KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Lawmakers Brace For Conference As House Liberals Vow Not To Give In On Key Issues

The Los Angeles Times reports that Democrats are looking ahead - and at each other - before beginning the "potentially difficult" process of reconciling the Senate and House versions of health care reform.

"Democrats are hopeful that the momentum generated by the long-awaited Senate vote - and the high political stakes involved in finishing the job - will grease the wheels of negotiations with the House." Differences between the bills include the treatment of abortion in the bills and the presence of a public option for health insurance, which is absent from the Senate version but front and center in the House.

"Negotiators also will have to hammer out disagreements that will determine how quickly the bill takes effect, what taxes will be raised, and other items that reach deeply into every hospital, doctor's office and home medicine cabinet." White House health czar Nancy-Ann DeParle "acknowledged that many liberal House Democrats feel they already have compromised too much on the public option," but said they have signaled also that they are willing to negotiate (Hook, 12/23).

The Hill reports on President Barack Obama's role in shaping the health care overhaul legislation in the weeks ahead. "Obama, who has largely deferred to congressional leaders on healthcare reform, is expected to play a major role in ironing out differences between the House and Senate in order to sign a bill early next year. House and Senate Democrats have already started to play the leverage game, with both factions pointing out they have little to no ground to give. The House passed its version 220-215, while Senate Majority Leader Harry Reid (D-Nev.) needed to convince every member of his conference to overcome a 60-vote legislative hurdle on Monday morning."

"Aside from the public option, the White House will need to referee House/Senate differences on abortion, immigration and tax increases, among many other issues. … House leaders have stressed they will not take up the more centrist Senate legislation, but it is hard to envision the conference bill making a major move to the left. Given the difficulty of winning 60 votes in the Senate, liberals are unlikely to win concessions on these issues in a conference. That means Obama and his aides will have to convince them that what is left of their hopes for healthcare reform is worth moving" (Youngman and Cusack, 12/23).

The Associated Press reports that the abortion issue could still defeat health reform as lawmakers work to find a suitable solution between House and Senate treatments of abortion in plans participating in federal exchanges.

"The House health care bill would bar any health plan that receives federal money from covering abortions. Under the less restrictive Senate language, plans that get federal money could cover abortion as long as customers pay premiums for the procedure separately with their own money, and the premium payments are kept in a separate account. 'Something's going to have to give,' said Rep. Bart Stupak, D-Mich., author of the abortion language in the House." Stupak has said he and 10 others in the House find the Senate language unacceptable, but didn't say it would keep him from voting for the final version of the health reform bill (Werner, 12/23).

Other House Democrats, in the meantime, are insisting they "have no plans to roll over for the Senate" in the imminent conference committee, Politico reports. But they "acknowledged it would be all but impossible to reinsert a public insurance option or force the so-called millionaire's tax" on the Senate. That House provision would help pay for the health reform by levying a tax on citizens with higher incomes.

On a conference call with her leadership, House Speaker Nancy Pelosi talked about the differences in the bills without giving away her priorities, aides told Politico. They include "replacing the Senate's state-run exchanges with a national exchange established under the House bill, adding tougher mandates to make sure everyone secures health coverage and closing a gap in (Medicare) prescription-drug coverage next year. Senate negotiators have agreed to close the so-called 'donut hole,' but they haven't agreed on a time to implement those changes" (O'Connor, 12/22).

Congressional Progressive Caucus leader Rep. Raul Grijalva, D-Ariz., said he'll push hard for changes to be made to the Senate bill, but didn't say he would vote to kill the measure if changes are not made, Roll Call reports. "Grijalva ticked off a list of items he would like to see addressed, including allowing immigrants to buy in to the new insurance exchanges, repealing the antitrust exemption for the insurance industry, including 'some form of public aspect to the plan,' and moving up implementation of the heart of the bill faster than the 2014 date in the Senate bill" (Dennis, 12/22).

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