will
negotiate rates individually with providers.
It won over
Rep. Earl Pomeroy (D-N.D.), who’d steadfastly withheld his support
because he says Medicare shortchanges providers in his state. He
announced his support for the new bill to a loud cheer in the
“That’s a big win,” said Rep. Baron Hill
(D-Ind.), a Blue Dog leader who helped broker the “negotiated rates”
compromise in July in the House Energy and Commerce Committee.
$894 billion bill would extend coverage to 36 million people, ensuring
coverage for 96 percent of the country, excluding illegal immigrants.
full cost of the bill is $1.055 trillion, but $167 billion in revenue
from penalties to be paid by those without insurance make the “net
coverage” costs $894 billion, according to the Congressional Budget
Pelosi and House leaders say President Barack
Obama’s $900 billion figure was for net coverage. But the Senate has
used total cost, rather than net coverage.
left ambiguity there,” said Pomeroy, a member of the fiscally
conservative Blue Dog Coalition. “Further discussions will need to be
held on that.”
The CBO also said the House plan would reduce
the federal deficit by $104 billion over the next 10 years. In the 10
years after that, the plan would “probably” create “slight reductions”
in the deficit, though that estimate is “subject to substantial
“In order to make an informed decision about the
legislation, we believe it is necessary to have as full and clear a
description of its long-term budgetary effects as CBO can provide,” the
Republicans decried the bill as a complex takeover of the health system by the federal bureaucracy.
marched an entire hardcopy of the Democrats’ nearly 2,000-page
healthcare bill before TV cameras to denounce the measure for raising
taxes, creating mandates and cutting Medicare.
hundred and ninety pages; that’s about four reams of paper. I can say
that the people who are getting reamed are the American people,” Rep.
Joe Barton (R-Texas) said at a press conference surrounded by fellow
top-ranking House Republicans.
But Pelosi has labored for
weeks to bring enough Democrats on board so she doesn’t need GOP votes.
Extensive whip counting showed the Medicare-based option couldn’t get
the necessary 218 votes. Less counting, if any, has been done on the
Pelosi celebrated the
announcement with a ceremony on the west steps of the Capitol that
included speeches by lawmakers, horror stories from citizens mistreated
by health insurance companies and a small contingent of protesters off
to the side.
“We have listened to the American people,” she
said. “We are putting forth a bill that reflects our best values and
addresses our greatest challenges.”
Later in the day, members
of the Progressive Caucus went to the White House, where Obama was
likely to try to assuage their disappointment on losing their version
of the public option and try to keep them on board for the healthcare
Democrats indicated that debate on the bill will start
late next week. They need to wait at least six days to live up to their
promises to give lawmakers and the public time to read the bill. The
bill rolled out Thursday will be up for three days, after which leaders
will introduce a tweaked final version, called the “managers
“We’re going to have 72 hours to not read the bill,” quipped Rep. Anthony Weiner (D-N.Y.), mocking critics of the measure.
House is supposed to be out the following week for Veterans Day, but
leaders said the debate could go through the weekend and into the days
before the holiday.
“We would go through the weekend,
through Monday or Tuesday, and get home for Veterans Day,” said House
Rules Committee Chairwoman Louise Slaughter (D-N.Y.). “If we need to,
In addition to the public option the bill includes provisions to,
End the anti-trust exemption for the health insurance industry and cap
industry profits at 15 percent. The healthcare industry has irritated
Democratic leaders in recent weeks by releasing a study saying the bill
would raise premiums. Democrats were angry that the study ignored a
provision that would reduce premiums.
• Allow Medicare to
negotiate drug prices with drug makers, making the pharmaceutical
industry another loser in the bill. The industry has fought such a
provision for years, managing to keep it out of the Medicare
prescription drug benefit when Congress was run by Republicans. The
provision flies in the face of a deal the Obama administration and
Senate leaders have made with the industry not to allow such
negotiations in exchange for giving up $80 billion in profits.
Expand eligibility for Medicare, the government health plan for the
poor, to those making one and a half times the federal poverty income
level. That was added because the “negotiated rates” option costs $85
billion more than the “robust” plan. Medicaid pays less than Medicare,
so the Medicaid provision expands coverage at a lower cost.
bill also includes an income surtax on the wealthy to pay much of the
cost of the bill. But Pelosi raised the income thresholds to $500,000
for individuals and $1 million for families. The original bill had
lower income thresholds, sparking protests from members, especially
Raising the income thresholds on the tax
appears to have appeased some of the freshmen, who objected to the tax
soon after Democratic leaders introduced it last summer.
very pleased with the direction things are going. I’m thrilled they’re
moving in the right direction,” said Rep. Jared Polis (D-Colo.), who
drafted a letter to leadership from 20 freshmen opposing the tax.
said he could not commit to voting for the bill until he reads it. But
he occupied a prominent spot at Pelosi’s roll-out ceremony. So did
fellow freshman Rep. Gerry Connolly (D-Va.), who’d also signed the
None of the leaders of the Blue Dog Coalition or the
Progressive Caucus attended the event, though their rank and file
members did. The only caucus chairmen who attended were Rep. Joe
Crowley (D-N.Y.) of the New Democrats and Rep. Mike Honda (D-Calif.) of
the Asian-American Pacific Islander Caucus.
lawmakers listed as “no” votes on a leaked whip count for the robust
public option were on stage — Rep. Kathy Dahlkemper (D-Pa.) and Rep.
Steve Kagen (D-Wis.).
Leadership aides said “no decisions”
have been made about what amendments would be allowed on the floor,
although Grijalva said he’d heard reports from lawmakers that the bill
would have a “closed rule,” meaning no amendments.
don’t see that as open at this point,” Slaughter said. “Bart Stupak is
one of my best friends, but he’s wrong about this. There’s no money for
abortion in this bill.”
Weiner, who had been promised a floor vote on a “single-payer” amendment, said he’d been “told all systems are go.”
But Pelosi signaled a reluctance to allow amendments, though she added she is open to the idea and has not yet made up her mind.
have to be talked into it, I think, but — let’s put it this way — I’m
open to it,” Pelosi said during a conference call Thursday afternoon
with liberal bloggers.
She said that she considered the
variety of meetings in recent weeks with her caucus members as
tantamount to having allowed amendments.
“We’ve probably had
78 caucuses on this subject, where we’ve listened to members — they’ve
had I think 2,000 town meetings on the subject,” she said, adding:
“I’ve considered all of that input as our amendment process.”
Molly K. Hooper and Michael O’Brien contributed to this article.