Pelosi tries to unite divided Democratic factions in House

Speaker Nancy Pelosi, D-Calif., is facing a difficult task in the House: herding the different Democratic factions to fashion a single health care bill.

"It's Whac-A-Mole time for Speaker Nancy Pelosi. The second one faction retreats, another surfaces with contradictory complaints," Politico reports. "With all the attention focused on the Senate Finance Committee markup this week, Pelosi put her rank and file on notice Wednesday, telling Democrats in a closed-door session in the Capitol basement that she 'hopes' to unveil a combined House health care bill by the end of next week. The speaker is anxious to preserve as much leverage with the Senate as she can, meaning she'd like to go as far left as possible without losing too many of her own. But colleagues say she's a long way from the 218 votes she needs to move legislation through the House."

One divisive question is how to pay for the bill. "A group of freshmen met with the speaker's staff Tuesday night to rehash their concerns about a surtax on the wealthy that, they argue, imposes an unfair burden on small-business owners. Why, these members want to know, will House Democrats be forced to vote for a tax that faces dim prospects in the Senate — where Democrats have shown little interest in it." Blue Dogs are also concerned about "a public option that relies on Medicare rates — instead of allowing doctors to negotiate directly with the government," a proposal that liberals support (O'Connor, 9/24).

Roll Call: "Rep. Earl Pomeroy (D-N.D.), another Blue Dog, gave Pelosi just a 50-50 chance of being able to pass a bill on the House floor that tied the public insurance option to Medicare rates. 'There are going to be a lot of Democrats, myself included, who can't vote for it,' he said. Although that move would save an estimated $65 billion to $70 billion, Pomeroy said those savings would be extracted from providers in states like his, which have low reimbursement rates under Medicare, and could result in fewer hospitals and other facilities" (Newmyer and Dennis, 9/24).

In a second article, Roll Call reports that "House liberals on Wednesday upped the pressure on Democratic leaders to strip language from Senate health care legislation that limits legal and illegal immigrants' access to medical care. Twenty-nine Democrats signed on to a letter to Congressional leaders to 'strongly urge' the elimination of a five-year waiting period for legal immigrants in the Medicaid program. The proposal was put forward by the Obama administration and is currently in the health care bill authored by Senate Finance Chairman Max Baucus (D-Mont.)" (Bendery, 9/23).

Roll Call also reports that "House Minority Whip Eric Cantor (R-Va.) on Wednesday accepted House Majority Leader Steny Hoyer's (D-Md.) offer to meet and discuss areas of bipartisan agreement on health care reform. But Cantor said the conversation would not center on the Democratic health care reform bill, which many Republicans believe should be 'scrapped'" (Kucinich, 9/23).

Congress Daily: "The House Energy and Commerce Committee finally finished its work on the healthcare overhaul Wednesday, cobbling a series of amendments together for the Rules Committee to add to the broader bill in the coming weeks. … The changes will require an expert on children and adolescents to sit on the Health Benefits Advisory Committee; create a special enrollment period for chronic care special needs plans; require the HHS secretary to attract 10 percent of all eligible providers to act as bundling test sites in a public program; and require the public plan to reimburse the Veterans Administration for the costs of treating non-service-related injuries, among other changes" (Hunt, 9/24).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.