House Democrats pushed ahead Thursday with legislation on President Obama's proposed health care overhaul, which carries a price tag of about $1 trillion over 10 years, even as they debated the thorny details of just how to pay for it.
Congressional Budget Office Director Douglas Elmendorf warned lawmakers that the legislation that he has seen would raise costs, not lower them. Asked by Senate Budget Committee Chairman Kent Conrad (D-ND) if the bills Congress is considering would "bend the cost curve," Elmendorf said, "The curve is being raised."
"In the legislation that has been reported, we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount," he said. "And on the contrary, the legislation significantly expands the federal responsibility for health care costs."
The Medicare and Medicaid cuts that lawmakers have offered to pay for the coverage expansion aren't big enough to offset the cost trend, particularly in the long term, Elmendorf explained.
Nonetheless, House Democrats won a coveted endorsement of their legislation from the American Medical Association, saying the bill "includes a broad range of provisions that are key to effective, comprehensive health system reform."
Three separate House committees worked to hammer out pieces of the bill Thursday.
The House Education and Labor Committee passed an amendment to speed up access to health insurance for people with pre-existing medical conditions. As written, the measure would have stopped insurance companies from denying coverage because of pre-existing conditions beginning in 2012, but the panel agreed to move up the date for group plans to six months after the bill takes effect.
The tax-writing Ways and Means Committee is trying to figure out how to provide coverage to nearly all Americans by subsidizing the poor and penalizing individuals and employers who don't purchase health insurance. Republicans have vowed to fight a Democratic plan to impose a surcharge on families making more than $350,000.
Negotiations were expected to be tougher in the House Energy and Commerce committee, where a group of fiscally conservative Democrats known as the Blue Dogs holds enough seats to block the measure. Rep. Mike Ross (D-AR), chairman of the Blue Dogs' health care task force, said significant changes were needed to protect small businesses and rural providers and to contain costs before the group could sign on.
"We cannot support the current bill," he said.
The Senate Health Committee approved a version of the bill with no Republican votes Wednesday.
The Obama administration wants both the Senate and the House to pass health care legislation before their August recess. If that happens, a small group of lawmakers would meet to iron out a compromise bill once lawmakers return in September.
The president has been making the rounds to encourage Congress to act. He held meetings Thursday morning at the White House with two potential Senate swing votes, Sens. Ben Nelson (D-NE) and Olympia Snowe (R-ME). On Wednesday, Obama met with a group of Senate Republicans in search of a bipartisan compromise and appeared in the Rose Garden for the latest in a daily series of public appeals to Congress to "step up and meet our responsibilities" and approve legislation this summer.
In an interview on NBC, the president declared "there is no free lunch" and reiterated that the country cannot afford to postpone dealing with the health care problem.
"I think the best way to fund it is for people like myself who have been very lucky to pay a little bit more," he said in another interview on CBS.
Members of Congress also lobbied for passage. Sen. Tom Harkin (D-IA), who sits on the Senate Health, Education, Labor and Pensions Committee, had a news conference Thursday in which he said several things have changed since President Clinton tried and failed to overhaul the health care system.
"This time we have most of corporate America with us; the insurance industry wants reform," Harkin said. "Heck, even Harry and Louise are demanding reform."
Harry and Louise, the fictitious couple that appeared in 1990s-era political ads that helped doom Clinton's health care plan, are back on television — this time in support of an overhaul.
The ads, sponsored by Families USA and the Pharmaceutical Research and Manufacturers of America, feature middle-aged actors Louise Caire Clark and Harry Johnson. In 1994, they worried aloud about higher costs and fewer choices, but today, the aging couple is more concerned about getting affordable health coverage and keeping it if they lose their jobs.
From NPR staff and wire reports