WASHINGTON (CNN) – President Barack Obama's top domestic priority moved one step closer to congressional approval Friday as a key House committee passed comprehensive health-care reform legislation.
The vote occurred as the House of Representatives adjourned for its August recess.
The 31-28 vote in the House Energy and Commerce Committee came after several days of intense and often contentious negotiations between Democratic House leaders and an influential group of fiscal conservatives in the party.
Three members of the Democrats' conservative "Blue Dog" caucus - John Barrow of Georgia, Jim Matheson of Utah and Charlie Melancon of Louisiana - voted against the bill, along with two other Democrats, Bart Stupak of Michigan and Rick Boucher of Virginia.
The committee's bill will now be merged with two separate versions passed by other House panels before being considered by the full chamber in September.
The prospects for health-care reform in the full House, however, remain unclear. Democrats remain deeply divided, with a number of liberals expressing strong opposition to concessions made to the Blue Dogs on the Energy and Commerce Committee.
The fate of health-care reform also remains uncertain in the Senate, where the Finance Committee recently postponed its long-awaited vote on a bipartisan compromise plan until after the August recess.
The coming fights in both chambers serve as a backdrop for what is expected to be a month of furious campaigning for and against the bill as members of Congress meet with constituents back home over the break.
House Speaker Nancy Pelosi said Friday that House Democrats were returning to their districts with a series of talking points and memos to help them rebut opponents running "a shock and awe campaign ... to perpetuate the status quo."
"Facts mean nothing" to insurance industry executives and others opposed to change, she said. "Misrepresentation is the currency of their realm."
Pelosi did not indicate, however, how Democratic divisions in the House might be overcome when Congress returns in the fall.
On Thursday, 57 members of the House Progressive Caucus sent a letter to Pelosi and others complaining that the agreement with the Blue Dogs had weakened language creating a government-funded health insurance option.
"Any bill that does not provide, at a minimum, for a public option with reimbursement rates based on Medicare rates - not negotiated rates - is unacceptable," the letter said.
The revised bill calls for the government-run public insurance option to be reimbursed on rates determined by negotiations with the insurance industry. The original version called for the same reimbursement rates as in the government's Medicare program for senior citizens.
The progressive Democrats also argued that cuts to the bill's overall price tag would shortchange subsidies meant to help low- and moderate-income Americans buy health insurance.
Some of those concerns were addressed Friday when the Energy and Commerce committee boosted funding for the subsidies and added a provision empowering the federal government to directly negotiate prescription drug rates in the public plan.
The agreement with the Blue Dogs, estimated to lower the cost of the House plan by $100 billion over a decade, would also exempt businesses with payrolls below $500,000 from having to provide health coverage to their workers.
"We can compromise no more," warned Rep. Lynn Woolsey, co-chair of the 81-member Progressive Caucus. "When leaders of the House meet ... to consider the three bills and produce a final one, we expect that it will retain a robust public option. If it doesn't, we will vote against it."
Opposition from progressive Democrats and some conservative House Democrats who want additional cost cuts could defeat the bill.
Pelosi admitted Thursday that she preferred the original bill, but noted that much of the new language matched a proposal supported by Sen. Edward Kennedy, D-Massachusetts, a long-time champion of health care reform who is revered by liberal Democrats.
She also pointed out that the bill could change when House and Senate negotiate a final measure in coming months.
On the Senate side, key Republicans in the Finance Committee negotiations had signaled before Thursday's announcement that they were unlikely to complete work on a compromise plan before the August break.
Grassley and Sen. Michael Enzi of Wyoming told CNN Wednesday night that too many issues remained unresolved to sign on to a deal by the time the Senate breaks for its recess on August 7.
On Thursday, Grassley said that pressure from the White House and Democratic leaders to speed the process didn't help.
"It would be better for me to say that instead of saying there's no way we can cut a deal, there's no way we can get all the compromising that needs to be done by an artificial deadline of Friday of this week," Grassley said. "So we're going to continue to work together this week and next week. But we're getting close."
