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. Rich (Charleston, SC)

    This whole thing is getting worse and worse. Now, this bill is going to be the sole make-up of Nancy Pelosi, Harry Reid, and Obama. Not only no input from Repblicans, but also no input from the conservative and moderate factions of the Democratic Party. And also, they get to put this bill together behind closed doors where no one can see or hear. The 2010 election can not get here too fast for me, so we can get rid of all of those who feel they are above the people and can do what they want, regardless if its effect on the country. For all those that bought the slogan "Change we can believe in" without knowing who or what Obama and the liberal Democrats were, we all got what we deserve. There are good people in both parties, but the liberal arm of the Democratic party has led this country down a road to a mess that will haunt the people for generations.

    January 5, 2010 02:53 pm at 2:53 pm |
  2. Justen

    Promises made, Promises broken.

    1. Make Government Open and Transparent
    2. Make it “Impossible” for Congressmen to slip in Pork Barrel Projects
    3. Meetings where laws are written will be more open to the public
    4. No more secrecy
    5. Public will have 5 days to look at a Bill
    7. We will put every pork barrel project online
    8. No lobbiests will work in his administration
    9. No more "earmarks"

    But the dems on here just don't seem to care, do you?

    January 5, 2010 02:55 pm at 2:55 pm |
  3. lisa

    elections can't come soon enough

    January 5, 2010 02:59 pm at 2:59 pm |
  4. Marshall

    What have we become when we are excluding elected official and not allowing a portion of the citizens of the country to be represented?

    January 5, 2010 02:59 pm at 2:59 pm |
  5. Jeff, Huntington Beach, CA

    It is about time... why waste time with the party that is in the insurance industry pocket. Now if the Democrats could just get away from the trial lawyers...

    January 5, 2010 02:59 pm at 2:59 pm |
  6. sensible Cape Coral FL

    What would be the point of including them? What purpose would be served? The Republicans are determined to do everything possible to undermine any positive legislation.

    January 5, 2010 03:00 pm at 3:00 pm |
  7. Vonnie932

    That the only way anything will get done is to leave GOP leaders out or allow them to further paralize the country.
    Public option and drugs from Canada show be allowed.

    January 5, 2010 03:01 pm at 3:01 pm |
  8. Jane/Seattle

    WE REQUIRE THE Public Option for Equality here. How can any political party hope to not be exposed if WE The People must be forced to buy from the election funders? In this case it is the Healthcare Industry doing the buying! Shutting them out is the only way to let the people really know that they offer NOTHING for US – The Ones Who Pay! Democrats: Take NOTE: If YOU SCREW US with this tax penalty, instead of reigning in the industry, your days will be numbered, also! We are Sick of ALL of YOU Self-Servers!

    January 5, 2010 03:01 pm at 3:01 pm |
  9. eric in Denver

    Is this a story. They have not involved the republicans from the beginning of this bogus bill.

    January 5, 2010 03:01 pm at 3:01 pm |
  10. barbara

    ....and when the pugs take control of congress, do not be surprised when they play the very same game.

    January 5, 2010 03:01 pm at 3:01 pm |
  11. hdjones

    Bravo. There is no reason to include the members of the Party of No in the final health care discussions. The right-wingers have made it clear from the beginning that they refuse to contribute anything positive and are only interested in disruption.

    January 5, 2010 03:01 pm at 3:01 pm |
  12. C Trebout

    How typical of the Democrats to run and hide in rooms where no one else can have any input on the one of the biggest messes this country has ever seen. Hurry up and pass something to make Obama happy because if Obama isn't happy then the rest of us have to suffer. How childish and immature can these people be? We the American people have a right to be represented in this merger of the two versions of this bill but heaven forbid that any one bus a Democrat who supports Obama be allowed to speak in what is supposed to be a country where free speech is encouraged. I am mad and very disappointed with Obama's Democratic Party.

    January 5, 2010 03:02 pm at 3:02 pm |
  13. Truth Teller

    It's about time they left the obstructionists republicans out of this.

