Democrats Unveil Health Care Bill

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House Democrats bowed toward their more conservative members with their new health care overhaul bill, which was unveiled Thursday. Throughout the negotiations, Republicans remained firmly on the sidelines, leaving Democrats to cobble together a bill that can satisfy enough of their own members to make a majority

MELISSA BLOCK, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block at NPR West in California.

ROBERT SIEGEL, host:

And I'm Robert Siegel in Washington.

Today, House Democrats bowed towards their more conservative members with a new health care overhaul bill. It was unveiled on the steps of the Capitol. Throughout the negotiations, Republicans have remained firmly on the sidelines, which means that Democrats have been trying to cobble together a bill that can satisfy enough of their own members to make a majority.

NPR's Julie Rovner reports.

JULIE ROVNER: It was a mostly relieved-looking House Speaker Nancy Pelosi, who gathered her troops on the scenic west front of the Capitol to unveil the bill. First, of course, came the statement of intent, if you will, or what she says the year's hard-fought negotiations have been all about.

(Soundbite of applause)

Representative NANCY PELOSI (Democrat, California; House Speaker): It covers 96 percent of all Americans and it puts affordable coverage and reach for millions of uninsured and underinsured families, lowering health care cost for all of us.

ROVNER: Then came the requisite reminder that this bill isn't just about covering the uninsured, but helping the majority of Americans who already have insurance.

Rep. PELOSI: That reins in premiums, copays and deductibles, limits out-of-pocket costs and lifts the cap on what insurance companies cover each year.

ROVNER: Of course all those things were already in the bills when they emerged from three separate committees last summer. What's been mainly at issue for the past three months is whether and what kind of government-run public option should be available to individuals and small businesses who will buy coverage in the new marketplaces called insurance exchanges.

Most Democrats wanted that public option to closely resemble the federal Medicare program with doctors, hospitals and other health care providers paid based on Medicare's rates. But that didn't fly with many so-called Blue Dog Democrats from rural areas, like North Dakota's Earl Pomeroy, where they say Medicare rates are simply too low.

Representative EARL POMEROY (Democrat, North Dakota): It's not a matter of arm twisting. I could not support something that I believe threatened the health delivery structure of the place I represent. And so this was a non-negotiable item for me, a clear bright line.

ROVNER: And there were enough people like Pomeroy that in the end House leaders had to give in. So, the public option in the bill allows doctors, hospitals and other health care providers to negotiate rates with the government, just like they do with private insurance companies. That's left liberals like New York's Anthony Weiner smarting, not just it being essentially overruled by a minority of their own caucus, but at the fact that the version favored by those more moderate members actually costs more money.

Representative ANTHONY WEINER (Democrat, New York): You should ask them why it is they want to have higher taxes, why it is that you should have less competition.

ROVNER: But the key for democratic leaders is that Weiner and his fellow liberals aren't unhappy enough to walk away. Fellow New York Democrat Jerry Nadler says he's satisfied that the leadership did everything it could to get the strongest public option possible in the bill, but in the end, just couldn't muster the votes.

Representative JERROLD NADLER (Democrat, New York): So, at this point, to say it's not good enough would be an academic exercise. We're getting what can be done and it's very good. It's a major step forward. It'll go down in history with Medicare and Social Security.

ROVNER: And liberals know they need the moderates because Republicans, for their part, want no part of the bill at all. House Minority Leader John Boehner held his own news conference within minutes after the Democrats finished theirs.

Representative JOHN BOEHNER (Republican, Ohio; House Minority Leader): It's not just the so-called government option, it's the over 50 new mandates, bureaucracies, tax hikes, commissions. All of this is going to require tens of thousands of new federal employees, which is poorly designed for a government takeover of our health care system.

ROVNER: Democrats, however, haven't ironed out all the wrinkles in their bill. They're still trying to negotiate language to satisfy anti-abortion members of their party, who claim to have enough votes to block the bill from being brought to the floor. They want further guarantees that no federal funds can be used to pay for abortions.

Julie Rovner, NPR News, Washington.

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House Democrats Unveil Health Care Overhaul Bill

House Speaker Nancy Pelosi unveils a bill that overhauls the U.S. health care system. i

House Speaker Nancy Pelosi (D-CA) on Thursday unveils a bill overhauling health care that will insure 36 million more Americans. Alex Brandon/AP hide caption

itoggle caption Alex Brandon/AP
House Speaker Nancy Pelosi unveils a bill that overhauls the U.S. health care system.

House Speaker Nancy Pelosi (D-CA) on Thursday unveils a bill overhauling health care that will insure 36 million more Americans.

Alex Brandon/AP

House Speaker Nancy Pelosi on Thursday unveiled details of a health care bill that Democrats say would extend insurance coverage to 36 million more Americans and outlaw exclusions for pre-existing conditions and that includes a public option.

The measure calls for the creation of a new government-regulated insurance exchange, so private companies could sell policies in competition with the government.

Under the bill, most Americans would be required to have insurance by 2013 through their employer, a government program or the new exchange. Federal subsidies would be available to lower-income individuals and families to help them pay for the policies.

As changes are phased in, a temporary government program would help people turned down by private insurers because of poor health or a pre-existing condition. The plan would also expand Medicaid, the health program for the poor.

Heard On 'All Things Considered'

The bill "reduces the deficit, meets President Obama's call to keep the cost under $900 billion over 10 years, and it insures 36 million more Americans," Pelosi, surrounded by Democratic lawmakers, said at a news conference on the west steps of the Capitol.

Obama said the plan meets his goals of being fully paid for and reducing the deficit.

"They forged a strong consensus that represents a historic step forward," Obama said Thursday during a meeting with small-business leaders.

He said the House bill and one being drafted in the Senate would benefit small-business owners and their employees by making coverage more affordable and offering a tax credit to small businesses that are trying to provide coverage.

"Under the House and Senate bills, millions of small businesses would be eligible for a tax credit of up to 50 percent of their premiums," the president said.

The Congressional Budget Office has estimated the plan will cost $894 billion over the next 10 years, according to House Democrats.

It would be paid for by cuts in planned Medicare spending and an income tax surcharge of 5.4 percent on individuals making at least $500,000 annually and couples making at least $1 million.

The bill comes after months of negotiations to combine separate plans proposed by three committees. Pelosi wanted a government-run public option where the government would set the rates to be paid to doctors, hospitals and other health care providers, but she couldn't persuade enough Democrats to support it.

Instead, the House plan includes a government-run insurance plan in which the rates would be negotiated between the government and providers.

Republican lawmakers were quick to attack the bill.

"This really is a government takeover of health care," said Rep. Mike Pence of Indiana, the chairman of the House Republican Conference. House Republicans are expected to oppose the bill unanimously.

Not all Democrats are onboard. Rep. Lynn Woolsey of California, co-chair of the Congressional Progressive Caucus, hasn't committed. "This is not walk-away time, and it is not acceptance time," she said.

Pelosi promised the plan will lower costs for patients, but it still leaves 4 percent of the population — about 12 million people — without coverage.

House Democrats have not worked out disputes over abortion services and health care for immigrants, issues that must be settled before the bill can come to a vote.

Meanwhile, Democrats in the Senate are also working on a bill. Earlier this week, Majority Leader Harry Reid said the Senate plan would include an option for a government-run plan, but states would have the option of dropping out of it, if they wanted.

According to The Associated Press, the bill would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price fixing and bid rigging. Democratic officials said the bill also would give the Federal Trade Commission authority to look into the health insurance industry on its own initiative.

From NPR and wire service reports

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