Pelosi pressing, cajoling Democrats to include public option in final health bill

News outlets covering Capitol Hill report that, with pressure from Democratic leaders, the public option now appears more likely to be in final health care reform legislation.

The Hill: "Hopes are running higher than ever for supporters of creating a government-run public option as part of healthcare reform. The question is not settled and the healthcare reform project itself is far from guaranteed to succeed but liberals see mounting evidence that their position is going to prevail. Supporters of the public option perceive a tide turning their way -and sweeping up previously reluctant Democrats. 'I think people are sensing an inevitability that it's going to be in the bill,' said Sen. Sherrod Brown (D-Ohio). 'There is momentum working here'" (Young, 10/24).

The Los Angeles Times reports that House Speaker Nancy Pelosi, D-Calif., said "that states might be able to 'opt out' of any nationwide government insurance plan, a compromise that she suggested could unify congressional Democrats and enable President Obama to sign a healthcare overhaul bill later this year."

"Pelosi remains a leading champion of the 'public option,' which would establish a federal health insurance program that would give consumers who don't get coverage through their employer an alternative to plans offered by commercial insurers. But she told reporters at the Capitol that she did not 'think there's much problem' with the opt-out alternative, which had sparked interest among moderate Democrats in the Senate. ... A group of Senate Democrats is also trying to build support for such a plan in the healthcare bill that Senate Majority Leader Harry Reid (D-Nev.) is planning to bring up for a vote next month" (Levey and Oliphant, 10/24).

Politico: "During an end-of-the-week press conference, Pelosi told reporters, 'Part of the decision is not just about votes...We have a very strong Democratic majority here. Part of it is the end-game of conference. I think it's really important to note this...The atmosphere has changed.' The 'atmosphere' she's referring to is that in the Senate, where Majority Leader Harry Reid seems to be giving some ground on a public option - which was long thought to be dead in the Upper Chamber. Now that the Senate is giving optional government-sponsored coverage a serious look, Pelosi seems to be open to their suggestions. ... 'So this is about the endgame now...There's no philosophical difference between a robust public option and negotiated rates. It's just a difference in money. It's just a difference in money. And money is important'" (O'Connor, 10/24).

The Associated Press reports: "... it's no longer a debate about whether there will be a health care bill. The questions are when, how — and who can compromise. Democratic leaders expect their members, looking ahead to next year's elections, to vote for a health care bill despite any misgivings. But the vote-counters have no real way of knowing until each chamber produces a bill. That's why negotiators have slogged through months of hearings, hundreds of amendments and meetings with members that require interminable listening, waiting, reassuring, cajoling and answering questions from the recalcitrant"  (Kellman, 10/24).

The New York Times: "Speaker Nancy Pelosi stepped up the pressure on House Democrats on Friday to support her preferred version of legislation that would require the federal government to sell health insurance in competition with private insurers. Her action came amid indications that Ms. Pelosi had not locked down the votes for the proposal, the most contentious element in a bill that would provide health insurance to more than 35 million people, at cost of nearly $900 billion over 10 years."

"Other provisions of the bill, including enhanced Medicare benefits, could take the total cost over $1 trillion, Democrats said. But they promised to offset the cost and avoid any increase in federal budget deficits" (Pear and Herszenhorn, 10/23).

In a separate story, The Associated Press: "Some moderate Democrats have expressed reluctance to support a bill as high as $1 trillion. Last month, Obama said in a nationally televised address before a joint session of Congress that he preferred a package with a price tag of around $900 billion. Obama also said he would not sign a bill that raised deficits, and the CBO estimates the emerging House bill meets that objective. Officials said the measure would reduce deficits by at least $50 billion over 10 years and perhaps as much as $120 billion."

"'The bill will be paid for over 10 years. It will reduce costs but also will not add a dime to the deficit' in future years, (Pelosi) said at a news conference" (Espo, 10/24).

Roll Call reported that, breaking his current pattern, President Obama did not use his weekly address to talk about health reform, but Republican Sen. Mike Johanns, R-Nebraska, did: "Johanns painted a dire prospect for a broad spectrum of the population if Democratic-backed legislation passes. ... 'To the recent college graduate burdened with student loans: You'll be forced to buy health insurance the government mandates, and if you refuse, you'll be hit with a penalty,' Johanns said. 'To our seniors who wish to receive care in the comfort of their homes: Funding for hospice care and home health care services would be cut,' he said ... Johanns added that although Obama promised negotiations on C-SPAN, 'a 1,500-page bill, full of carve-outs and backroom deals, is currently being brokered behind closed doors.'  (Koffler, 10/24).


Kaiser Health NewsThis 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.

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