Pelosi calls House, Senate bills "75 percent compatible"

House Speaker Nancy Pelosi, D-Calif., indicated Thursday that she may be amenable to a Senate compromise that would expand Medicare and allow the federal government to oversee nonprofit national health plans in lieu of the public option, CNN reports. She had previously maintained that inclusion of a public option was necessary in order for a reform measure to gain House approval. "Pelosi ... said she wants to get the Congressional Budget Office analysis of the Senate alternative before judging it, but she opened the door to a final bill without the public option."

Meanwhile, if the Senate does approve its version of health legislation, that bill would have to be merged with the House-passed measure by a conference committee and both chambers "would have to approve the final bill before it could be sent to Obama to be signed into law." About this process, Pelosi said, "the House and Senate bills are 'probably 75 percent compatible.'" She also said "that a final merged bill could win approval from both chambers before Christmas if the Senate completes its work by the end of next week and a conference committee can meet over the weekend of December 19-20" (Bash, 12/10).

"Ms. Pelosi (D., Calif.) stopped short of endorsing the full Senate compromise, saying she needed to see 'something in writing.' But she said 'there is certainly a great deal of appeal' in expanding Medicare," The Wall Street Journal reports. The broad outline of the Senate deal is that some people between 55 and 64 years old would have the opportunity to buy into Medicare, and the government's Office of Personnel Management would negotiate contracts with private, nonprofit insurers to create new, lower-cost health plans (Hitt, 12/11).

Despite Pelosi's receptiveness, The Washington Post reports, "the California Democrat reiterated that she would prefer to create government-sponsored coverage for Americans of all ages, and questions linger in the Senate about the politics and policy of expanding Medicare by allowing people ages 55 to 64 to buy into the federal insurance program for the elderly." One concern is that, depending on the details, the Medicare buy-in could be too expensive to help many would-be customers. Another is that doctors and hospitals object to the prospect of seeing more patients at Medicare's rates, which they say are too low (Goldstein, 12/11). 

Politico reports, "'We would do almost anything if it meant we would pass health care for all Americans (by) the Christmas holidays,' Pelosi told reporters Thursday," although it seems unlikely she would fast-track the legislation by accepting the Senate version in the House. Pelosi also said she wanted a "full conference," in which lawmakers from both houses would negotiate to merge the bills. "Conference negotiations can sometimes take months, but the speaker suggested Thursday that negotiators could wrap up these health care talks over a single weekend if the Senate finishes its bill by the end of next week" (O'Connor, 12/10).