Pelosi to bear heavy lifting in selling centrist-influenced health plan to left

Speaker Nancy Pelosi has begun the difficult task of selling a healthcare bill heavily influenced by Senate centrists to her liberal members.

Success could be the difference between President Barack Obama signing his signature domestic policy initiative into law, thereby boosting the party in his second year, or watching a year’s worth of work crumble 10 months ahead of the midterm elections.

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Pelosi (D-Calif.) will have the support of Obama and Senate liberals, many of whom have already started emphasizing the positive elements of the bill that passed their chamber on Christmas Eve.

But the heavy lifting will fall squarely on her shoulders, as she has long been a respected liberal member who pushed for key provisions that are unlikely to be in the final product.

On Tuesday Pelosi and other House Democratic leaders expressed confidence that the two chambers would reach a compromise. The Speaker hinted the House would likely drop its insistence that the bill include a government-run health insurance option.

Emerging from a two-hour meeting with her leadership team and three key House chairmen, Pelosi did not directly say that the public option would be dropped. But the Speaker said House Democrats would stand by any policy that lived up to a set of principles.

“We want our final product, and I think everyone in the House and the Senate would agree, to ensure affordability for the middle class and accountability for the insurance companies as it provides accessibility by lowering costs at every stage,” Pelosi said at a news conference after the meeting. “And those are the standards that we have, which I think are shared in the House and the Senate.”

Pelosi and House Majority Leader Steny Hoyer (D-Md.) were to meet with Obama and Vice President Joe Biden Tuesday night. Senate Majority Leader Harry Reid (D-Nev.) and Majority Whip Dick Durbin (D-Ill.) were expected to join them by telephone.

Pelosi has scheduled a meeting Thursday for her entire caucus, though many members are likely to participate via conference call.

Without the public option, individuals who do not qualify for existing programs like Medicare and Medicaid would be legally required to purchase private health insurance. Some liberals view that as a giveaway to insurance companies.

Pelosi on Tuesday said that the final bill will hold insurance companies accountable.

“I contend that whatever we have coming out of this bill will hold them accountable, and then they’ll be crying out for the public option,” she said.

While House leaders have recently taken to talking more about what the two bills have in common, rather than their differences, they must still find a way to secure 218 votes for a host of health, tax and other politically charged policies other than those that passed in the House, or they must demand only those changes that would not tear apart the fragile 60-vote coalition that Reid spent months stitching together.

Leaders gave no indication how long discussions would last or what form they will take.

Hoyer noted that “there are significant differences” between the two bills.

“We will be discussing these in the next coming weeks,” said Hoyer, who, as a centrist, has been the quickest among House leaders to embrace the Senate’s preferred direction. “We expect to move very, very forcefully on this effort to bring these two bills together. We are very hopeful that we will pass the conference report in the near term and send it to the president for his signature.”

Hoyer’s specific mention of a “conference report” was meant in the generic sense, his staff later clarified. In fact, Pelosi and Assistant to the Speaker Chris Van Hollen (D-Md.) stated at Tuesday’s news conference that House and Senate leaders have yet to decide on the mechanism for merging the two bills.

Many have long assumed Democrats would turn to a traditional bicameral conference to iron out policy differences and sign off on a single House-Senate bill. But speculation has built in recent weeks that leaders in both chambers have decided to opt for having the House take up a pre-agreed-upon set of changes as a package of Senate amendments to the House bill.

That prospect stirred up additional problems for Democrats on Tuesday, who were confronted with a formal request from C-SPAN to allow the network to film and broadcast the bicameral deliberations, and additional questions from reporters about whether or not they would grant C-SPAN’s request.

“We don’t even know yet whether there’s going to be a conference,” said Van Hollen, whom Pelosi tapped to tackle the C-SPAN issue. “As the Speaker said, it’s not clear whether or not that’s going to happen.”

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House leadership aides said Pelosi wants agreement among her leadership team, Senate leaders and the White House on the logistics prior to Thursday’s caucus meeting, but that she intends to use Thursday as a way for rank-and-file Democrats to weigh in on the potential policy changes.

The three House committees that originally authored the House’s healthcare reform legislation have prepared a memo detailing those major discrepancies that must be resolved to present a final bill to Obama.

Beyond the public option, other tricky issues must be resolved, such as how generous and widely available to make subsidies for health insurance while keeping the bill below $900 billion in new spending; whether to tax high-cost insurance plans or wealthy earners to finance the bill; how strongly to establish a requirement that employers offer health benefits; and how to establish restrictions against federal dollars funding abortions without restraining subsidy recipients from accessing those services.

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