    January 5, 2010 03:02 pm at 3:02 pm |
  14. Drew

    It is about time the Democrats see that the Republicans do not want the President to succeed and now is the time for the Democrats to show their strenght and exclude them. Thanks Democrats for being strong for the American people.

    January 5, 2010 03:02 pm at 3:02 pm |
  15. Larry

    Typical. We're going to end up with a bill so watered down that it will be like no reform at all.

    Our government doesn't have the spine to stand up to the insurance lobbyists.

    That's ok, we have the vote. And a lot of them will be leaving office this year and 2012.

    January 5, 2010 03:02 pm at 3:02 pm |
  16. TCM

    yeah, Pelosi, Reid and Obama will exclude, and ignore the GOP and the majority of the country who do not want this overstuffed and fruitless pork project...however, we'll all be invited when it comes time to pay for it! Now, I bet Nancy and Harry will have to make a doctor appt for exhaustion after all this! And just think, they'll be able to continue on with their "premimum," plan because they wouldn't dare subject themselves to anything they're planning for the country! Vote these idiots out of office! You liberals wanted healthcare reform, but you're not going to like what these incompetents have come up with for you! You'll be sorry!

    January 5, 2010 03:03 pm at 3:03 pm |
  17. Ed, Santa Fe, NM

    good for the Dems..... stupid GOP only says no to everything anyway....

    January 5, 2010 03:04 pm at 3:04 pm |
  18. munchmom

    Well, the dems are running scared, or they wouldn't do this. So much for bi-partianship that they claimed they have wanted all along. Liars, all of them. Sneaky too, but then Pelosi, Reid, et al are all sneaky. Hurry up 2012!

    January 5, 2010 03:04 pm at 3:04 pm |
  19. janice brooks

    I believe that the Democrats will be able to put a bill together that will help the American people. There are people dying out here. There are others who need help.

    Mobile Al

    January 5, 2010 03:05 pm at 3:05 pm |
  20. linda

    The obstructionist Party of NO gets shut out – most appropriate for this disgusting party. Thank you Dems

    January 5, 2010 03:05 pm at 3:05 pm |
  21. Tommygunn

    This should have happen back this summer. The GOP wants to take down AMERICA "for their party sake" and "not their ideology".

    The HEALTHCARE debate was battled within the DEMOCRATIC party.

    While the REPUBLICAN party said "NO" and clammered the airwaves with bold misleading sound bites.

    The real HEALTHCARE debate is based on COST, ACCESS, IMPROVEMENT and PRACTICAL APPLICATION. Nothing the REPUBLICANs wanted to address. And something the DEMOCRATs politely viewed with self inflicted differences.

    It is what AMERICA needs HEALTHCARE REFORM!!!!!

    January 5, 2010 03:05 pm at 3:05 pm |
  22. Vote the bums (D) out...

    The Democrats have excluded the Republicans in the first drafts. Instead of working together, Pelosi, Reid and Obama (the hypocrite) have forced a useless piece of unrealistic legislation through. The numbers (costs) are fake, the 'solution' is unsustainable (pay 10 years for 5 years of 'reform'), and still over 15M aren't covered.

    This health insurance bill needs to die and another REAL REFORM bill needs to written. Reforming piece by piece is the best solution. Pick a problem and fix it, then move to the next....

    January 5, 2010 03:06 pm at 3:06 pm |
  23. Alienprophecy

    Thank God Obama has managed to bring us into this new era of Change, where we can have transparency and bipartisanship.

    January 5, 2010 03:06 pm at 3:06 pm |
  24. Jeff from Boston

    Finally, Obama is working with Congress to keep his promises. He promised to put an end to "closed door negotiations". He promised to televise the negotiations on C-SPAN. He promised "bipartisanship".

    Obviously, he's doing a great job of leading....so long as your head is buried in the sand.

    January 5, 2010 03:07 pm at 3:07 pm |
  25. T'SAH from Virginia

    That's right – KICK 'EM TO THE CURB because all they know how to talk is TRASH!!!!

    And PLEASE – include the PUBLIC OPTION!!!!

    January 5, 2010 03:07 pm at 3:07 pm |
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