Healthcare merger

Majority Leader Harry Reid (D-Nev.) will consult with White House Chief of Staff Rahm Emanuel and the two committee chairmen who have moved healthcare bills through their panels in an effort to craft legislation that can pass the Senate.

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Democrats in the House and Senate are running out of time to deliver healthcare reform to President Barack Obama’s desk by the end of the year, making it crucial for Reid to conclude his negotiations as soon as possible.

Assuming Congress adjourns for the Thanksgiving holiday, lawmakers have eight weeks to complete their work.

That includes the week of Veterans Day, when the House is expected to adjourn. It does not include the pre-Christmas week of Dec. 21, though it no longer seems unimaginable that lawmakers could still be in Washington that late in December.

The problem for Reid and House Democratic leaders is that every change made to attract a wavering centrist threatens to lose support from more liberal members. Republicans in the House and Senate are expected to vote en masse against the bills, though Sen. Olympia Snowe (R-Maine) cast the first GOP vote in favor of a reform bill last week during the Senate Finance Committee’s markup.

In the House, Speaker Nancy Pelosi (D-Calif.) has a similar problem. She’ll gauge support in her caucus for reform legislation that includes a public insurance option to compete with private firms.

Meanwhile, the Senate is expected to vote this week on a major piece of legislation intended to deliver support for healthcare from a key interest group: doctors.

The legislation would increase Medicare payments to doctors at a cost of $246.9 billion over 10 years. Fixing the physician payments would be a huge win for the American Medical Association, and as Alexander Bolton reports in The Hill today, Reid has made it clear that he’d expect the powerful lobby to support healthcare reform in exchange.

But the fix will also open up Democrats to criticism that their healthcare reform legislation is not really adding to the deficit. 
Congress isn’t all about healthcare this week.

The House Financial Services Committee on Tuesday or Wednesday will vote on a bill to create a Consumer Financial Protection Agency.

That Chairman Barney Frank’s (D-Mass.) panel will approve the agency’s creation seems assured. The question for Congress will be whether a bill reaches Obama’s desk, and what it looks like.

The Financial Services legislation will not allow the new agency to regulate smaller banks and credit unions, though it will still cover larger firms. It will also hold power over home loans, credit cards and payday loans, all of which have been scrutinized in the wake of the financial crisis.

But the fight isn’t over yet, and several lobbies will try to change the legislation as it moves to the House floor, through the Senate and into a conference.


Player of the Week: Sen. Harry Reid (D-Nev.)

The fate of healthcare reform rests largely in Senate Majority Leader Harry Reid’s hands this week, as he has the power to point the direction for his party on President Barack Obama’s top initiative.

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Reid will spend a good part of his week with senior White House aides and two key committee chairmen, merging two vastly different bills that represent varying viewpoints among Democrats. The goal is to finish by the end of the week.

In his right hand, Reid holds the Senate Finance Committee bill, a measure that is backed by centrists, perhaps a couple Republicans and a positive financial analysis from the Congressional Budget Office.

But it lacks a government-run insurance proposal, which House Speaker Nancy Pelosi (D-Calif.) and other liberals say is essential to healthcare reform. The Finance bill would also offset costs by taxing high-cost insurance plans, a move that would affect, among others, union members in dangerous lines of work who often negotiate for such plans.

Liberals would prefer Reid look to his left hand, which holds the Senate Health, Education, Labor and Pensions (HELP) Committee bill.

That has the public option and more generous subsidies for lower- and middle-income people.

Reid has to balance those differences with the reality that he needs 60 votes to move legislation in the Senate. He also has to worry about how powerful industry players will respond. But the Nevada Democrat last week took steps to get one of the most credible voices on his side, meeting with doctors groups to get them to support the broader healthcare package.

As an incentive, Reid is bringing legislation up this week that would impose a 10-year freeze on scheduled cuts to Medicare reimbursements. Without the freeze, groups estimate that doctors could see their payments cut by more than 20 percent next year and nearly 40 percent by 2016.

Reid’s actions this week will set the tone for the Senate and House floor debates that are to begin shortly. While others will surely have an impact on the debate, Reid has the power to bring his party together around one bill and send it forward with a big push.

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