WASHINGTON — House Speaker Nancy Pelosi said today that her chamber would have a sweeping health care bill on the floor by the end of July, an announcement that President Barack Obama hailed.
“That’s the kind of urgency and determination that we need to achieve what I believe will be historic legislation,” the president said at the White House, standing on the south driveway with Pelosi and Democratic leaders of the relevant House committees.
“Our health care system is broken,” Obama said. “We are not going to rest until we’ve delivered the kind of health care reform that’s going to bring down costs for families, improve quality, affordability, accessibility for all Americans.”
Pelosi, D-Calif., and other House Democrats had met with Obama and Vice President Joe Biden in the Oval Office just before going outside to make their announcement. No Republicans were present, and neither were any senators.
“We promised him that we will have this important legislation on the floor of the House before the August break,” Pelosi announced. “Our goal is to have a healthier America.”
Neither the speaker nor the president offered details of how the legislation will look, the subject of ongoing debate on Capitol Hill. The White House is remaining mostly quiet as proposals emerge for discussion among lawmakers, preferring to let Congress come up with a plan and engage more on the specifics later on.
Obama’s plan to provide coverage to some 50 million uninsured Americans is the cornerstone of his promise to enact a larger overhaul of the health care system. Independent experts put the costs at about $1.5 trillion over 10 years.
But turning that vision into reality remains the biggest challenge for the president and his backers, because hard cash — not just ideas — is required to cover upfront costs of expanding coverage.
The final financing package is likely to include a mix of tax increases and spending cuts in federal health programs. Among the possibilities are tax increases on alcoholic beverages, tobacco products and sugary soft drinks, and restrictions on other health care-related tax breaks, such as flexible spending accounts.
Senators also are considering limiting — but not eliminating — the tax-free status of employer-provided health benefits.
Employer-provided health insurance technically is considered part of workers’ compensation, but unlike wages, it is not taxed. The forgone revenue to the federal government amounts to about $250 billion a year.
So even if they’re lucky enough to avoid going to the doctor or hospital, and never use their job-based health insurance, some Americans may find themselves paying taxes on at least part of its value.
Some taxes don’t seem to be on the table, such as a federal sales levy to pay for health care or a new payroll tax.
On the question of taxing health benefits, Senate Finance Committee Chairman Max Baucus, D-Mont., who chaired a round table of senators on Tuesday, is staking out a position that could put him at odds with Obama.
The president adamantly opposed such taxes during the campaign, arguing they would undermine job-based coverage. Obama’s aides now say he’s open to suggestions from Congress, even if he criticized Republican presidential rival John McCain for proposing a sweeping version of the same basic idea.
Baucus said he wants to modify the tax break, not abolish it.
“We are not going to repeal it,” he said.
Baucus suggested that the benefit could be limited by taxing health insurance provided to high-income individuals, although he did not specify at what income levels. He also said that plans offering rich benefits — for example, no co-payments or deductibles — might be taxed once their value exceeded a yet-to-be-determined threshold.
Many experts say Congress won’t be able to come up with the kind of money needed to provide coverage for all unless limitations on the health care tax break are part of the mix.
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