Congress Returns, Healthcare Looms

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MICHEL MARTIN, host:

I'm Michel Martin, and this is TELL ME MORE from NPR News.

Coming up, on this 8th anniversary of September 11th, how Americans view Islam? Have opinions evolved over the years as more Americans engage with people of the faith? And as America becomes more religiously diverse, so has the army. We'll meet Army's first chaplain who follows the Buddhist faith.

But first, back to the issue that's dominated the headlines this summer, health care. After a summer of heated debates and town hall meetings, Congress was back in session this week and met the issue head on or at least the president insisted they do so. In a speech to a joint session of Congress, President Obama urged members to stop the bickering and find a way to pass a health care overhaul.

While there's been much discussion about whether Republicans are actually being constructive participants or just partisan obstructionists in this discussion, especially after one GOP lawmaker yelled at the president during his speech, the truth is that Democrats are divided. And one of the biggest sticking points is whether there should be a government-run insurance plan, a so-called public option for people who don't have access to private health insurance.

We've called on two Democratic members of Congress with very different perspectives to talk this over. Congresswoman Lynn Woolsey represents California's Sixth District. She's co-chair of the Congressional Progressive Caucus. And Congressman Jason Altmire represents Pennsylvania's Fourth District. He's a co-chair of the task force on health care reform for the New Democratic Coalition, that's a group of moderates. He's a Blue Dog. Welcome to you both. Thank you for joining us.

Representative LYNN WOOLSEY (Democratic, California): Thanks for having me, Michel.

Representative JASON ALTMIRE (Democratic, Pennsylvania): Happy to be here.

MARTIN: Thanks. Congresswoman Woolsey, I'm going to start with you because in a recent letter to the president, you and Arizona Democratic Congressman Raul Grijalva stated that you would not vote for a bill without a public option. And in his speech, the president specifically asked advocates of the public option to be open to other ideas. So, what do you say now?

Rep. WOOLSEY: Well, I say, I stand for behind that letter and I'm planning on working very hard with the president and our leadership to ensure that what - actually, the president had in his list of things that will be part of his health care reform a government public insurance option. So, we'll work with him on that, and I don't care what it is called. It can be called, you know, ice cream, for all I care. But what we have to have is something that will bring down the cost, provide competition and more security.

MARTIN: So you're not drawing a line in the sand over a government-run plan per se?

Rep. WOOLSEY: Well, it will be government run. I mean, it will be a plan that competes with the private insurance carriers. And the best way to do that is with a government-run plan that is probably linked to Medicare for its provider network and modeled after Medicare's rate structure. We have to have something that's in place that can get started right now so that the people who are people caught in between already will have a place to go and find the coverage that they need. And it will be good coverage and it will be cost-effective coverage.

MARTIN: So you - I guess, what I'm asking you is what's your bottom line? Is you bottom line, universal access somehow, someway or there has to be a government option?

Rep. WOOLSEY: Well, yes, universal access but that's - the best way to do it is already - we've already worked it out is a government plan, a public option. So, I - whoever - you can call it what you want, but it will be backed by the government once - the government will get it started. The plan will pay back the government and it will stand on its own. But it will be totally separate from the private - from private industry.

MARTIN: Congressman Altmire, let's turn to you. You've expressed concern about the cost of these overhaul plans. Did the president's pledge to make any plan deficit-neutral address your concerns?

Rep. ALTMIRE: It did. Now, Congress has to write the bill in a way that meets that specification. The Blue Dogs, as a group, have not taken a position on the public option. There's different views on that. But one thing that we have said clearly as a group is that we've to do this in a fiscally responsible way. It cannot add one penny to the deficit, it has to be completely paid for. And we can't raise taxes on individuals and businesses to do this. And we can't impact small businesses in a way that's going to actually harm their bottom line and prevent them from making the steps necessary to offer health care for their employees. And whether or not the public option plays a role in that is yet to be determined.

I - I'm speaking for myself, I think that the public option may, if it's done correctly may be a part of the package and could play a role. As Congresswoman Woolsey described, it would have to airtight, completely self-sustaining, not funded through taxpayer subsidies, and have to meet all the same insurance regulations. So, I don't think that is the sticking point for the Blue Dogs and the moderate members. I think what we are most concerned about is we have to do this in a fiscally responsible way.

MARTIN: And what does that mean?

Rep. ALTMIRE: Well, that mean squeezing the costs in the inefficiencies out of the current system, using the savings that you achieve to bring as many people in as possible. But again, you can't raise taxes to do this. You can't impact small businesses in a negative way. And most important, we cannot add one penny to the federal deficit when this process is complete.

MARTIN: Do you credit the argument that - that cost savings can pay for the - can pay for the plan?

Rep. ALTMIRE: I think that you can squeeze the inefficiencies out of the system and generate enough cost to bring a lot of people into the system. Truth be told, you probably can't do the whole group of 47 million by doing that. But if that's the best we can do I think that's a big step forward. We would greatly expand the risk pool, make it more fair for the people who have insurance now and do away with some of these practices with the insurance industries with preexisting conditions and lifetime caps and dropping you when you get sick. Helping small businesses to pull their employees and bring down their rates. And if we do all of these things together, that's a big step forward.

