House Democratic caucus considers larger Medicaid expansion, public option

House Democrats emerged from a caucus meeting Wednesday without a clear sense of how they will tackle the remaining problem of a public option, but may push a larger Medicaid expansion than initially proposed.

Roll Call: "Democrats discussed at least three approaches to the (public option) provision, according to Rep. Bart Stupak (D-Mich.): Pegging reimbursement rates in the program to those in Medicare, allowing the federal government to negotiate rates with health care providers and authorizing the provision only as a fallback option." Some moderates oppose tying the plan's rates to Medicare and say the public option has no Senate backing (Newmyer, 10/7).

CQ Politics reports that the Congressional Budget Office is saying it's cheaper to cover people in Medicaid than to provide people with subsidies to buy health insurance. House members have pegged that as reason to perhaps enlarge the proposed Medicaid expansion in the House health care reform bill to people earning up to 150 percent of poverty. "Right now the House version of the legislation would cover people earning up to 133 percent of the poverty level, or about $29,000 for a family of four." This proposal is controversial. "The program pays doctors and other health providers such low rates that many of them refuse to accept patients covered by the program." House Democratic leaders hope to formulate a combination of policies "that will draw the support of most of their caucus" and allow them to pass a health overhaul soon (10/7).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.