January 5th, 2010
02:29 PM ET
8 years ago

Democrats set to exclude GOP from final health care deliberations

Washington (CNN) - Top Democrats are prepared to short-circuit the traditional legislative process and exclude their GOP counterparts during final congressional health care deliberations, senior Democratic sources have told CNN.

Democrats are trying to prevent the Republicans from using Senate rules to slow the push for final passage of a comprehensive reform bill, the sources added.

House Speaker Nancy Pelosi is set to discuss the politically contentious health care issue when she huddles in her office with other House Democratic leaders Tuesday afternoon. The House Democratic leadership is also likely to meet with President Barack Obama, and plans to hold a conference call with their entire caucus.

The full House of Representatives is not scheduled to return from vacation until January 12; the Senate meets January 19. Pelosi and Senate Majority Leader Harry Reid, however, have already discussed the issue over the phone, aides said.

Congressional leaders are working to merge an $871 billion Senate bill and $1 trillion House bill that differ on several critical details.

Democratic leaders hope to get a bill to Obama's desk by early February, near the time of the president's State of the Union address, several Democratic sources have said. Pelosi admitted last month, however, that this deadline could slip.

Should the measure that emerges from House-Senate negotiations become law, it would constitute the biggest expansion of federal health care guarantees since the enactment of Medicare and Medicaid more than four decades ago.

Formal House-Senate negotiations, under the ordinary legislative process, would likely have started shortly after both houses of Congress reconvene. Democratic concerns over the GOP's ability to slow the process, however, may result in the traditional process being replaced with informal, high-level talks, sources stated.

In order to hold a formal conference, conferees - members of the House and Senate - must be formally appointed by both bodies, with resolutions passed by both the Senate and the House. One Democratic leadership aide said getting those resolutions passed in the Senate could delay and even derail Democratic efforts, because Republicans would be allowed to offer amendments and hold lengthy debates on the resolutions to appoint conferees.

Many observers believe the more liberal House measure will be largely forced to conform to the Senate bill. The traditionally fractious 60-member Senate Democratic caucus struggled to unify behind a single measure, and needs to remain united in order to overcome solid Republican opposition.

The different approach to financing in the House and Senate bills is one of the many differences that must now be reconciled.

The House measure is paid for through a combination of a tax surcharge on wealthy Americans and new Medicare spending reductions. Individuals with annual incomes over $500,000 - as well as families earning more than $1 million - would face a 5.4 percent income tax surcharge.

The Senate bill also cuts Medicare by roughly $500 billion. But instead of an income tax surcharge on the wealthy, it would impose a 40 percent tax on insurance companies that provide what are called "Cadillac" health plans valued at more than $8,500 for individuals and $23,000 for families.

Proponents of the tax on high-end plans argue it's one of the most effective ways to curb medical inflation. However, House Democrats oppose taxing such policies because it would hurt union members who traded higher salaries for more generous health benefits.

Back in December, Obama predicted the final bill will probably end up with a variation of both the income tax surcharge and the tax on high-end plans.

"Cadillac plans ... don't make people healthier, but just take more money out of their pockets," he argued in an interview with National Public Radio.

The Senate bill also would hike Medicare payroll taxes on families making over $250,000; the House bill does not.

Another key sticking point is the dispute over a public option. The House plan includes a public option; the more conservative Senate package would instead create nonprofit private plans overseen by the federal government.

Given the reality of the 60-vote threshold in the Senate, however, there hasn't been much serious discussion among House leaders about pushing hard to keep the public option.

One of the top House liberal leaders - South Carolina Rep. James Clyburn - recently said he could vote for a bill without the government insurance plan.

"We want a public option to do basically three things: create more choice for insurers, create more competition for insurance companies, and to contain costs," Clyburn said on the CBS program "Face the Nation. "So if we can come up with a process by which these three things can be done, then I'm all for it. Whether or not we label it a public option or not is of no consequence."

Maryland Rep. Chris Van Hollen, chairman of the Democratic Congressional Campaign Committee, said at the end of December on the show "Fox News Sunday" that the public option is "not dead, but we also recognize that the Senate was able to just muster the 60 votes."

Individuals under both plans would be required to purchase coverage, but the House bill includes more stringent penalties for most of those who fail to comply. The House bill would impose a fine of up to 2.5 percent of an individual's income. The Senate plan would require individuals to purchase health insurance coverage or face a fine of up to $750 or 2 percent of his or her income, whichever is greater.

Both versions include a hardship exemption for poorer Americans.

