Democrats split on health care plan

WASHINGTON — Liberal Democrats and fiscally conservative Democrats are on a collision course in the House over the shape of President Barack Obama’s health care overhaul.

The disagreement between the Congressional Progressive Caucus and the conservative Blue Dog Coalition comes on the eve of the kickoff of a national campaign to rally support for health care legislation that’s being orchestrated by Obama’s campaign team.

The dispute could complicate House approval of a health care bill. Majority Democrats will need to keep most of their members on board as they’re unlikely to get much, if any, GOP support for their plans.

The conflict between the liberals and moderates is over the contours of a new public insurance plan that’s likely to be included in a health care overhaul.

Such a plan, strongly opposed by Republicans, would compete with private insurers and offer the first opportunity for most Americans not eligible for Medicare or Medicaid to get government-sponsored health care.

The Progressive Caucus, which claims 80 members, released a set of principles for the new public plan Friday that in several instances directly oppose principles released Thursday by the 51-member Blue Dog Coalition. Democrats have 257 of 435 seats in the House of Representatives.

Some examples:

  • The progressives say the public plan must cover all comers and must not be conditioned on private industry actions. The Blue Dogs say the public option “must adhere to the same rules and regulations as all other plans.”

    The Blue Dogs say the public plan should occur only as a fallback, triggered if private insurers aren’t doing a good enough job on access and costs. The progressives say “we oppose any conditions or triggers undermining and limiting the availability of the public option.”

    The progressives say the public plan must be an entity operated by the federal government that “bears the risk for paying medical claims to keep administrative costs low.” The Blue Dogs say claims must be covered by premiums and copays without relying on the federal treasury.

    The disagreements underscore steep challenges ahead as Congress rushes to meet Obama’s goal of passing a health care overhaul that keeps down costs and extends coverage to 50 million uninsured Americans.

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