Democrats had hoped the Finance Committee could finish its work before the August break to show progress toward health legislation.
–CNN's Craig Broffman and Deirdre Walsh contributed to this report
In the last 8 years please tell me what one republican did regarding health care reform.....I'm waiting. Thank you President Obama for caring enough about this country and the people to attempt to change the system!
Of those in the committee who voted in favor, I wonder how many have actually read it. We know Conyers will not read it– too many pages for him, he says.
I get the feeling that Obama and the democrat Congress want to try and pass this before the People know what is in it. Kind of like the stimulus bill. 16% of the economy should not be reorganized without everyone knowing what is in the proposed law.
Americans do not want this Socialism forced on them. They didn't vote for this, and they won't wait for 2012 to be rid of these Democrats – 2010 will start the process of undoing the election of 2008.
It's scary to think the Federal Government is going to be in control of our health bill when they screwed up the "cash for clunkers" by not taking into account the amount of money it would take to keep the program afloat.
I expected no less confusion and ego mania on this important topic. ever hear of too many cooks in the kitchen. well instead of a balanced meal. we will end up with a sandwich, chips & a taxed soda!! those who are serious about change and voted for obama to suceed. need to say so. and say so loudly. there are a lot of kooks and haters out here that want this president to fail for their own selfish and narrow minded reasons. amen
Hello fellow taxpayers, you know who you are. We are the minority here in America. Can you feel the tax increases coming your way?
Cap & Trade will double you utility bills and Government health care will break us. You hard earned money is no longer yours you are the worker for Big brother…
Three Blue Dogs voted NO!
This is not bad really when you consider that there
are about 50 Blue Dogs.
This is a good sign for Health Care Reform............
but you have to keep the pressure up during recess
Who cares? The American people are not going to be interested in a bill that sucks up ONE SIXTH of the entire economy and delivers a health care system that is vastly inferior to the quality of care we now have. Perhaps it is President Teleprompter's time to lead us all in a rousing version of "Oh, Canada."
Gee I wonder what kind of taxes I will have to pay when this gets passed? Now I read there is information out there that my elected officials are looking at a "federal car tax" to pay for an energy bill or some darn thing. So not only will you have to pay state tax and registration. you will have to pay an annual federal tax on each vehicle you own. Geeze, this is not the change I wanted...fire the idiots in congress..slow down. I want my country back.
Did any of them read the whole thing before they voted and will they read the whole merged version before they vote the next time? I predict they will NOT just as they didn't for the stimulus. Seems it isn't necessary now to know what you are voting on anymore.
If we do not get a non-profit option then all the republicans and blue dog democrats should be let go.
Our health is no longer up for profit. No more multimillion $ salaries/bonuses for executives or dividends for shareholders or private jets or gold trim dinnerware in the board rooms.
People demand a single payer non-profit system.
We need health care reform now!
Here's an idea:
A sponsorship program:
make it so that people can pay for their loved one's insurance (non-dependents) and the cost would either be tax-deductable or a write-off.
I'm sure that the number of uninsured would go down if the government gave families & friends more incentives to take care of their own.
"Bipartisan" means reaching out to the opposing side, not being dominated by it. Republicans snark at the President because he's not a miracle worker. Obama is changing Washington with his calm, rational, non-combative way of dealing with issues. If Republicans don't want to play, then you can't make them.
Democrats did not win overwhelming majorities by promising to placate the Republicans. And for those more concerned about politics than doing what the American people elected you to do: let's follow this through to its logical conclusions. Either a bill is passed that Republicans like and is a victory to be claimed by Republicans (in addition to doing nothing for your constituents), or nothing gets done and Democrats are mocked for being a "do-nothing Congress" in spite of having overwhelming majorities.
Please stop trying to be clever and be smart. This goes for everyone.
More evidence that the Church Age has come to an end !