Employers face a much stricter mandate under the House legislation, which would require companies with a payroll of more than $500,000 to provide insurance or pay a penalty of up to 8 percent of their payroll.

The Senate bill would require companies with more than 50 employees to pay a fee of up to $750 per worker if any of its employees rely on government subsidies to purchase coverage.

Abortion also has been a sticking point for both chambers. A compromise with Catholic and other conservatives in the House led to the adoption of an amendment banning most abortion coverage from the public option. It also would prohibit abortion coverage in private policies available in the exchange to people receiving federal subsidies.

Senate provisions, made more conservative than initially drafted in order to satisfy Nebraska Sen. Ben Nelson, would allow states to choose whether to ban abortion coverage in plans offered in the exchanges. Individuals purchasing plans through the exchanges would have to pay for abortion coverage out of their own funds.

Nelson recently warned on CNN's "State of the Union" that he would withdraw his support if the final bill gets changed too much from the Senate version.

Despite their differences, however, the House and Senate have already reached agreement on a broad range of topics.

Both chambers have agreed to subsidize insurance for a family of four making up to roughly $88,000 annually, or 400 percent of the federal poverty level.

They also have agreed to create health insurance exchanges designed to make it easier for small businesses, the self-employed and the unemployed to pool resources and purchase less expensive coverage. Both the House plan and the Senate bill would eventually limit total out-of-pocket expenses and prevent insurance companies from denying coverage for pre-existing conditions.

Insurers would also be barred from charging higher premiums based on a person's gender or medical history. However, both bills allow insurance companies to charge higher premiums for older customers.

Medicaid would be significantly expanded under both proposals. The House bill would extend coverage to individuals earning up to 150 percent of the poverty level, or roughly $33,000 for a family of four. The Senate plan ensures coverage to those earning up to 133 percent of the poverty level, or just over $29,000 for a family of four.

Both the House and Senate bills would permit the creation of non-profit private insurance cooperatives to increase competition.

–CNN's Dana Bash, Lisa Desjardins, Alan Silverleib, and Deirdre Walsh contributed to this report

Filed under: Health care • House of Representatives • Senate
soundoff (135 Responses)
  1. Jimmy James

    What happened to CSpan and no more back room deals? I get Wilson was right. LIAR!

    January 5, 2010 02:31 pm at 2:31 pm |
  2. Allen Hussein

    While it would be nice to have some good faith bipartisan effort put forth by the Republicans but as long as they are going to act like spoiled Party of No obstructionist brats, then the Democrats are fully justified in leaving them out.

    January 5, 2010 02:33 pm at 2:33 pm |
  3. TexasBob

    I'm sure the Republicans will moan and scream and excoriate the Democrats for this decision. But by what right do they assume they now should have any voice in this bill? Every single Republican in the Senate voted against the bill, as did all but one single House Republican. There is little doubt that they will do the same thing on the final bill. Since they are not interested in the passage of the bill anyway, why should they be included in determining its final form. It's all typical Republican blustering – much ado about nothing. I have, until this year, always been a staunch Republican, but the party's inexcusably obtuse performance in the past year has made me consider switching parties. I will surely never vote for a Republican in Texas again!

    January 5, 2010 02:34 pm at 2:34 pm |
  4. Anonymous

    was about time....

    January 5, 2010 02:36 pm at 2:36 pm |
  5. 31m-PA

    Change we can believe in!!

    January 5, 2010 02:37 pm at 2:37 pm |
  6. Mac

    Yeah lets not allow the use of any established rules – lets just ram this bill home!


    January 5, 2010 02:37 pm at 2:37 pm |
  7. JES

    So now we go behind closed doors and leave out an entire party so this stupid bill can get to the President's desk in time for his Atate of the Union address.

    How STUPID is this. Who gave them the right to leave the voice of the people out. The majority of the people don't want another bill that cost more money and get us deeper in debt.

    Get these STUPID people out before they flush us down the drain before it's to late.

    We need Health Care Reform but not with this bill they are trying to get passed.

    For a change the Majority of people need to speak up and not let the minority control what we do.

    January 5, 2010 02:37 pm at 2:37 pm |
  8. lila

    Right on. They have done nothing but try and make every thing fail. They are losers who want company. Well forget it. The GOP failed. Losers. They could have gotten large tax breaks put in place for businesses that provided health insurance (most do anyway so it would have been a boon to business) if the GOP had been willing to honestly work with democrats instead of trying to turn health care into Obama's Waterloo. I'll say it again, the GOP are losers who helped no one. Why should they be allowed in with the grown ups?

