KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Pelosi Continues Push For Public Plan In House Bill

"House Speaker Nancy Pelosi stepped up her push for a publicly run health plan that has divided congressional Democrats, saying it could 'save enormous amounts of money,'" The Wall Street Journal reports. "Congressional aides said including a government-run plan for people under 65 in the health overhaul could save as much as $100 billion, if such a plan were to pay health-care providers the low rates used by Medicare, the federal health program for the elderly."

"Ms. Pelosi is accelerating efforts to develop a consensus House bill that would meld committee versions passed during the summer ... Key issues to be decided: how to squeeze the cost of the bill and ensure the legislation doesn't drive up the deficit over the long term, aides said. Under the speaker's timetable, the bill could be on the House floor in mid-October. But the speaker is getting pushback from moderate Democrats, many of whom are wary about the public option. Hospitals and doctors, whose support is coveted by lawmakers, have complained that a public plan paying Medicare rates would leave them underpaid" (Hitt and Adamy, 9/25).

The Hill: "'The vast majority of the caucus wants a public option, but we have to get the votes of a majority of the Congress,' said Rep. Jim Moran (D-Va.) after leaving a closed-door caucus meeting. He said he was surprised by how many freshmen and New Democrats oppose the public option, in addition to Blue Dogs, who have been more vocal in their opposition. Still, he expects Pelosi to include a public option. 'My guess is that leadership will prevail,' Moran said" (Soraghan, 9/24).

Meanwhile, a Congressional Budget Office report released on Thursday estimates that a public option linked to Medicare rates, which liberal Democrats prefer, would save $85 billion more than a version the conservative Blue Dog Democrats prefer, Congress Daily reports. "The original House bill required the public plan to pay providers 5 percent more than Medicare reimbursement rates. But as part of a package of concessions to Blue Dogs, the House Energy and Commerce Committee accepted an amendment that requires the HHS Secretary to negotiate rates with providers. ... Medicare rates are typically lower than those paid by private insurers, so using that formula would allow the public plan to charge considerably lower premiums to stay solvent. If the government has to negotiate the same way insurance companies do, public plan premiums likely won't be as low -- hence less savings" (Hunt and House, 9/25).

CBS News reports on Pelosi and the "trigger option:" "The trigger is an idea supported by many fiscally conservative Blue Dog Democrats. The idea is that private insurance companies would get a window of time to get in shape, reduce costs and expand coverage. If the insurance companies fail to do so after a certain period of time, then the government could step in by creating a public insurance option to compete with private insurers. Moderates in both the House and Senate have favored, or are at least open to this idea, because it would give markets a chance to reach the goals Congress sets, but could, ultimately, keep the government out." Pelosi has not embraced the idea of the trigger option as a possible compromise. "She said that members of her Caucus felt that 'a trigger is an excuse for not doing anything'" (Jackson, 9/24).

NPR interviewed House Minority Leader John Boehner, R-O.H., who said that while common ground exists between the two parties on health care, President Obama has not reached out to Republican leadership. "'I just think it's time for the president to hit the reset button. Let's just stop all of this. Let's sit down in a bipartisan way and find a way to agree on those things that will make the current system work better.' There are a number of common-sense reforms that can be implemented to improve the current system, he told [NPR host Linda] Wertheimer. But simply throwing the system out, he argued, makes no sense" (Morning Edition, 9/25).

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