January 5th, 2010
02:29 PM ET
4 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. Dominican mama 4 Obama

    Invitations have been repeatedly issued to the GOP to partake, come to the table of negotiations and ideas, and be a part of the process. They flat out refused. Heck some didn't even RSVP. And all the while they whined and lied about being purposefully excluded. Well, guess what......you're being excluded now! Whine to your hearts content, people are no longer listening.

    January 5, 2010 03:08 pm at 3:08 pm |
  2. nancy

    I am so tired of Congress. Whatever the Republicans like, the Democrats don't, and if the Democrats like something the Republicans don't. The only people whose interest they have at heart are the lobbyist who pay for their reelection campaigns. Where are the Statesmen/Women who care about this country.

    January 5, 2010 03:08 pm at 3:08 pm |
  3. brandy pappas

    Might as well go ahead without the Republicans...they haven't
    brought anything to the table yet, what makes you think they would start now. They just want to do everthing possible to make Obama
    look bad. I hope the American people don't forget what the Republican administration has done to our country. I know I won't.

    January 5, 2010 03:08 pm at 3:08 pm |
  4. Fed Up

    Good. That way you can take the credit, or blame, for everything that happens. There should be NO Republican votes, including Olympia.

    January 5, 2010 03:09 pm at 3:09 pm |
  5. Sam

    Good Move! All that the GO. Pee knows is to stay on the sidelines and say no anyway.

    January 5, 2010 03:09 pm at 3:09 pm |
  6. Chas in Iowa

    If the "public option" is missing they may as well get rid of the manditory partisipation requirements and the tort ceilings. Otherwise it is a bill written for big insurance.

    They let Grassely have his input to stuff the tort reform and manditory requirements into the bill and then he votes against it. By pass the GOP altogether and pass a bill that middle class Americans can live with.

    January 5, 2010 03:09 pm at 3:09 pm |
  7. single mom

    Can anyone confirm or deny that there is a clause that prohibits repealing this by future sessions of Congress?
    Granted I haven't studied the Constitution but I'm pretty sure that kind of thing requires an Amendment.
    I would really appreciate anyone who can clarify that for me.

    Thanks!

    January 5, 2010 03:10 pm at 3:10 pm |
  8. Sheryl

    Keep rolling Dems!!!! Please pass this bill we as AMERICANS want this bill passed, this is a must please do what we the people sent you there to do reform!!!

    January 5, 2010 03:10 pm at 3:10 pm |
  9. Ken in NC

    Republicans have not been a part of the process to this point anyway except to say "NO" so this is not news.

    January 5, 2010 03:12 pm at 3:12 pm |
  10. big papa

    As well they should...

    ...the GOP is full of traitors...

    ...many in our government...

    January 5, 2010 03:12 pm at 3:12 pm |
  11. Future expat

    GOPers, whose contributions to the health care debate so far include loud yelling about "death panels" and banners depicting the Holocaust, will now complain that the government isn't listening to them.

    They simply do not have the mental capacity to understand that their own behavior is the reason now must be excluded if anything is to get done.

    January 5, 2010 03:13 pm at 3:13 pm |
  12. Big Ed

    From what I can see, the Republicans have not offered any reasonable alternative plan and they have offer no constructive ideas. They send out memos on how to obstruct, (as if they need any directions in doing that) and try to scare people half to death (see the bogus "Death Panels"). If they don't want to make a constructive contribution to what the American people want, then yes; exclude them!

    January 5, 2010 03:13 pm at 3:13 pm |
  13. vwrtb

    Please give me the house version!

    January 5, 2010 03:13 pm at 3:13 pm |
  14. Steve-Illinois

    This bill is a joke! First you have to bribe your own party members to get the votes. Then you must ignore protocol to get the two bills merged. For the sole purpose of an Obama, Pelosi, Reid, backslapping convention at the state of the union address. What you really have to appreciate, is, after months, and months, of these leaders blasting the evils of the insurance industry, they are going to pass a bill that not only does not control costs, but also hands these same insurance companies 15 million new customers that will be required by law to purchase their products!!! And, even though you will not be denied coverage for pre-existing conditions, the bill allows older people to be charged higher prices. Who gets to decide what age group "older" falls into?
    You sheeple have been had!!!
    One thing you won't find in this bill- COMMON SENSE!

