Democrats close to health bill deal as some Democrats - and all Republicans - hold out

Congressional Democrats, reportedly closing in on a final health reform agreement, are seeking to alleviate concerns of reluctant members.

The Associated Press: "It will come down to a phenomenal effort by congressional leaders and the White House to win over skittish lawmakers after a year of incendiary debate … A closed-door meeting in House Speaker Nancy Pelosi's office Wednesday evening moved congressional leaders and administration officials close to agreement on such issues as additional subsidies to help lower-income families purchase health insurance and more aid for states under the Medicaid program for low-income Americans." Pelosi said after the meeting with White House Chief of Staff Rahm Emanuel: "We're going to get started" (Werner, 3/11).

Roll Call: "Sources said the House and Senate Parliamentarians also attended the meeting to advise on reconciliation rules" (Drucker, 3/10).

Politico: "The speaker and her leadership team have their work cut out for them as they approach an Easter deadline to wrap up a year's worth of work on health care reform in the next two-and-a-half weeks. … The speaker will start outlining the finished package to the rest of her rank-and-file in a meeting Thursday morning" (O'Connor and Budoff Brown, 3/10).

Reuters: "The leader of the U.S. House of Representatives -- a persuasive arm twister and deal maker -- faces her toughest challenge yet: getting 216 votes to pass final legislation revamping the U.S. healthcare system. House Speaker Nancy Pelosi, a Democrat, is scrambling to hit that number in coming weeks and will likely have to rely solely on fellow House Democrats, who have 253 of the 431 seats. All 178 Republicans seem lined up against the effort" (Ferraro, 3/10).

CongressDaily: Democrats are waiting for two scores from the Congressional Budget Office before revealing the final measures. "CBO wrote congressional staffers Wednesday telling them to expect a cost estimate on the Senate overhaul bill as it was passed. The assessment will take into account that the bill would be enacted this spring rather than the end of 2009 and incorporates any adopted amendments." The office doesn't expect that score to differ substantially from one it made before the Senate adopted its bill, but lawmakers are also expecting a score on President Obama's proposal" (Edney, 3/11). 

CongressDaily, in a separate story: "House Minority Whip Eric Cantor and Senate Minority Whip Jon Kyl used an unusual joint news conference today to try to undercut Democratic support for healthcare legislation, suggesting the bill will not get through the Senate without changes even if Democrats use reconciliation." The duo promised to hold up a reconciliation bill with amendments and points-of-order contentions (Friedman, 3/10).

The Washington Post: "As they push to finish health-care legislation by the end of the month, Democratic leaders in Congress are weighing whether to add another of President Obama's priorities to the package: a popular proposal to overhaul the federal student loan program." But some senators, including Budget Committee Chairman Kent Conrad said that inclusion of such an overhaul would jeopardize both measures. After two days of meetings, no decision had been reached, though "[o]ne participant said a consensus appeared to be emerging that it would be unwise to risk the health-care bill by including the education measure" (Montgomery and Murray, 3/11).

The Hill: Another provision splitting Democrats: whether immigrants will be allowed to purchase their own coverage in proposed health care insurance exchanges. Hispanic lawmakers will tell President Obama Thursday they will not vote for health reform without such a provision. "The Senate language would prohibit illegal immigrants' buying healthcare coverage from the proposed health exchanges. The House-passed bill isn't as restrictive, but it does — like the Senate bill — bar illegal immigrants from receiving federal subsidies to buy health insurance." The lawmakers say it is better policy to allow immigrants to use their own money to buy insurance because without it, they are likelier to use emergency rooms, where costs are high (Allen, 3/10).

Politico, in a separate story: Obama is pushing Reid to get rid of deals in the health bill that are aimed at attracting individual votes. "The president wants to eliminate more than just Sen. Ben Nelson's 'Cornhusker Kickback' and Sen. Bill Nelson's agreement to shield 800,000 Florida seniors from Medicare Advantage cuts, the White House told Politico Wednesday in response to questions about other deals in the bill. Obama has asked Reid to strike provisions requested by senators from at least five other states, in an unusual move that accentuates the culture clash between the president's rhetoric on changing the ways of Washington and the Senate leader's needs to exercise the old-fashioned tools of Congress to pass laws" (Budoff Brown, 3/10).

Roll Call: Democratic congressional leaders are worrying about "the amount of mischief" that could stem from liberals in their own caucus on the health bill:  "some [Senate] supporters of creating a public insurance option are privately worried that they will be asked to vote against the idea during debate on the bill, which could occur before March 26." Democratic leaders may ask their caucus to oppose all amendments, including one to create the public plan, to avoid scuttling the legislative effort with excessive delays (Pierce and Drucker, 3/11).

The Boston Globe: Other Democrats aren't coming along so easily either: "Democrats are bickering over the policy details of a final package. Many House members are fed up with the Senate, annoyed that the chamber known as the world's Greatest Deliberative Body can't seem to move on hundreds of bills the House has approved, never mind health care" (Milligan, 3/11).