Audio: Health On The Hill – January 21, 2010

Jackie Judd, Kaiser Family Foundation; Mary Agnes Carey, Kaiser Health News

The fate of congressional health overhaul legislation is uncertain after Republican Scott Brown’s win in Massachusetts’ special election on Monday and Democrats’ loss of a filibuster-proof majority. In addition, Nancy Pelosi said Thursday the Senate’s current version of the health bill will not pass in the House.


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Jackie Judd: Good day, this is an update of Health On The Hill. I’m Jackie Judd. The election of Republican Scott Brown to fill the senate seat held for decades by Ted Kennedy has thrown the debate over health care reform overhaul into turmoil. Because once Brown is seated, Democrats lose their filibuster-proof majority. To bring us up to date is Mary Agnes Carey of Kaiser Health News. She’s on Capitol Hill now. Mary Agnes, today speaker Nancy Pelosi conceded she does not have the votes to simply pass the Senate’s health care reform bill, in the House. Is this essentially the death now, for health care reform in the near future?

Mary Agnes Carey: Not necessarily. I mean she made it very clear that as it currently exists, the Senate health care bill, there are not the votes for it as you say. She said all options are still on the table. She made it very clear that her intention, and the intention of the Democratic caucus was to stop and take a breath, look at where they could reach consensus – perhaps in the scaled-back bill – what they need to do to get a bill passed. They’re not necessarily in an immediate rush, but I think her comments, and that of other lawmakers, still expressed a greater urgency to focus on health care. Can they salvage this issue for them? Let’s remember, they’ve been working very intensely on this for a year. Three House committees, two Senate committees, both chambers have passed their own version of the bill. And they’re so close to the finish line, they’d really like to get there. The key is what they do to obtain that goal.

JJ: And the president said last night that nothing should be done, essentially, until the new senator from Massachusetts is seated?

MAC: That’s exactly right, and Harry Reid, who’s the majority leader in the senate has said the same thing. It’s very clear that while procedurally — and if there had been support in the House, which as we discussed there’s not, if there had been support among House Democrats to pass the Senate bill quickly and move it to the president, that is not going to be popular with the voting public. They would think it’s too fast, it’s a dirty trick, Congress is – Democrats in particular – are trying to pull a fast one on the American public, and so they’ve really taken that cue from the Massachusetts election to say, wait a minute, we’re not going to try to push this through before Scott Brown is seated. He was already on the Hill today with Paul Kirk who took over for Sen. Kennedy after he passed away, the interim Massachusetts senator, to welcome him to the Hill. He’s not necessarily seated yet, but Democrats and president Obama have made it clear that they’re not going to do a rush job on this before he’s seated.

JJ: So what’s in the realm of possibility, Mary Agnes: a piecemeal approach, the use of reconciliation? What’s out there for the Democrats to look at and think reasonably, at least pieces, of health care overhaul could happen?

MAC: All those things are on the table. They’ve got key objectives. House and Senate Democrats want to make it accessible to people, they want to make it affordable, and they want to make it, in their words, accountable. Make sure insurance companies are accountable. So what can they do to stop practices like insurers denying coverage for you for preexisting medical condition. Nancy Pelosi talked about something today called the medical loss reissue, but that’s a requirement that insurers spend a certain amount of the premium dollar on health care. You mentioned the idea of reconciliation. That would be basically a corrections bill that could fine tune some of the financial elements of the bill, perhaps the subsidy levels, perhaps the taxes that would be used to finance it. But it’s a very restrictive, fairly prescriptive way to go that would be teamed with another bill, so we have to wait and see what they do. I think everything is on the table, and they’re really trying to find out what’s the most effective way to focus on key objectives. Some members are talking about, they’re wondering if they can get some Republican support; it’s even more key in the Senate to do that. But I think it’s extremely unclear on which path they’re going to go. But you do get a sense of unease from members that they can proceed with a very large, comprehensive bill that they’ve already passed, that perhaps the window has closed on that. And they need to have a new strategy at the end of the day.

JJ: What are Republican leaders saying about what their intentions are?

MAC: They said basically they’re open. John Boehner, who is from Ohio, he’s the House Republican leader, said today, we’ll be open to talking with House Democrats. But he made it very clear that the bill they currently have is dead.  There is no room for consensus, it’s too big in his view, it takes people too much, it requires too many changes and people aren’t comfortable with it. But then other Republicans, including Paul Ryan of Wisconsin, said today that he thought any idea of Democrats reaching out to Republicans was not in the near future of a possibility. He said they’re on plan C, trying to figure out what they need to do get their own caucus together, and the idea of reaching out to Republicans was way, way lower on the list, lower in the alphabet. So I think that they’re not very hopeful on this side, Republicans don’t think that Democrats would be actively reaching out to them. I mean, it remains an open question in the Senate. Olympia Snowe is a very likely candidate over there. She’s a Republican moderate from Maine. But she has a lot of concerns with the way the bill is currently drafted. So I think the idea of getting Republican support right now would be difficult, not only because of the complexities of the bill, but politically, this has worked very well to their advantage. To not support the Democratic bill and look at the concerns in the polling about the Democrats’ health care bill.

JJ: And a final question, Mary Agnes. And it’s a question about the mood on Capitol Hill. After Democrats got so close, are they still in a state of shock? How deflated are they?

MAC: I think they’re very stunned, they’re still very upset. They can’t believe they got that far and now they have this major roadblock. But you still have many members who are committed to health care reform legislation. They’ve spent, not only the past year for a lot of them, but for many other members, many more years, possibly decades on this legislation and they want to try and achieve a solution. The key thing here is timing. Democrats are very eager to move on to talk about jobs, talk about the economy. So I think they’re looking for a solution. They could move as soon as they could so they could pivot the discussion, especially as we get close to this November midterm elections, onto jobs and onto the economy, which are key concerns to voters.

JJ: Okay, thank you very much, Mary Agnes Carey of Kaiser Health News, talking to us from Capitol Hill. I’m Jackie Judd and this has been Health On The Hill.

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