Health Care To Dominate Congress In Fall

Congress returns Tuesday, and health care is expected to dominate the agenda for much of the fall. After a month of sometimes raucous town hall meetings, members of the House and Senate now face actual votes on actual bills.

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From NPR News, it's ALL THINGS CONSIDERED. I'm Noah Adams.

Congress returns to Washington tomorrow - so does the debate on overhauling health care. After a month of quiet at the U.S. Capitol and sometimes raucous town meetings around the country, lawmakers now face actual votes on actual bills. On Wednesday night, President Obama addresses a joint session of Congress to try to get his top domestic priority back on track. Today in Cincinnati, speaking to a Labor Day gathering of union workers, the president referenced that address.

(Soundbite of applause)

President BARACK OBAMA: We are going to reform the system for those who have insurance and those who don't. Now, I'll have a lot more to say about this on Wednesday night. I might have to save my voice a little bit.

ADAMS: And with us now to preview that action is NPR health policy correspondent Julie Rovner. Welcome, Julie.

JULIE ROVNER: Nice to be here.

ADAMS: A lot of people complained during all those town hall meetings, in that they were confused about the bills floating around Washington. Exactly where are we? I ask you exactly - exactly where are we in terms of legislation as Congress comes back? Start with the House, if you will.

ROVNER: Well, you know, people have a right to be confused. There's a reason President Obama wanted the House and Senate to each pass their bills before the recess. That way there only would've been two plans that people would've had to try to decipher. Instead it's more like four, with a fifth one still in process. In the House, technically, the next step is actually a floor vote. There were three committees that are in charge of the bill. They needed to act and they did so before they left for the recess. So the question in the House is: Can the leadership merge those bills in a way that there'll be 218 vote -that's a majority.

You've got angry liberals on the one hand, who say they won't vote for a bill unless they keep the option for a government-run public plan in it. It's in the bill now. Then you got those wavering fiscal conservative Blue Dogs who say they won't vote for a bill if it does have that public plan in it.

ADAMS: And let's shift to the Senate. What's the status in the Senate?

ROVNER: Well, the Senate is a lot less far along. The late Senator Edward Kennedy's committee finished work on its bill in July, but we haven't actually seen the whole text of it yet. And we don't know who's going to take over the chairmanship of that panel. Then there is the Finance Committee, where the so-called Gang of Six: three Democrats, three Republicans, led by Committee Chairman Max Baucus of Montana, has been negotiating a way for what seems like months now trying to come up with a bipartisan compromise.

Over the weekend, we saw report of a bill from that group that doesn't have a public plan, but would have funding to create something called nonprofit co-ops that were intended to provide some competition for private insurance companies. But it's not clear if that co-op idea will satisfy anyone beyond those six senators, if that.

ADAMS: Now, into all of this comes President Obama. This is coming up Wednesday night on television all over the world - in some places. He's going to try to get this effort back on track. What does he need to say to make that happen?

ROVNER: Well, he's certainly getting no shortage of advice on that question, much of it conflicting. And he's got lots of competing priorities here. On the one hand, there's a public that seems to be concerned more about keeping down cost than about covering the 45 million people who don't have any insurance. You have a House where members seem strongly in favor of having a public plan and a Senate where a public plan probably can't pass.

So the president's walking quite the tightrope. So far it isn't clear if he's going to draw any actual lines in the sand about what it is that he wants or not. Until now, about the only line that he drew was that deadline for the House and Senate to pass their bills before the August recess, and we know that didn't happen.

ADAMS: And what happens next?

ROVNER: Well, congressional leaders have two choices. They can try to pass the bills in what we call regular order, go to the floor, get 218 votes in the House and what amounts to 60 votes in the Senate, that's the number that you need to cut off a filibuster. But, remember, without Senator Kennedy, we basically are down, effectively, to 59 democratic votes in the Senate.

ADAMS: Then there's this idea called budget reconciliation. Quickly, can you tell us what that is?

ROVNER: Yeah, budget reconciliation only requires 51 votes in the Senate and it can't be filibuster. It would make the bill easier to pass, and they wouldn't even need some of these wavering moderates. But there's a lot of things you can't put in a budget reconciliation bill because it has to be directly tied to the budget. It would also make Republicans furious, who say it would be, you know, going around them.

On the other hand, there's not that many Republicans who seem to be left trying to find a compromise. So, there's a lot of questions still to be answered. I think we'll start getting some of those answers Wednesday night.

ADAMS: Thank you, Julie. That's NPR health policy correspondent Julie Rovner.

ROVNER: You're welcome.

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