House Democrats continue courting, counting votes for 'robust' public option

The New York Times reports that Speaker Nancy Pelosi is scheduled to discuss the public option and health costs with other Democratic leaders. "Ms. Pelosi has been working hard to build support for the most liberal version of a government-run insurance plan, the so-called robust public option, which would generally tie payments to doctors, hospitals and other health care providers to Medicare rates. But so far Ms. Pelosi has been coming up short." Aides say she may have to settle for a more moderate alternative that would require government to negotiate payment rates (Herszenhorn, 10/26).

Roll Call reports that liberal Democrats are warning that they won't vote for a bill that doesn't embrace "a strong public insurance option." This part of the party caucus says "a reform plan with rates tied to Medicare instead of higher rates negotiated between the government and health care providers would save taxpayers $85 billion and would insure the most people" (Dennis, 10/27).

Republicans, in the meantime, are waiting for their leaders to act on health reform, The Hill reports. "According to several GOP lawmakers, the leadership is split over how to proceed in terms of unveiling an alternative to the final Democratic bill that Speaker Nancy Pelosi (D-Calif.) intends to unveil as soon as this week. ... Adding to the frustration is the fact that GOP leaders promised in June that they would introduce a leadership-endorsed measure." GOP aides say it makes little sense for their party to introduce a plan before Democrats have finalized theirs (Hooper, 10/27).

House consideration of other health issues also received media attention:

The Associated Press: "House health care legislation expected within days is likely to include a new long-term care insurance program to help seniors and disabled people stay out of nursing homes, senior Democrats say. The voluntary program would begin to close a gap in the social safety net overlooked in the broader health care debate, but it must overcome objections from insurance companies that sell long-term care coverage and from fiscal conservatives."

The proposal, called the Community Living Assistance Services and Supports Act, or CLASS Act, has the support of President Barack Obama. "In return for modest monthly premiums while they are working, people would receive a cash benefit of at least $50 a day if they become disabled. The money could be used to pay a home care attendant, purchase equipment and supplies, make home improvements such as adding bathroom railings, or defray the costs of nursing home care" (Alonso-Zaldivar, 10/27).

The Wall Street Journal: "House lawmakers will propose a $20 billion fee on medical device makers, while Senate leaders have whittled down their plans to tax the industry to pay for the health overhaul." The House version will be an excise tax on the device where it is sold. It would create $20 billion in revenue between 2013 and 2019. All retail products would be exempt from the plan in the House (Vaughan and Adamy, 10/26).

The Chronicle of Philanthropy: Representatives also are urging House Democratic leaders to include some nonprofit aid in the health reform bill. A letter from 40 members requests help for charities that provide health insurance to their employees, similar to the proposed relief for small for-profit employers who offer insurance (Perry, 10/26).