WASHINGTON — At 7 a.m. today, the Senate plans to push landmark health-care legislation over the finish line with the last in a string of midnight and daybreak votes capping months of infighting and procedural delays. And with that, the hardest work of all will begin: reckoning with long-standing differences with the House and uniting behind a single bill that can be sent to the president.
Democrats are already outlining a strategy to achieve a final compromise that can satisfy the more liberal House without upsetting the painstakingly assembled coalition of 60 Senate Democrats and independents.
Central to those talks, House leaders said, will be the search for an acceptable substitute for a government-run insurance plan that those without medical coverage could purchase, a provision the House designed to compete with private insurers and force them to rein in costs. While the Senate has decisively rejected the “public option,” House leaders say they will demand other concessions to ensure that Americans can afford the insurance they will be required to buy if the bill becomes law.
“We have to be absolutely convinced that this is going accomplish the goal of holding down the cost of health insurance. The American consumer cannot be left hostage to the whims of private insurance,” said Rep. Chris Van Hollen, D-Md., a member of the House leadership. “We’re asking every American to share some responsibility in getting health insurance; we need to ensure that every American can afford it.”
House Speaker Nancy Pelosi, D-Calif., has signaled approval for the Senate’s solution: the creation of at least two nationwide insurance plans run by private companies but overseen by the Office of Personnel Management, the same federal agency that handles health insurance for members of Congress. In a conference call Wednesday, Pelosi also assured rank-and-file Democrats that they would not be asked to rubber-stamp the Senate bill and began soliciting ideas to improve it.
Among the options under discussion: pressing the Senate to increase the federal subsidies that would be offered to low- and middle-income people who do not have access to affordable coverage through an employer. Having a single national marketplace for people buying insurance, rather than 50 separate state-based exchanges the Senate prefers. And moving up the launch date of those marketplaces and subsidies to 2013, one year earlier than under the Senate bill.
Other contentious issues must also be resolved in talks between the two chambers, including how to handle abortion coverage and whether to permit undocumented immigrants to use their own money to buy insurance on the exchanges. The House and Senate also differ on which taxes to raise to pay for the most dramatic expansion of insurance coverage since the 1965 creation of Medicare and how to enforce nearly $500 billion in proposed payment cuts to Medicare providers.
Talk to us
> Give us your news tips.
> Send us a letter to the editor.
> More Herald contact information.