    January 5, 2010 03:14 pm at 3:14 pm |
  15. phoenix86

    There you have it. The founding fathers warned of a dictatorship of the majority. Pelosi, Obama and Reid have shown it for what it truely is. Welcome to American totalitarianism.

    January 5, 2010 03:15 pm at 3:15 pm |
  16. Clara Smith

    The sooner the health carebill is passed into law the better it is for the nation. The Republican Senetors who all enjoy Govt. Health care are opposing Govt. Involvement. Is it not true hipocracy? This can only happen in America, which is the dumbest country in the world. The top 1 or 2% of Americans have been brainwashing the rest of the American sheep. It is time to shed our ignorance and make informed and intelligent decisions, which are good for our people. The whole world is laughing at us and we have burried our heads in the sand so long that we just continue to call them all jealous people. Tell me what is left in our nation for others to be jealous of, except the fact that we rose above our prejudices and elected President Obama. The light is still flickering. Please don't let it go off.

    January 5, 2010 03:15 pm at 3:15 pm |
  17. El Kababa

    There is no reason to include any member who did not vote for the bill. Republicans have nothing to offer and no strategy except failure. If they could, they would amend the bill so that it does not work.

    Conservatives would rather rule a bankrupt country than help govern a prosperous one. America's Conservative leadership believes that the Game of Life divides the winners from the losers. Conservatives have no interest in the Loser Classes (what you and I call the middle and lower classes).

    This is not class warfare exactly. After all, the dairy farmer does not make war on his herd. He does, however, butcher the non-producers. Also, if a cow is so unhealthy that it costs more to treat her than she's worth, they let her die.

    January 5, 2010 03:15 pm at 3:15 pm |
  18. Just a Mom

    They've been excluded durring the rest of the process, so why not exclude them durring the final diliberations?
    So much for reaching across the isle. So much for being so transparent that they will show the diliberations on C-Span!
    What exactly have they done that they said they would do durring the campaign?
    Sneeky, Slimy pond scum! Botttom Feeders! Every one of them! But what would you expect from a bunch of Ambulance chasing lawyers!

    January 5, 2010 03:16 pm at 3:16 pm |
  19. Nate

    Republican or Democrat, this is wrong.

    January 5, 2010 03:17 pm at 3:17 pm |
  20. Jim Andrews

    According to all the polls, even from CNN, the majority of Americans are opposed to the health care legislation being considered in Congress. Now, the Democrats are apparently meaning to deny the Republicans any voice whatever in the final work to combine the House and Senate versions. Doesn't that constitute "taxation without representation?" Isn't that what led to the American Revolution?

    January 5, 2010 03:18 pm at 3:18 pm |
  21. Sniffit

    Awwww, poor babies...here GOP, have a tissue...we all know you were depending on the Dems never growing a pair and using YOUR OWN tactics against you.

    January 5, 2010 03:19 pm at 3:19 pm |
  22. Jim

    At this point, unfortunately, the GOP adds nothing to the negotiations. They want to kill the bill, that's it...nothing else.

    January 5, 2010 03:20 pm at 3:20 pm |
  23. J. Rochester, NY

    Fine with me as long as they include a Medicare Buy in or a public option. Without one of those 2 items this is nothing more than the government forcing people to buy insurance, just funneling more money into the pockets of Insurance companies, which I thought the was GOP's job.

    January 5, 2010 03:23 pm at 3:23 pm |
  24. Party Purity will never bring Political Power!

    Good! Keep the Party of NO on a short leash!

    After all, what other than trying to STOP legislation, ANY legislation, have they contributed? Nothing.

    Cons walk out of committee meetings, even though they are PAID to be there, they bad mouth President during a time of war and state publicly the party agenda is for the President to fail and the head of the RNC states "bi-partisanship is overrated".

    Keep the republiklans out of the conference, after all, it was the shrub and republiklans that stated proudly "we do not negotiate with terrorists"!

    Let that apply to "domestic terrorists" of the "christian cabal " as well.

    January 5, 2010 03:24 pm at 3:24 pm |
  25. obama the liar

    two of the biggest losers in D.C....not counting bama

    January 5, 2010 03:25 pm at 3:25 pm |
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