Debate Over Health Care Gets More Intense

President Obama is taking his argument for a health care overhaul to the American people this week. Obama hosted Thursday a town hall-style meeting in Cleveland. In Washington, however, the fate of an overhaul is uncertain. Senate Majority Leader Harry Reid said there will not be a vote on health care before the August recess.

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ROBERT SIEGEL, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

MADELEINE BRAND, host:

And I'm Madeleine Brand.

We begin this hour with the debate of over health care. It's getting more intense. President Obama is taking his argument for health care overhaul to the American people this week. It dominated his news conference last night. And today, the president hosted a health care town hall in Cleveland. Back in Washington though the fate an overhaul is as uncertain as ever. We've asked NPR health policy correspondent Julie Rovner to come in and help us sort all this out. And Julie, the president, just this afternoon, he acknowledged, conceded really, what Senate Majority Leader Harry Reid said earlier today, that there will be no vote on health care before the August recess. Does that surprise you?

JULIE ROVNER: No, this is really just a formal recognition of the reality of the situation. The Senate only has two more weeks before it leaves for its recess, that's not nearly enough time to get this off the Senate floor, and frankly only one of the two Senate committees has completed its work. The Finance Committee, the committee with really most of the jurisdiction over this issue, is and has been huddled behind closed doors for more than a month now trying to hammer out a bipartisan compromise. They say they're making progress and I take them at their word. I don't think they'd be meeting everyday if they weren't making some progress, but they're not finished yet. Now, something else that Senator Reid did say today is, that while the Senate isn't going to finish its work before the August recess, he does want the Finance Committee to finish its work. So they have two more weeks and I think everybody expects that that's probably doable.

BRAND: Okay, let's look at the House now. That was one on a faster track it seemed to getting its bill voted on, but it doesn't seem that that's going to happen soon either.

ROVNER: Well, that's right. As of now it's not clear what the state of things are in the House. There's three committees working on a bill there, two have finished. The third is stuck because there's enough of those conservative, so-called Blue Dog Democrats to block a vote. Now technically the House doesn't have to wait for that third committee, and there was apparently a very contentious meeting of House Democratic leaders this morning. Here's how Speaker Nancy Pelosi described it at her weekly news conference.

Representative Nancy Pelosi (Democrat, California; Speaker of the House): I've invited the views of members in terms of some of the issues and the timing as we go forward. And it was pretty exciting, but there was definitely a sentiment in the meeting that members wanted to get this done before the break.

BRAND: And Julie, why wouldn't the House want to vote before the recess?

ROVNER: Well, it's a risk. They've got this big tax increase in the bill for the families who earn more than $350,000 a year. They may not want to vote for it, the Senate ended up doing something completely different and that tax doesn't end up in the bill. On the other hand, when Congress leaves town for five weeks in the summer, it creates this vacuum that lets opponents of various pieces of legislation nibble away at it. When they come back it's always harder to put things together.

BRAND: Mm-hmm. Well, let's look again at the news conference last night. A lot of people said that this was the president's pivotal moment, that he needed to convince people to support this. Did he do that?

ROVNER: Well, he certainly tried to do that. I think there's a couple of places where the president may have sort of misstated a few things. There was one place, where he said that he wasn't going to let it add to the deficit. Here's what he said.

President BARACK OBAMA: I've also pledged that health insurance reform will not add to our deficit over the next decade, and I mean it.

BRAND: Julie, little fact checking here, any place where he overstated his case?

ROVNER: Well, I think that was the place. And I think, you know, there's about $250 billion in the bill that would go to help doctors not take a 20 percent pay cut next year. The administration says it's not going to count that towards the - towards how much the bill costs, the congressional budget office begs to disagree. They said that money is being spent. So, there's a distinction about whether or not you think that adds to the deficit or not. I guess it's people's call to make on their own.

BRAND: NPR health policy correspondent Julie Rovner. Julie, thank you.

ROVNER: You're very welcome.

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Obama Stumps For Health Vote Despite Setback

President Obama pressed for a new timeframe for passage of an overhaul of the U.S. health care system Thursday after Senate Democrats decided not to vote before the August recess.

Obama took the decision by Senate Majority Leader Harry Reid (D-NV) in stride, saying at a town hall meeting in Cleveland that he didn't mind the wait, as long as lawmakers are trying to work out difficult issues associated with the plan. Pushing back from his original August deadline, the president said he still wants to sign a bill into law this year, preferably in the fall.

As the president headed to Ohio to push the plan, Reid announced his decision to wait on a vote, saying he wanted to give Republicans more time to work with Sen. Max Baucus (D-MT) on a bipartisan deal in the Senate Finance Committee.

"Working with Republicans, one of the things that they asked is that they have more time," Reid said, adding that he would rather have a bill that was based on quality and thoughtfulness than try to hurry to get something through by the break.

He said the Finance Committee would be able to act before the month-long break, leaving him to combine the bill with one already passed by the Health, Education, Labor and Pensions Committee. Merging the two is expected to be difficult because the health committee's bill was passed by Democrats on a party-line vote.

In the House, some Democrats favored staying past their July 31 recess date to work on the bill, but House Speaker Nancy Pelosi (D-CA) was noncommittal.

"We will take the bill to the floor when it is ready and when it is ready we will have the votes to pass it," she said.

Thursday, Obama continued to pressure Congress to pass a bill, taking the fight to Ohio, where 17 percent of working-age adults are uninsured.

"Stay on your members of Congress. Keep up the heat," he told about 1,600 residents, community leaders and invited guests at a town hall meeting in the Cleveland suburb of Shaker Heights. "We've got to get this done."

Saying initiatives to improve the U.S. health care system have been on the table since President Truman was in office in the late 1940s and early 1950s, Obama set a new timeline for passage of the bill.

"I want it done by the end of the year. I want it done by the fall," he said to applause. "If there's not a deadline in Washington, nothing happens."

He told the audience that spiraling costs are hurting American families and the U.S. economy.

"As we meet today, we're seeing double-digit rate increases on insurance premiums all over America," the president said. "That's a future America can't afford."

According to the Ohio Family Health Survey, the percentage of uninsured Ohioans aged 18-64 rose to 17 percent statewide last year — and nearly 22 percent in rural areas and Appalachia. The state's uninsured residents also reported more use of hospital emergency rooms, a practice tied to high medical costs.

Obama again laid out plans for his initiatives, emphasizing that no one will be forced to give up a coverage plan they like.

The chief tenants of the plan are that it would expand coverage to the 46 million who are uninsured; prevent exclusions because of a pre-existing condition or serious illness; allow coverage to continue for those between jobs; and limit out-of-pocket expenses.

"An American who needs insurance will have access to affordable plans through a health insurance exchange — a marketplace where insurance companies will compete to cover you, not to deny you coverage," he said.

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