[Apologetics] Steny Hoyer says Obamacare Bill "very difficult to pass" in House; in Senate "no bill 60 Democrats would agree to"

[Art Kelly]

Health overhaul closer than ever - and yet far off

By RICARDO ALONSO-ZALDIVAR, Associated Press Writer 18 mins ago 
 
WASHINGTON - Eight months in office, Barack Obama has now pushed closer
than any other president in generations to creating a basic health care
safety net for working Americans. Yet the fate of legislation delivering
on his goal is far from certain: Republicans are nearly unified in
opposition, Democrats hardly united in support.

Indeed, few if any of the major arguments about the scope and costs of
the historic undertaking are settled as congressional leaders prepare to
take legislation to the floor in the next two weeks.

Democrats on the Senate Finance Committee came together early Friday -
after 2 a.m. - to finish the heavy lifting on a bill designed to appeal
to moderates. Obama hailed it as a milestone and noted, for history,
that overhauling health care has eluded presidents from Harry S. Truman
to Richard Nixon to Bill Clinton.

"We are now closer than ever before to finally passing reform that will
offer security to those who have coverage and affordable insurance to
those who don't," Obama said.

But not yet. And not for sure.

The 10-year, $900 billion bill would remake one-sixth of the U.S.
economy, clearing a path to health insurance for millions who don't have
it now. It would be financed by reducing Medicare and Medicaid payments
to health care providers, and by ordering new taxes and fees that are
already meeting resistance. Insurers would no longer be able to turn
away those in poor health.

Final passage in the Finance Committee, a political bellwether, is all
but assured next week. After that, things really start to get
interesting.

Senate Democratic leaders will begin tugging on Finance Chairman Max
Baucus' hard-won compromise to try to meld it with a liberal-leaning
version passed by the Senate Health, Education, Labor and Pensions
Committee. That second version would allow the government to sell
insurance in competition with private industry, a highly controversial
issue, while the plan from Baucus, D-Mont., would not.

The government-run plan doesn't appear to have the votes to clear the
Senate. In the House, it's the other way around. A bill that doesn't
include a government plan to compete with private insurers won't get off
the floor, Democratic leaders say.

That's not the only fault line.

The House plan taxes the wealthy to pay for subsidies needed to make
health coverage affordable for millions who are now uninsured. The
Senate instead taxes the health care haves - those with expensive
insurance plans.

The House plan - and the Senate health committee bill - would require
employers to offer coverage to their workers or pay a tax penalty. The
Senate Finance bill has no requirement that employers offer coverage,
although it would levy a charge on businesses whose workers end up
getting government subsidies.

If lawmakers manage to work their way through those issues, they still
won't be safely through the political minefield. They'll face
contentious issues including how to deal with coverage for abortions and
how to keep benefits from going to illegal immigrants.

"A lot of people have a lot of non-starters, and they are different
non-starters," said House Majority Leader Steny Hoyer, D-Md. "If you add
up all the non-starters, it makes it very difficult to pass a bill. When
we get an agreement in the House, it will contain things some people
will prefer weren't in there. It will also contain things they want. As
in every major piece of legislation, you have to find a balance."

Increasingly, Obama will have to step in to settle disputes and keep the
bill moving forward. That will please some lawmakers and alienate
others. He can't afford to lose many of his fractious Democrats.

Polls show the public has many concerns and questions about the
legislation. But for now, most Americans seem to want Congress to keep
working.

Republicans are certain that the more people learn, the less they'll
like about the Democrats' approach.

"What we know for sure about this proposal, the core of it will include
half a trillion dollars in Medicare cuts over 10 years and hundreds of
billions of dollars in tax increases on both individuals and
businesses," Senate Republican leader Mitch McConnell of Kentucky told
reporters Friday. 

Senate Majority Leader Harry Reid of Nevada has said he wants meld the
Finance and health committee bills in fairly short order. He could have
a bill on the floor the week after next, with debate expected to last
for weeks. The Democrats have 60 votes in the Senate - 58 from their
party and two independents - and that's the magic number needed to
overcome roadblocks. But as yet there's no bill that 60 Democrats would
agree to. 

In the House, the third week of October is the earliest a bill could
come to the floor, Hoyer said. Leaders are still meeting with
rank-and-file Democrats to work through disagreements. 

On Friday, more than 100 Democrats sent House Speaker Nancy Pelosi,
D-Calif., a letter opposing the tax on high cost insurance in the Senate
Finance plan. They argued the tax would ultimately be paid by
middle-class union members who bargained hard for comprehensive health
plans. 

"The purpose of this letter is to put a big red flag in front of the
White House and the congressional leadership," said Rep. Joe Courtney,
D-Conn., who circulated the letter. "This will be a problem." 

Finance Democrats have felt the pushback already. Baucus accepted an
amendment by Sen. Jay Rockefeller, D-W.Va., that would ease the bite of
the insurance tax on retirees over the age of 55 and for plans that
cover workers in high-risk jobs like coal mining. 

Still, the wrangling obscures considerable agreement on what the health
care system would look like after it's reengineered. Some of the
outlines have emerged: 

* Although government will play a bigger role than it does now, most
people will still be covered by private insurance plans sponsored by
their employers. 

* Medicaid will be expanded to cover more low-income people, including
childless adults for the first time. 

* Self-employed people and those working for a company that doesn't
provide health insurance will be able to buy coverage through new
insurance purchasing pools called exchanges. Government would provide
tax credits for many middle class people. Insurers participating in the
exchanges will have to take all applicants and will be limited in what
they can charge those who are older and sicker. 

* Medicare would adopt a new philosophy geared to better coordinating
care for seniors with chronic illnesses and trying to keep them out of
the hospital. 

Even Democrats who are upset with the Senate Finance bill say they're
optimistic that Congress can get legislation to Obama. 

"There is enough momentum now that I would disagree with the
characterization that it's going to be impossible to meld the two
sides," said Courtney, the Connecticut Democrat trying to derail the
insurance tax. "My hope is it will be by Thanksgiving, and my honest
opinion is closer to Christmas." 

___ 

Associated Press Writers Erica Werner and David Espo contributed to this
report.




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