House face-off looms over sweeping health bill

House Democrats, who last week touted their health overhaul bill after it passed two of three committees have fight on their hands this week.

Roll Call: "The most serious threat remains from moderates in the Blue Dog Coalition, who, varyingly, want deeper cost cuts, a more limited public option and a fix for regional disparities under Medicare. … But Blue Dogs are planning to make their stand this week in the Energy and Commerce Committee." The Blue Dogs, with the backing of another Democrat on the committee, helped pass a Republican amendment, a blow to Energy and Commerce Committee Chairman Rep. Henry Waxman, D-Calif., on the House bill, Roll Call reports.

Other Democrats also are expressing concern. "Led by Rep. Jared Polis (Colo.), 22 Democrats, mostly freshmen, on Friday sent Pelosi a letter expressing strong objections to the surcharge tax on the wealthy that would raise $544 billion to pay for expanded coverage. The freshmen, who huddled with Pelosi twice last week, argued that the tax increase would hurt small businesses. They made the case for a smaller tax - and the need to cut spending - directly to President Barack Obama and Chief of Staff Rahm Emanuel in a meeting at the White House on Friday" (Newmyer, 7/20).

The Wall Street Journal reports that Democrats like Polis, representing "some of the country's richest congressional districts" are holding up efforts to tax the rich to pay for health reform: "Friday, two freshmen representatives - Dina Titus, from suburban Las Vegas, and … Polis, representing Boulder, Vail and some of the tonier suburbs of Denver - joined Republicans to vote against Mr. Obama's top-priority health-care overhaul when it faced a vote in their House Education and Labor Committee. … Election gains in some of these affluent regions have helped give Democrats big majorities in the House and Senate. Of the 25 richest districts, 14 are represented by Democrats, according to Congressional Quarterly. In 1995, Democrats represented just five of those districts" (Weisman, 7/20).

In the meantime, a fight is underway for the Blue Dogs' votes, CQ Politics reports: "After the vote [on the Republican amendment], Waxman asked the Blue Dogs if they intended the vote as a statement. Waxman said they told him they did not; rather, they simply thought (Oklahoma Rep. John) Sullivan's amendment was meritorious. Still, leaders on both sides got the message: Blue Dogs' votes are up for grabs" (Wayne, 7/19).

Costs are the main reason Blue Dogs are standing in the bill's way, with their leader now expressing his reservations publically, Roll Call reports in a separate story: "Now, Ross has become the rallying point for a massive revolt against the leadership health care plan and may be the biggest obstacle to Speaker Nancy Pelosi's (D-Calif.) oft-stated desire to pass it by the August recess. 'I think the leadership has misread this one,' he said. 'This is not a midnight surprise. We expressed our concerns three months ago'" (Dennis, 7/20).

NPR reports that "Ross said the Blue Dogs' health care task force would need to see more protections for small businesses and rural health care providers before he could sign on" (7/18).

In a separate story, CQ Politics reports that "the health care overhaul bill would produce a deficit of $239 billion over 10 years, according to a new Congressional Budget Office estimate.  The CBO estimate released late Friday pegs the gross cost of the bill (HR 3200) at $1.04 trillion, with the price tag partially offset by a surtax on the wealthy and other revenue raisers that would raise $583 billion and anticipated efficiencies that would squeeze $219 billion out of Medicare and Medicaid. The analysis also shows that many of the provisions would have no net impact on the deficit, which could severely complicate any effort to consider the legislation through filibuster-proof fast-track "reconciliation" rules in the Senate.

The chairmen of the House committees responsible for health care say the figure should show their plan to be deficit neutral: "The reason: the bill's $245 billion 'fix' to Medicare payments to physicians. Without it, they said, the rest of the bill would produce a $6 billion surplus over 10 years" (Allen and Clark, 7/18).

House Speaker Nancy Pelosi is trying to rally Democrats to get behind the reform bill, The Los Angeles Times reports: "'I'd like to wring more money out of the system... but to the extent that this must be paid for, there has to be a revenue stream. The alternative that had been put forward was taxing [health] benefits. That's a tax on the middle class,' (Pelosi said.) 'What we are saying is, let's leapfrog over the middle class to the wealthiest people in our country. They've had it pretty good the last eight years in terms of tax policy under President Bush. And we think that's a place you can go'" (Levey, 7/18).

Rep. Charlie Rangel, D-N.Y., has also said higher taxes are needed to make reform work, CQ Politics reports in a third story: "Providing broader health coverage through a government-run program simply cannot be done without higher taxes of some kind, House Ways and Means Chairman Charles B. Rangel , D-N.Y., said on the CBS program Face the Nation. 'I don't see the executive branch being able to set the course if they can't raise the taxes,' said Rangel, who heads one of the committees responsible for writing the health bill in the House" (7/19).

The Washington Post reports: "...on Monday, the hard work will begin for the chairman of the House Energy and Commerce Committee as he labors to advance President Obama's endangered health-reform agenda. If Obama is to succeed, he will need the 5-foot-5 Los Angeles liberal to quell an uprising by conservative Democrats, overcome a budget gap in excess of $240 billion and possibly swallow compromises on pet issues such as biogenerics and a new government-sponsored health program. … 'A health-care bill is, under any circumstance, going to be difficult,' Waxman said in typical understatement. 'If it had been easy, we would have done it a long time ago. But I'm optimistic'" (Connolly, 7/20).