Pelosi vows to defend House healthcare bill

Speaker Nancy Pelosi (D-Calif.) on Thursday told her caucus she would not let the House be forced into signing off on the Senate’s healthcare bill.

Pelosi spent two hours addressing her caucus via conference call on Thursday for the first time since she agreed to let the Senate bill serve as the vehicle for delivering a congressional health reform bill to the White House.

But Pelosi insisted from the onset that the House would not simply accept the Senate bill, despite the extremely fragile coalition that allowed a bill to emerge from the Senate.

“She answered questions about whether the White House wants just the Senate bill,” a senior Democratic aide said after the call. “The Speaker said that is not going to happen. We are going to negotiate a final bill.”

For the next two hours, Pelosi and other Democratic leaders fielded questions about the areas in which the Senate bill differs substantially from the healthcare bill Pelosi steered through the House in November.

From language that bars federal dollars from covering abortion procedures to how to raise taxes to fund health insurance expansion to the very mechanisms designed to make such insurance more accessible, the House and Senate bills present leaders with significant political and substantive gaps to bridge.

Pelosi took no policy stances beyond those she has made publicly, aides and sources on the call said. She declared earlier this week that a final bill must only meet her “AAA” affordability, accountability and accessibility test. 

Instead, she and other House leaders used Thursday’s call to lay out all of the issues that must be addressed, and to let members air their concerns about Senate provisions that are gaining momentum, including a state-based public insurance exchange, rather than a national, government-run “public option” like the one written into the House bill.

A so-called “public option” is seen as having almost zero chance of surviving in Senate.

At the same time, Pelosi told House liberals that the public option was still among the items under consideration by House, Senate and White House policy staff working on merging the two bills.

Rep. Jan Schakowsky (D-Ill.), a member of the House Progressive Caucus, said she came away with the assurance that the public option was “still part of the discussion.”

“For a number of people, it was important to have the public option discussed,” Schakowsky said after calling in from her congressional office in Washington. “There’s a sense of satisfaction that the things we worked so hard for in the House bill are still part of the discussion.”

Schakowsky said there were no ultimatums offered on the public option or other issues.

She and other Democrats described the tone of the call as patient, probative and cordial — a stark departure from where House Democrats were a month-and-a-half ago.

“This wasn’t about people showing signs or their cards or their positions or anything else,” Education and Labor Chairman George Miller (D-Calif.) said. “It was just a conversation. It wasn’t about trying to ferret out people’s concessions or positions.”

House Democrats will caucus again on Tuesday, and on Wednesday they begin their three-day “Issues Conference,” where they will hear from Obama directly.

Many members are awaiting guidance from the president, and there is a hope that he will help the two chambers clear their remaining hurdles.

Talk of meeting in the middle on certain areas was already permeating some of the policy discussions on Thursday.

Rep. Frank Pallone Jr. (D-N.J.), who chairs the health subcommittee of the Energy and Commerce Committee, said that the taxes issue could be resolved by simply splitting the difference between the two chambers. 

The House would raise the bulk of its funding from an income surtax on high-income earners. The Senate-passed bill would levy an excess tax on high-cost, "Cadillac" health insurance plans, which labor unions and many House Democrats oppose, along with an increase in the Medicare payroll tax on the upper-income bracket. "Those three things could be in play in some way to achieve the pay-for," he said.

“We prefer the millionaire tax," Pallone said. "The president has always been in favor of the excise tax, and the question is whether or not it’s in there or it’s pared down in some way and replaced in part with some of the House pay-fors, particularly the surcharge." The Medicare payroll tax increase, he said, is "similar to the surcharge so there might be some way to work with that so that the senators go along in some way with what we have in mind with the surcharge on upper income."