As House lawmakers near vote, controversies linger

As a vote on the House's final health reform legislation appears near, the Democratic leadership has renewed its focus on the public plan, although other issues also remain on the table. "House Speaker Nancy Pelosi (D-Calif.) and her top lieutenants said Thursday that they are close to corralling the 218 votes they need to move forward with comprehensive legislation that would include a version of the public option prized by liberals as a fundamental pillar of reform," the Washington Post reports (Montgomery and Murray, 10/23).

Pelosi said Democrats could be assured that a public option will be in the House bill, the New York Times reports. She also cautioned, however, that many have focused too much on the public option and overlooked other key provisions of the legislation. "So much attention has been paid to the public option and once we have a bill, which will be soon, then you can also pay attention to so many other good things that are in the bill," she said (Herszenhorn, 10/22).

The Hill reports that while Democrats may be close to a winning vote count on the public option, they are not there yet. "The survey ordered by Pelosi turned up 46 Democrats who said they would vote against the so-called 'robust' public option, according to a Democratic lawmaker who spoke on the condition of anonymity." That's enough to block the legislation (Soraghan, 10/22).

The public option isn't the only controversial issue circulating in the House:

CongressDaily: "A group of 36 House Democrats is threatening to derail healthcare reform legislation if CBO projections don't show lower costs over the long term." The group includes mainly Blue Dogs, but not all are members of that conservative coalition (Hunt and House, 10/23). 

Roll Call: "Pelosi vowed Thursday during her weekly press conference that the House bill must reduce the deficit in the second decade, not just the first, but she does not yet have a conclusive CBO statement to that effect." Hoyer and Pelosi both said they were confident that they could achieve goals both of paying for the bill now, and lowering the deficit in the future (Dennis and Newmyer, 10/22).

CQ Politics: The House bill will include a federal antitrust exemption for health insurance companies, Pelosi said. "The House Judiciary Committee approved a bill Wednesday that would partially repeal the 60-year-old exemption from antitrust law for health insurers ... (and) authorize the government to prosecute insurers for antitrust violations if they are found to be engaged in 'price fixing, bid rigging or market allocations.'" The Senate is considering similar legislation (10/22).

Associated Press/Boston Globe: Meanwhile, "House Democrats have reached a deal on Medicare payments that will secure critical support from heartland and Pacific Coast lawmakers for President Barack Obama's goal of revamping health care." The deal includes two studies that would identify recommendations for paying physicians based on quality, rather than volume, and address geographic differences in how much doctors are paid. The recommendations would be implemented unless Congress rejects them (Alonso-Zaldivar, 10/22).

Associated Press/Boston Globe: "House Democrats are at an impasse over whether their remake of the nation's health care system would effectively allow federal funding of abortion." At least 24 anti-abortion Democrats are protesting measures they say could lead to taxpayer funding for the procedures (Werner, 10/23).

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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.