House health-care bill unveiled with fanfare

WASHINGTON — Democratic leaders Thursday invoked the spirit of generations of party heroes to rally their members of the House of Representatives behind a new health-care plan — but it's clear that winning a majority will be a tough fight.

House Speaker Nancy Pelosi, D-Calif., unveiled a 1,990-page bill at an elaborate ceremony on the west front of the Capitol.

However, it was telling that of the 100-odd lawmakers surrounding Pelosi, few if any belonged to the conservative, 52-member Blue Dog Democratic coalition. They'll be crucial to her bill's success.

Still, House Democratic Caucus Chairman John Larson, D-Conn., said flatly: "We've got 218," the number of votes needed for passage. The House, which has 256 Democrats, 177 Republicans and two vacancies, is expected to debate the bill next week. No Republicans are expected to support the bill.

Many Blue Dogs aren't yet ready to join their party's liberal leaders.

"The plan on the table has some good points and some bad points. I want to look at it," said Rep. Lincoln Davis, D-Tenn.

Blue Dogs wanted to hear from constituents, many of whom are more conservative than those represented by most Democrats.

"I have both sides of the health-care debate well-represented in my district," said Rep. Allen Boyd, D-Fla.

Blue Dogs and some party moderates have been concerned about the plan's cost, as well as its impact on small business and expansion of government. Those concerns remain.

Davis, of Tennessee, said a key concern is that "small business is struggling with this constantly," and he has to be convinced that a new plan would create a system where small employers are treated fairly.

Rep. Gene Taylor, D-Miss., retains questions about its fiscal impact, saying, "We cannot add an expensive new subsidized health-care program on top of the huge current debt that is $11 trillion and growing rapidly."

At least one major Blue Dog concession was met: The bill would allow the government to negotiate the public plan's reimbursement rates with doctors, hospitals and other health-care providers, instead of tying those fees to Medicare's rates.

"That was the critical element, and it's been successfully resolved," said Rep. Earl Pomeroy, D-N.D. He said that physicians and hospitals in his state say they aren't properly reimbursed by Medicare. He said he could now support the bill.

House Democratic leaders still face other disputes among some of their members, notably over abortion and immigration.

Staunch anti-abortion Democrats want explicit language barring any new sources of federal funding for abortion except in cases of rape, incest or when a woman's life is in danger.

An analysis of the House bill released late Thursday by the nonpartisan Congressional Budget Office estimated that just 6 million people would choose a public plan, making it a relatively small player, despite the issue's outsize role in the health-care debate.

The House bill would require most individuals to purchase insurance and would require employers to provide health coverage to their workers or face a penalty, although firms with payrolls below $500,000 annually would be exempt.

House Minority Leader John Boehner, R-Ohio, mocked the bill's 1,990 pages as 620 pages longer than President Clinton's failed overhaul plan 15 years ago. The conservative Republican Study Committee warned of "higher taxes, job-killing employer mandates, choice-restricting individual mandates, government-run insurance, budget-busting entitlement expansions, and countless provisions that set Washington bureaucrats firmly between you and your doctor."

The process — born of high stakes and deep divisions — has few parallels in recent congressional history.

"It was unruly," said Rep. Diana DeGette, D-Colo., and vice chairwoman of one of three committees that wrote the bills which were combined into the single bill l released on Thursday.

The tense moments were enhanced by the fact that many knew that their careers could be on the line, especially freshman from competitive districts.

Ben Marter, a spokesman for Rep. Betsy Markey, a freshman Democrat from rural northern and eastern Colorado, said Markey still has strong concerns about the legislation's overall cost and has not yet decided whether she will vote for it.

And in the end, Democrats say their own differences were less weighty than the idea that failing to pass health reform — after a historic election and possessing large congressional majorities — would be a disaster for their party far greater than the attacks lawmakers endure for approving it.

"This is the biggest bill that we will pass in our lifetimes," DeGette said. "Not having a bill was really not an option."

Material from

The Washington Post

and Denver Post is included

in this report.