MARTIN: If you're just tuning in, this is TELL ME MORE from NPR News. We're talking about health care with Democratic lawmakers Jason Altmire and Lynn Woolsey. Jason Altmire is from Pennsylvania. Lynn Woolsey is from California.

We're talking about the substance, but I do want to spend a minute on the politics. I mean, the president made a strong argument that - or at least I think he hoped it was a strong argument that - the time to address this issue is now. He said he hoped to be the last president to have this argument. I wanted to ask each of you is: can you face the voters next fall not having passed a bill? Even if you have strong objections, can you face the voters without having passed a bill? Congressman Woolsey, can I ask you first?

Rep. WOOLSEY: Well, my voters will be very disappointed if we don't have a very good health care reform bill. The majority of them - and this will probably not surprise anybody, I represent Marin and Sonoma, just north of San Francisco -really want a single payer system. So, they would consider a health care bill without at least compromising enough to have a public option, not really health care reform. So, they're watching it very carefully. And they do want health care reform, but they want real reform. They don't want tweaking around the edges.

MARTIN: And Congressman Altmire, you represent a district in which you have a - a significant population of seniors on Medicare. And we see from the polling that seniors are one of the groups most skeptical of reform groups so far. So, some would argue that that takes some of the pressure off of you, that the status quo is working just fine for this group, what do you say to that?

Rep. ALTMIRE: Well, I think everyone has had a personal experience with the health care industry that leads them to believe that we can do better, whether it be having a family member in the nursing home that had a bad experience, having to spend an hour on the phone haggling with the insurance claims adjuster who just denied your claim, or a small business who had to make the decision to drop coverage after four years of 20-plus percent rate increases. Everyone understands we can do better.

But what I hear time and again is we have to preserve what's working in our current system because there are a lot of things in this country that we do better than anybody else in the world. And we don't want to lose that while we find a way to bring more people into the system and bring down the costs.

So, I think the worst possible option for my constituents would be to pass a bill that makes the system worse. But a very close second would be to do nothing because the status quo is simply not acceptable. The cost curve that we're on is unsustainable. And we have to do something to make health care more affordable.

MARTIN: You know, listening to the two of you, it does sound as if there's - I mean, it just seems like the rhetoric over the summer sounded as if there -there just no hope of compromise. But just listening to the two of you it sounds as if there's a lot of room. What is your sense in talking to your colleagues?

Rep. WOOLSEY: Well, actually the president gave us our marching orders of (unintelligible). And I think, as the Democratic Caucus in general, we want to work with him. We have all along and we're committed to work with him and our leadership. And we can do it. We know we can do it. But we have to - and provide competition. There's ways that we know will work.

And if we take the politics out of scaring people to death, then we might have of a little slice of a government plan, which actually saves tens of billions of dollars. Once we start with, you know, stepping up to what we need or want and what saves money and what costs money, I think we're going to be just fine. We've got three house bills, two of which I support totally.

What I'm kind of wishy-washy about is the Energy and Commerce Bill, parts of it. But I think when we unite those three bills we're going to come up with something that Jason and I can work on together. We worked on other bills together haven't we, Jason?

Rep. ALTMIRE: That's right.

MARTIN: Okay. But Congresswoman Woolsey, you're saying that the top priority is to cover everybody. But Congressman Altmire seems to be saying the top priority is to do no harm to the people who already like what they have. So, that doesn't seem like the same perspective to me.

Rep. WOOLSEY: Well, no, it isn't. But it won't do any harm. I mean, if we do this right, we will add more security to the people who already have coverage. There's the argument that people who have coverage - the 85 percent of those people are covered by their employer that they totally like their coverage, that's a misconception. But even worse than that, I mean, their lives are covered, yes. But do they like being turned down by an insurance clerk?

MARTIN: Sure.

Rep. WOOLSEY: No, but even worse than that they have this fear in their hearts and they should that their employer could decide not to cover them, not them as an individual but as a group or they could want to change jobs, the individual. They could get fired. They could get laid off. Where do they go? We want them to have a place to go and have a choice. And this exchange, we could talk about that later if you have time.

MARTIN: Sure. We're almost out of time. I do want to ask if Congressman Altmire could have the last 30 seconds. I apologize. I just want to give him the last word.

Rep. ALTMIRE: Well, again, I would just say that we are all working together. There are very few, if any, members of the Democratic Caucus who think that the status quo is the best outcome for this. And we have 535 people that are involved in this process. And you're going to have 535 differences of opinion on what the perfect bill would be. But I share Congresswoman Woolsey's confidence that we will find a way to accommodate everybody's views.

MARTIN: Okay.

Rep. ALTMIRE: We're going to move to a consensus approach. And I believe we're going to get this done.

MARTIN: All right, thank you. Congressman Jason Altmire represents Pennsylvania's Fourth District. He's co-chair of the new Democratic coalition's Task Force on health care reform. He joined us by phone from Wexford, Pennsylvania. We were also joined by Congresswoman Lynn Woolsey, who represents California's Sixth District. She's a co-chair of the Congressional Progressive Caucus. She joined us by phone from her home office.

This is TELL ME MORE from NPR News. I'm Michel Martin. Please stay with us.

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