    January 5, 2010 02:41 pm at 2:41 pm |
  9. Tanya Kujath

    Well it's about time. I think they have argued long enough with a party that doesn't want to walk forward...

    January 5, 2010 02:42 pm at 2:42 pm |
  10. George

    Good for the Dems. The GOP has rejected everything since last January. Let them pout and let the voters see why they have done nothing for America. Vote the GOP out this year!!! They only care about big business because that is who is paying the congresses.

    January 5, 2010 02:43 pm at 2:43 pm |
  11. Maryland

    Democrats are a disgrace! How can you pass a bill with no support from the other side of the aisle and also while 61% of Americans polled are opposed to it. The only thing that Obama and the democrats are concerned about is expanding more government and control into our lives.

    Having a government option is not competition. It is like a pitcher calling his own balls and strikes in baseball.

    January 5, 2010 02:43 pm at 2:43 pm |
  12. seebofubar

    That will be the final nail in the Democrat party's coffin.

    January 5, 2010 02:43 pm at 2:43 pm |
  13. Justin

    Why bother including them? They aren't interested in passing a bill anyway. They had their chance to provide their input to the bill and declined to do so. F'em.

    January 5, 2010 02:43 pm at 2:43 pm |
  14. james Miller

    Why not !! They have contributed zilch to the debate. Any fool can fold their arms and say, NO NO NO, we don`t like that.

    January 5, 2010 02:44 pm at 2:44 pm |
  15. Eugene

    Nothing terribly unusual about this at all. The Republicans have attempted to thwart health care reform for decades and all through this past year, knowing full well how detrimental reform will be to their future as a party. What do they have to contribute to the process at this stage other than spit on the conference table?

    January 5, 2010 02:44 pm at 2:44 pm |
  16. BLM

    What do you expect from those who are planning a power grab. Its not about health care, its all about ideology and his highness. Very Sad.

    January 5, 2010 02:45 pm at 2:45 pm |
  17. Dean

    Sounds logical to me. The Democrats are ready to push this bill through regardless of the will of the people or the financial destruction that will follow.
    Say goodbye Nancy and Harry. You two are going to be history.

    January 5, 2010 02:46 pm at 2:46 pm |
  18. Fred L

    I can't believe what I'm reading! Regardless of anyone's position on this bill, does anyone believe eliminating the ability of the minority to slow down the majority is a good thing?

    If this bill is such a good idea, it will survive and grow better when subjected to review over time. If this bill is the superficial bill of misleading goods I suspect it is, then this frantic rush to get it passed before folks have time to change it makes sense.

    A key point here is that what the Democrats do today the Republicans can do tomorrow.

    Does anyone want any one political block to have so much power it can disregard the concerns of all others? That is what is about to happen if Pelosi and Reid get their way and push this through the back door.

    January 5, 2010 02:47 pm at 2:47 pm |
  19. Kevin in Atlanta

    Why would they be invited when they've made it abundantly clear they are dead-set against passing any kind of health reform bill? That would be a total waste of time.

    January 5, 2010 02:47 pm at 2:47 pm |
  20. Steph

    I agree with their decision. They've tried and tried to include the Republicans, even including some of their provisions, and all they get in return is political postering. As the Republicans have stated all along...they want to kill the bill, not improve or make changes to it. The Republicans have removed themselves from an honest dialogue on the subject of health care reform. The Democrats have no other option but to move forward without them because, contrary to what the loud mouth tea-bagger say, the majority of Americans desperately want health care reform.

    January 5, 2010 02:48 pm at 2:48 pm |
  21. Rosa Birmingham, AL

    Good, the GOP has been nothing but a hinderance so far and made the bills worse than they should have been.

    January 5, 2010 02:48 pm at 2:48 pm |
  22. Rob from MO

    GOP senators and representatives have already excluded themselves. The democratic leadership is acknowledging reality. Good for them.

    January 5, 2010 02:49 pm at 2:49 pm |
  23. Mark

    What's new? They have been shut out from the beginning.......

    January 5, 2010 02:50 pm at 2:50 pm |
  24. susie

    I will never vote for Democrats again.

    January 5, 2010 02:50 pm at 2:50 pm |
  25. Mike

    This wouldn't be the first time one party has excluded another in the process. Republicans did this the the Democracts when they were in power. Payback time!

    January 5, 2010 02:52 pm at 2:52 pm |
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