Rep. Baird remains undecided before health-care vote

WASHINGTON — Nearly to the end, Rep. Brian Baird stayed determinedly indecisive.

When the U.S. House takes a historic roll call Sunday on a health-care overhaul, the legislation's passage may be more predictable than the Vancouver Democrat's vote.

Baird became the only one of Washington's congressional Democrats to remain undecided on the health-care bill Saturday when fellow fence-sitter Adam Smith, of Tacoma, climbed into the "yea" column.

Baird stayed noncommittal even after Rep. Jay Inslee, D-Bainbridge Island, helped to broker a deal in the wee hours of Saturday that would boost Medicare reimbursement rates for hospitals in Washington and other states.

And Baird held out even after House Democratic leaders — confident they'll get the needed 216 votes — dropped a proposed maneuver that would have shielded reluctant or vulnerable Democrats and instead said they would hold a direct vote.

Baird also was the only Washington Democrat to vote against the original House health-overhaul bill in November. In advance of Sunday's vote, Baird has sought feedback from Smith, Inslee and a handful of other House colleagues.

Smith said the new bill, which is based on a version the Senate passed on Christmas Eve, wasn't perfect. But he said it was the best shot at covering millions of uninsured people now.

"The fact that reform is controversial should not be a reason to avoid it. Supporting change now demonstrates leadership," Smith said.

Smith noted the bill more than pays for itself and is expected to reduce the deficit long-term.

As the countdown rolled toward Sunday's vote, House Democrats scrambled to hash out last-minute amendments. In negotiations that lasted until 3 a.m. Saturday, Inslee and several members of the House's Quality Care Coalition got the Obama administration's pledge to start paying Medicare providers for quality of outcome, not simply for services rendered.

Inslee said the current Medicare reimbursement system shortchanges hospitals like Seattle Children's that have invested in reducing medical errors or appointment wait times.

Another amendment would boost payments to hospitals in Washington, Oregon, Iowa, Wisconsin and other states that collect less for each Medicare enrollee than states such as New York or Florida. The agreement makes available $400 million for hospitals around the country with the 25 percent lowest Medicare reimbursement rates.

Kyung Song: 202-662-7455 or ksong@seattletimes.com