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. Nevada dude

    Fine with me– if those stupid obstructionist Rethugs dont want to do their jobs then Democrats will demonstrate to the country that we dont need the GOP to get America's business done.

    Next election we can vote in people who actually want to make a difference.

    January 5, 2010 03:39 pm at 3:39 pm |
  2. chubby

    This is not new. The demorats have voted down every amendment submitted by Republicans to try and improve the health care bill even to the extent that some amendments would make it cheaper to the public. What happended to nobama saying the health care negotiations would be live on c span for everyone to watch. No, he wants a strictly demorat bill but it will cost the demorats in 2010 and 2012.

    January 5, 2010 03:39 pm at 3:39 pm |
  3. Jim

    Yup, there is tyranny in action...

    Jim

    January 5, 2010 03:39 pm at 3:39 pm |
  4. Chris - Denver

    The Republicans have ceded any right to participate in the reconciliation process by failing to negotiate in good faith during any prior stage of this legislative process. We all now know that the Republicans would not use a seat at the negotiating table to do anything constructive to improve the bill, but would impetuously delay, stall, and whine in a vain attempt to stall progress. It's a shame, really. We probably could use some input on this issue from moderate, thoughtful Republicans– if such a beast still existed.

    January 5, 2010 03:40 pm at 3:40 pm |
  5. Tom Bachman

    This sounds like Stalinist Russia. Rubber stamp the mess, who cares about the voters. They'll regret doing it in November.

    January 5, 2010 03:40 pm at 3:40 pm |
  6. John G

    Sounds about right. Transparent bipartisanship from our illustrious leaders in Washington.

    Rule #1:

    If you have to use cheap political ploys to get legislation passed, it probably isn't good legislation.

    Rule #2:

    You weren't elected to decide things for your constituents, you were elected to REPRESENT your constituents. Please stop treating Congress like it's the "Neener neener neener! I can do anything I want" club.

    January 5, 2010 03:40 pm at 3:40 pm |
  7. steve

    They should have done this much earlier. The GOP is absolutely useless does nothing but complain and work for the rich. They never help the common citizen unless it helps them first! Not that the Dems are perfect but they have a heart!

    January 5, 2010 03:40 pm at 3:40 pm |
  8. Susan

    Good for the Democrats. I think they have finally found their spines.

    The republicans have made it perfectly clear that they don't want change ... period. They are hell bent on promoting failure, which is sickening. If they really cared about the health & welfare of the citizens of this country, they would have done something (anything) when they controlled all 3 branches of the government.

    January 5, 2010 03:41 pm at 3:41 pm |
  9. demmie2

    dirty move by obama. so much for transparency and bipartisanship, eh?

    January 5, 2010 03:41 pm at 3:41 pm |
  10. Nick

    Republicans are set to stone-wall ANYTHING the Democrats are proposing despite good efforts at reaching across the aisle.

    Republicans are like mindless frat boys obsessed by partisan divide, no matter how good Dems are, there's always the knee-jerk reaction and a bit of freedom-whining.

    January 5, 2010 03:41 pm at 3:41 pm |
  11. ATL Guy

    Well, since the Republicans have publicly stated that their single goal is to kill the bill and not make sure that their constituents benefit from the legislation, then I don't see what the problem of shutting them out of the negotiations is. They are not going to participate so don't invite them. Simple enough.

    January 5, 2010 03:42 pm at 3:42 pm |
  12. landscapebear

    i hope when the "entire" caucus meets, that traitor Lieberman is not there, he should be excluded entirely from this whole process

    January 5, 2010 03:42 pm at 3:42 pm |
  13. don

    at least the democrats are getting things done,what do the gop do? just criticize without solutions.only lunatics vote for politician who do nothing but criticize.

    January 5, 2010 03:42 pm at 3:42 pm |
  14. RobK

    Frankly, I hope the Dems do this and the health care plan passes with no Republican support. Then they will own it, lock, stock and barrel. And when it proves the colossal disaster that it will be, the Dems will be lucky to have 20% representation in Congress and conservatives will hold the White House for the next 20 years.

    January 5, 2010 03:45 pm at 3:45 pm |
  15. Patience

    It is about time those spinless Democrats kicked those wing nut "No" weazels to the curb. They have nothing constructive to contribute and are only there to obstruct and bring down anything the popular President trys to accomplish.
    Oh yes public option will be a must or no support from me for the Democrats

    January 5, 2010 03:45 pm at 3:45 pm |
  16. Dex, Houston TX

    Way to go Democratic Party....The Republicans have made it perfectly clear for the past year that they have no intentions of supporting anything under President Obama. This president could find the cure for cancer and the Republicans would create another disease and blame the president for it....

    I've never hated anyone in my life, but the Republicans are wrong for America. They could careless about the American people they only care about ideologies....

    January 5, 2010 03:45 pm at 3:45 pm |
  17. racoco

    And not a single solitary reference on CNN about C-SPAN trying to open up the process for the American people. CNN apparenlty has chosen sides in the Democrat Party seizure of the healthcare system.

    January 5, 2010 03:45 pm at 3:45 pm |
  18. j russ

    "exclude their GOP counterparts during final congressional health care deliberations"
    transparency
    I will never vote for another democrat

    January 5, 2010 03:47 pm at 3:47 pm |
  19. Jiminez

    It's all politics. I can't say I am happy with Obama; he promised atleast trying to be bi-partisan, it looks like he and the congress have already given up.

    January 5, 2010 03:48 pm at 3:48 pm |
  20. cecilia lewis

    Good – now maybe they can pass a quality health care bill.
    and please dont think the republican opinions have not been heard, we heard you when you shouted all the obscenities about the President and health care reform.
    we just dont care anymore. even 8 years will not be enough to undo the damage that was done in the past Administration.
    if you see Cheney will you please ask him to shut up – he is removing all doubt that he is, in fact, a fool

    January 5, 2010 03:48 pm at 3:48 pm |
  21. Eyckie

    Good! Repubs have nothing to offer and they just don't want it. More than 60% of Americans do want and need health care. Shove it through with reconciliation.

    It's great that the GOP says NO to everything. Especially when it's for the American people. Shows 'the people' how little the GOP cares about anyone but themselves.

    You go Mr. Obama. Give the people what they want!

    January 5, 2010 03:49 pm at 3:49 pm |
  22. Greg Pottstown PA

    How do you liberals think Obama is doing on ending partisan politics?

    Why is it that democrats are always trying to do things in back rooms with the lights off?

    January 5, 2010 03:49 pm at 3:49 pm |
  23. Joe in CT - not Lieberman!!!

    Considering the GOP locked the Democrats out of final deliberations for pretty much every bill that was proposed between 1994 and 2006, I would say this is pretty much payback. Unless the Republicans are willing to offer positive suggestions they should sit back and shut up. Also, Harry Reid has the option of using a procedural measure to bring the bill up that will not require a cloture vote and can just require a simple majority to pass the final measure. Take that, Party of NO!

    January 5, 2010 03:50 pm at 3:50 pm |
  24. Beyond Absurd

    The Democratic leadership had better get its spokespeople out to make it clear that the Republicans have excluded themselves from the legislative process on this issue, by taking the position that health care reform is unacceptable, in any form. Do not let the Fox demagogues twist this to look like the Democrats are a run away Congress. Make it clear that the GOP has never in good faith worked to get a bill through Congress and that they have tried to make this a political power struggle instead of trying to deal with a pressing problem facing this country. Country before party. Country before ideology.

    January 5, 2010 03:50 pm at 3:50 pm |
  25. Obama Victim

    ah yes....transparency

    January 5, 2010 03:50 pm at 3:50 pm |
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