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. u2canfail

    Well thank goodness! If they will not contribute, shut them out.

    January 5, 2010 03:25 pm at 3:25 pm |
  2. Rickster

    This is good news for the republicans. This bill is radioactive and the republicans need to stay as far away from it as possible because it is such an awful assemblage of lies, bribes and pay-offs. On the bright side, this bill is the death knell of Barry Obama and the democrats reign of terror.

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

    I love this, a 2000 page bill condenced down to one long sentance by CNN. Of course what we all just read sounds great,but where's all the pork at in this pig of a bill?

    CNN your helping to screw America by not telling the whole truth, I wonder whom in the White House is telling you what to say and when to say it?

    I guess that we are all going to read this and thank you for your hard work and beleive evrything that you tell us, just like your beloved Odumbo that pays you a lot of money for advertising, why would you turn against him, MO MONEY IN 2012 is a coming.

    Yup, just like Chicago politics, money is everthing isn't it.

    January 5, 2010 03:25 pm at 3:25 pm |
  4. Adam

    What would it matter if the GOP were there anyway? They just say NO to anything regardless of what it is....This just makes it a much more efficient process.

    January 5, 2010 03:26 pm at 3:26 pm |
  5. crooksALL

    And C-Span , And the American people.

    January 5, 2010 03:26 pm at 3:26 pm |
  6. Laura

    The Republicans have made it abundantly clear they're not going to support any bill under any circumstances. Why should they be included in the final negotiations?

    January 5, 2010 03:27 pm at 3:27 pm |
  7. Proud Democrat

    This Democrat who was previously disappointed with the Democratic party is now DISGUSTED.

    This continued effort to push a health care bill that the majority of AMERICANS DO NOT want, is only going to ensure that Democrats lose their seats in 2010 and 2012.

    Are their egos so big that they do not see us or hear us. They choose to pretend it is only the republicans who are against the bill and they are wrong and will end up suffering for it at the polls.

    January 5, 2010 03:28 pm at 3:28 pm |
  8. matt

    Is it true C-Span wants to cover these talks but cannot? If so, I hope they change their mind. Let us see. It'll be fine. Let us see.

    January 5, 2010 03:29 pm at 3:29 pm |
  9. tjaman

    We've already heard everything they've got to say: Tort reform! Vouchers (that aren't enough)! A call for tax cuts! There's the endless parliamentary delay tactics, of course, and then there's the always reliable No! No! No!

    Never mind health insurance reform, lock these tantrum-tossing tosspots out of D.C. 😛

    January 5, 2010 03:29 pm at 3:29 pm |
  10. Jay

    Good. The Republicans have become nothing but crazy obstructionists.

    January 5, 2010 03:30 pm at 3:30 pm |
  11. Pat F

    This is almost as shocking as Obambi's announcement, a week after everyone else knew it, that al Queda had directed the Christmas bomber.

    This is news to no one but CNN. Democracy has no Democratic supporters.

    January 5, 2010 03:30 pm at 3:30 pm |
  12. Michael Shea

    I,like many others worked our rears for Barack Obama and Dwemocrat members of congress because all along the campaign trail there was talk of "CHANGE".

    President Obama and many Democrats in congress have back pedaled on the public option. Until we get corproate money out of politics, we the people are doomed no matter what the issue is.

    Years ago I went to a health care forum and one of the speakers said that only countries that have "SINGLE-PAYER" helath care have strong labor or socialist parties. Both our major political parties are corporate driven.

    I have been a "SINGLE PAYER " RECIPIENT SINCE 1971 through the VA healthcare system. The doctors, nurse and staff have all been top notch and show real concern for my health.

    It's time for America to wake up and do the right thing !!!

    January 5, 2010 03:30 pm at 3:30 pm |
  13. Brook E. Mantia

    Good! I hope the Democrats use every weapon in their arsenal to battle that most dreaded enemy of America: Republicans!

