Comments By CBO Director Underscore Conservatives’ Health Bill Concerns

A leader of the Blue Dog Coalition of conservative House Democrats said today that he and six others in the group will vote together to block health care legislation in committee unless changes are made to slow the rate of growth of federal health care spending and to ensure that rural hospitals are adequately reimbursed for treating new patients under the legislation.

“We simply are demanding a bill that contains costs so that health care can grow at the normal rate of inflation and that addresses many of the rural health care concerns that [hospitals be adequately reimbursed] and that we don’t put small businesses out of business through an employer mandate,” Rep. Mike Ross, D-Ark., said in an interview.

The conservatives’ position may have been strengthened today by the director of the nonpartisan Congressional Budget Office, Douglas Elmendorf. According to the Washington Post, he told the Senate Budget Committee that the bills drafted by House Democratic leaders and the Senate health committee do not propose “the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount.”

“On the contrary,” Elmendorf said, “the legislation significantly expands the federal responsibility for health care costs.”

Ross, chairman of the Blue Dogs’ health care task force, said the six others who would vote to block the bill in the Energy and Commerce Committee are Reps. Zack Space, Ohio, Baron Hill, Indiana, Charlie Melancon, Louisiana, John Barrow, Georgia, Jim Matheson, Utah, and Bart Gordon, Tennessee.

Ross said he and his colleagues will offer a series of amendments as the House committees begin work on the bill. He said the amendments were still being developed and could not provide details.

The Blue Dogs also are concerned about requiring employers, especially small businesses in rural areas, to offer insurance or pay a penalty, he said. And Ross said they oppose a government-run insurance option to help extend coverage to more Americans if hospitals aren’t paid far more than the rates allowed under the Medicare program, the federal program for the elderly and disabled.

The current draft of the House bill would reimburse hospitals at Medicare rates and doctors at a slightly higher rate. Under the bill, businesses that do not offer health insurance would pay an 8 percent payroll tax to help subsidize coverage in a new insurance exchange. The bill was changed slightly to exempt the smallest employers from the requirement, but Ross said that is not sufficient.

The House Democratic leadership has instructed the committees to complete work on the bill by next week. It would guarantee insurance to the vast majority of Americans at a cost of about $1 trillion over 10 years. A combination of taxes on the wealthy and reductions in spending for Medicare and Medicaid, the state-federal program for the poor, would largely pay for an expansion of insurance coverage.

“If it’s not amended, we cannot support the current bill, and it would only take seven Democrats to stop the bill in committee,” Ross warned.

Ross stressed that “we’re not trying to stop health care reform.” He said, “We just want to slow down and do it right. This is the biggest domestic reform that we’ll undertake in my lifetime. Why do they want to rush it in a markup that’s going to last two days this week and three days next week?”