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Pelosi Said to Be Pressing Ahead on Broad Health Care Bill

By Drew Armstrong, CQ Staff

House Speaker Nancy Pelosi is pressing her caucus to agree to clear the Senate health care overhaul plan along with a package of compromises passed through expedited reconciliation rules, according to a well-placed lobbyist—in spite of her recent declarations that the Senate plan cannot pass the House and decision to float a series of more limit alternative bills.

"I spent time last night talking with the speaker and her chief of staff and to lots of members of the House, and the notion of the leadership wants to play small ball is absolutely wrong," Families USA Executive Director Ron Pollack said late Thursday.

Pollack and his consumer advocacy group have been deeply involved in the health care overhaul process, with a seat at the table during crafting the Senate legislation in committee, and close contacts at the White House and elsewhere Congress.

Pollack said Pelosi, D-Calif., discussed with him a procedural tactic he has advocated—to have the House clear the Senate bill (HR 3590), and concurrently have the Senate and House pass a set of compromise measures through the Senate using reconciliation, a package that would incorporate key agreements with the House on items like a tax on high-cost plans.

"I think they are very intent to get legislation . . . and it's this two-step process," he said.

Pelosi has continued to meet regularly with committee heads and other party leadership in her chamber and also with Democratic leaders in the Senate. But all involved have been tight-lipped about their discussions.

"I had a conversation with the speaker today. We're moving forward," Senate Majority Leader Harry Reid, D-Nev., said Friday. Asked what process they would use to do so, he said, "We haven't determined that. That's why we're still communicating."

A spokeswoman for House Majority Leader Steny H. Hoyer, D-Md., would not comment on whether House Democratic leadership has decided to go forward with what Pollack said the speaker will push.

"We are not confirming a decision on the process moving forward," said spokeswoman Stephanie Lundberg. "We continue to look at options."

Pollack said Pelosi had not spoken to him about defaulting to a far-less-ambitious package of small health care proposals, as has been suggested recently by some lawmakers.

"I spoke to a lot of members last night, including folks we had concern about, and I think there is movement toward accepting this strategy," he said of plan to pass the Senate bill and a reconciliation package.

"At the early stages, after a week ago Tuesday, I think people were acting out of the first stage of grief," he said, referring to the surprise loss of Democrats' Massachusetts Senate seat to GOP candidate Scott P. Brown. "As people have taken some time and taken a deep breath, they know they've got to get this done and know they can't play small ball."

Using reconciliation to pass a package of changes to the bill would ensure that House members get important concessions from the Senate that they feel they need in order to clear the Senate bill, and would also let the Senate bypass the 60-vote threshold that has stymied health care efforts.

"It would enable House members who want to get this done but have significant concerns about the Senate bill to ultimately pass the Senate bill knowing that these modifications will be part of final law," Pollack said of his conversation with Pelosi.

Top Democrats in the House and Senate still have to agree about exactly what the reconciliation package will include.

"Once this agreement is reached, she will be able to get the Democratic caucus behind this legislation and follow the process she will outline," Pollack said.

Democrats have insisted that they remain committed to a comprehensive overhaul, but many have questioned whether they are only trying to create some political cover as they shift their focus to jobs legislation.

"Members in both bodies need to know what that final outcome is intended to be," Pollack went on. "Then the effort will be made to round up the votes. You can't round up votes until you have a product which people will ultimately be voting for."

So far, the idea appears to be Democrats' best and only remaining chance to get a comprehensive health care bill to President Obama.

But it hinges on rallying a majority in both chambers to pass the Senate bill and the reconciliation package.

"It's legislatively possible," said one lobbyist with a group working for the overhaul effort. The lobbyist said that it would be impossible to do a comprehensive overhaul through a series of smaller bills, because each incremental change would create a ripple effect through the health insurance marketplace.

The time-line for going ahead with any new strategy is uncertain, however.

Hoyer said recently that Democrats would need to find a way forward next week. Reid, meanwhile said this week that Democrats were focusing on jobs now, not health care.

"It seems like you have different things coming out of different leaders' mouths," said the lobbyist.

Kathleen Hunter contributed to this report.

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