    January 5, 2010 03:31 pm at 3:31 pm |
  14. Joe

    So basically what the democrats are saying is they don't care what you want, or think about the healthcare plan if you are represented by a republican. That doesn't sound like a fair and democratic system of government to me.

    January 5, 2010 03:31 pm at 3:31 pm |
  15. Libertarian

    While I think it's good to have consensus, I must agree with the decision to push on alone sometimes. " We the People" elect these officials to go to Washington and represent us and majority rules. THAT is democracy. Plain and simple. If the Republicans want to play politics to try and look good (and not do what is right) for elections then they will remain the minority. Whine as they may about not being included, that's Democracy. If we don't like the decision our ELECTED majority make...vote them out. Don't whine that you one little voice isn't being heard though....majority rules....you're just not in it.

    January 5, 2010 03:32 pm at 3:32 pm |
  16. thanks, but no thanks

    and CNN why is this news? None of Republicans voted for the bill, so why should they participate in conversation. Their motto has been prevent anything productive that this congress is trying to achieve. Remember the disgrace South Carolinian representative who suggested that health reform is going to be presidents downfall. Yep, he is right, it is going to be Republicans downfall in 2010 election. What a bunch of whinnies.....

    January 5, 2010 03:32 pm at 3:32 pm |
  17. babaganusch

    That must be the "change in Washington politics" the Democrats were talking about in the last election. They've decided to do away with our representative form of government, and completely disenfranchise anyone not belonging to their ideology, which happens to be close to half the country.

    January 5, 2010 03:32 pm at 3:32 pm |
  18. terry,va

    The Repubs have been excluded from the beginning. The Dems will own this disaster and will pay for it by losing their jobs. The American people are the real losers, however. It's too bad that the only thing that happens to these idiots is that they lose their job. Most should be jailed for being crooks. The rest are just stupid. I guess you can't jail people for being stupid or we wouldn't have enough jail space.

    January 5, 2010 03:33 pm at 3:33 pm |
  19. Peter s

    Why should you include them ? and they will just come and antagonize the whole process and at the end of the day they will vote NO!!!

    January 5, 2010 03:34 pm at 3:34 pm |
  20. Lisa P

    Based on their rhetoric and actions throughout the debate leading up to the House and Senate bills I'm sure the Republicans wouldn't have it any other way. Exclude 'em - if nothing else it will give them something different to whine about.

    January 5, 2010 03:34 pm at 3:34 pm |
  21. leet

    Isn't it great to have the party of change in control?

    January 5, 2010 03:35 pm at 3:35 pm |
  22. Joe

    Well, it's about time the Democrats wise up and realize that kissing Republican butts is getting them no where. As it is, I think they have been too patient for too long with the whining, cheap shots, and outright obstruction they've gotten from the GOP. If the "Party of No" is displeased at being marginalized, they have no one to blame but themselves.

    January 5, 2010 03:36 pm at 3:36 pm |
  23. Enough

    Great, the Democrats are 100% responsible for shoving this lousy health care bill down our throats and we will respond by voting them all out of office. We don't want this and they don't care. We want real health care reform, their mess will do NOTHING to control rising health insurance premiums. Stop the bankrupting of America, vote out ALL Democrats.

    January 5, 2010 03:36 pm at 3:36 pm |
  24. LacrosseMom

    Well, why not? The GOP have been stubbornly obstructing all year long. They do not want healthcare for Americans, so why not exclude them?

    President Obama tired over and over to reach out to the GOP, only to have them spit on him.

    January 5, 2010 03:37 pm at 3:37 pm |
  25. Bethie in TX

    The GOP excluded themselves near the beginning of this process. Now that the fine details of the bill that Democrats have put together are being hammered out, Republicans want to have their voices heard? Too little, too late. Next time, try to participate instead of going in the corner and crying.

    January 5, 2010 03:37 pm at 3:37 pm |
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