On to the Senate where the more Intelligent Members of Congress will squash it.
We hope and Pray.
Pelosi is the Worst of the Worst, and after seeing and hearing her on T.V., the Nation should be more convinced than ever that this Bill is Wrong for our Nation. Pelosi is not smart.
obama could care less about this Bill.
He just wants his name in lights and credit for a Healthcare Bill.
If obama can't run a 'cash for clunkers program,' how is he going to run Government Health Care.
The Senate shoulc scrap the entire Bill and Start Over. To really change Healthcare, reasonably, takes far more that a 'quck fix from 4 months of talk.'
Besides, let's see obama's hot-temper flare once more.
People in the White House must stop 'waliking on eggs' to please this incompetent and unqualified jerk.
obama has made a mess of everything he has touched so far, and the future for this country does look GRIM.
I personally followed thos hearings on cspan and read the HR 3200 and I'm in agreement with democrats. I support this bill 100 percent. Health Insurance industry bonus days are over, and this bill will put competition between public option and health care insurance in real competition. Of Course, United Health insurance is fighting for their lives and they know by competition it will help bring lower health care cost down. Plus this will put an end to pick and choosing of whom they will cover and ending discriminating against people with pre existing disease. However, GOP is using the Karl Rove playbook by using fear and boogyman tactics. I encourage every American to contact their representatives and senators to support the HR 3200.
Progressive Democrats???? They should admit the fact that they are Leftist Marxists!
Good to hear the final House committee passed a health-care reform bill. I agree with the small-business exemption, but I would not necessarily agree with including insurance companies in the public option negotiations.
The purpose of the public option is to improve competition in the market, whereby, extending affordable coverage overall. Putting the insurance companies into these vital negotiations would equate to putting foxes in charge of the hen house.
The insurance lobby is the main problem with the broken system we have. These greedy corporations have proven not to be trusted time and time again with Americans' health and well-being. They make decisions based on exorbitant profits instead of the best care for patients. Enough.
The insurance companies should have to compete in open markets to provide the best possible services for the American consumer in order to make fair profits through better quality products.
Wont the GOP look like total idiots when healthcare reform comes to pass and we are all the better for it. Us voters will remeber what party chose to side with the big corporate talking heads of the insurance companies, and not with the American working class.
The Democrats who voted against Health Care Reform should spend the recess visiting the emergency rooms of their local hospitals. There they will meet a lot of uninsured voters who will cost two or three times as much to treat because they could not go to private doctor to treatment for a cold, flu, sprained muscle or other minor issue. They will be waiting with patients who are having heart attacks but did not call an ambulance because of costs.
Health care reform is a matter of life and death for some Americans who have been denied coverage because of congenital conditions.
We expect Republicans to focus on birth certificates, carrying concealed weapons across state lines and starting the next war. But, we elected Democrats to get the work of the American people done. Health Care is about the American people.
"Any bill that does not provide, at a minimum, for a public option with reimbursement rates based on Medicare rates — not negotiated rates — is unacceptable," the letter said.
All insurance reimbursement is based on usual and customary fees. That's the overall fee average for all the doctors in that area. A doctor may charge $50 for a service, BCBS may pay $45 based on usual and customary rates or on the provider contracted rate.
Medicare does not pay the usual and customary rate. The government sets the price artificially low. The same service that BCBS pays $45, Medicare pays $30. Take it or leave it.
The only way to balance the loss is to raise prices on non-medicare patients.
A few of things I like to see in this bill if this turkey passes.
1. All politicians are to drop their current health care and enroll in this plan. If this plan is not good enough for them and their families than it's certainly not good enough for us.
2. Drop this stupid ideal of fining people a $1,000 plus if they choose not to have an health care plan. This is nothing but more greed on the politicians part to steal ever more money from us.
3. No illegals are to be afforded health care, not on the tax payers dime, with the exception of emergency care for a life or death illness and than bill the illegals country of origin for the cost of any treatment.