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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