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House Democrats Shrink from Comprehensive Health Care Bill

By Alex Wayne and Edward Epstein, CQ Staff

January 21, 2010 -- House Speaker Nancy Pelosi said Thursday that there aren't enough votes in the House to send President Obama the Senate-passed health care bill, as rank-and-file Democrats shied away from efforts to clear a comprehensive package.

Pelosi told reporters that she will move slowly in deciding how to proceed now that Democrats have lost their filibuster-proof 60-vote Senate majority.

"I don't see the votes for it at this time," the Speaker said regarding the Senate bill (HR 3590). "Our members have been very clear."

Tuesday's election in Massachusetts, in which Republican state Sen. Scott P. Brown upset Democratic state Attorney General Martha Coakley to fill the seat of the late Democrat Edward M. Kennedy has left Democrats demoralized and appears to have doomed their year-long effort to send Obama a sweeping overhaul of the U.S. health care system.

Pelosi stressed that she still wants the House to move a health care bill that would assure affordable coverage for the middle class, accountability for private insurance companies and steps toward reducing the federal deficit.

"We have to get a bill passed. That is the predicate we all subscribe to,' she added.

Pelosi has been huddling with members of the House's various Democratic factions to gauge their sentiment about how to proceed with health care legislation.

Some Democrats wanted the House to send Obama the bill (HR 3590) that the Senate passed on a party-line 60–39 vote on Christmas Eve, and perhaps accompany it with separate legislation making changes to the legislation that House-Senate leaders have negotiated since then.

The corrections bill, for example, could be used to scale back a tax on high-cost insurance plans included in the Senate bill and change provisions of the bill that would give some states more generous reimbursement than others for a Medicaid expansion.

But numerous House Democrats have objected to that plan, Pelosi said.

"Without changes I don't think it is possible to pass the Senate bill in the House," she added.

"I just don't see it as a viable option," said Rep. Joe Courtney, D-Conn.

Several members said Democrats do not trust that the Senate would actually pass the accompanying corrections bill.

"To trust we can fix it incrementally, reversing the process, I think gives people pause," Rep. Earl Blumenauer, D-Ore., said.

Pelosi said that she will continue to weigh options for advancing some type of health care legislation this year.

"We're not in a big rush. We will pause to consider the possibilities," she said.

Shattered Confidence
It was clear, whatever Pelosi said, that House Democrats are running scared after the Massachusetts election, and many have little appetite to continue pressing an expensive, comprehensive health care bill.

At a morning meeting of their caucus, not a single Democrat spoke in favor of passing the Senate bill, said Rep. José Serrano, D-N.Y., who attended. Instead, Serrano and others said, there was much conversation among Democratic rank-and-file about passing only the most politically popular pieces of the health overhaul as discrete legislation.

Such a strategy would almost certainly guarantee that near-universal insurance coverage, Obama's and other Democrats' ultimate health policy goal, will not be accomplished in this Congress.

"The sense is we shouldn't drop the subject," Serrano said. "But maybe we need to work on some pieces of it."

Blumenauer, said that there is "great interest" in passing elements of the health care bill "in bite-size pieces." Specifically, he mentioned a provision from the House's bill (HR 3962) that would mostly repeal health insurers' exemption from federal antitrust law. Many Democrats believe that would lead to greater competition in insurance markets, but insurers say it would have relatively little effect on their business. It is unlikely that the proposal, by itself, would significantly expand insurance coverage or reduce its cost.

The retreat from a broader health overhaul began Wednesday with Obama, who said in an interview with ABC News that Democrats should focus on only the "core elements" of the proposal. The White House's communications director, Dan Pfeiffer, later seemed to try to walk back Obama's remarks on the administration's official blog.

"Right now there are a lot of discussions going on about the best path forward," he said. "But let's be clear that the President's preference is to pass a bill that meets the principles he laid out months ago: more stability and security for those who have insurance, affordable coverage options for those who don't, and lower costs for families, businesses, and governments."

Across the Capitol, Senate Budget Chairman Kent Conrad, D-N.D., said Pelosi's comments left the health care effort "in limbo," but added that he thought it was still possible to path some sort of legislation this year;.

When asked how, Conrad responded, "Well, that would require a lot of thought."

One option, Conrad said, would be "a more incremental approach."

"I think almost everyone would acknowledge that there are things that have to be addressed—exploding cost, the insurance abuses that are occurring in the system—so I personally believe a package could be put together, even one that would have bipartisan support."

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