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The President Presses Congress for a Health Overhaul Bill

By Paul Jenks

President Obama urges lawmakers to pass a health overhaul measure and vows to restrain discretionary spending increases. A committee votes on a request for documents on private White House agreements with health care organizations.

President Obama pressed the case Wednesday for a health overhaul measure in the State of the Union address to Congress.

CQ Today reported that the president declined to elaborate a specific approach to passing legislation but pressed for action. Roll Call reported on different interpretations of the speech from lawmakers.

CQ reported before the speech that some interest groups were waiting for the president to give the green light to the House to act on the Senate bill (HR 3590). On the House floor Wednesday, Majority Leader Steny H. Hoyer, D-Md., held out the option (view video that the House could consider a health measure before the Presidents Day recess (Feb. 15). Roll Call reported that House Democratic Whip James E. Clyburn of South Carolina pressed to move a bill through the reconciliation process. In the Senate, CQ HealthBeat reported Wednesday that Sen. Joseph I. Lieberman, I-Conn., is uncertain about voting for a health reconciliation measure.

Lawmakers now grapple with forging alternatives and options for the two main proposals approved by the Senate or House (HR 3962). One example of a smaller measure, which includes some Republican support, is a small-business insurance pool proposal (S 979) offered by Sen. Richard J. Durbin, D-Ill,. Additionally, Democratic Sen. Ron Wyden of Oregon and Republican Sen. Robert F. Bennett of Utah have also proposed a more substantial health overhaul bill (S 391) for the past several years. House Republicans, led by Budget Committee ranking member Paul D. Ryan, R-Wis., on Wednesday introduced alternative tax and health overhaul legislation. Ryan previously offered a similar bill (view text) in 2008.

Budgetary reform pressures continue to tangentially press on discussions on the future of a health measure. The Morning Take on Tuesday reported on Senate efforts to craft a budgetary task force to overhaul the federal fiscal situation. President Obama weighed in on Wednesday with a commitment to create an alternative budget task force created by the White House. Slowing the growth of federal health spending is one of the original goals of health care overhaul proposals. Obama also reiterated a pledge to freeze non-defense and national security discretionary spending in his fiscal 2011 budget proposal.

Additionally, the administration also issued a statement Wednesday supporting statutory "pay as you go" (PAYGO) legislation in the Senate. The House passed a new PAYGO measure last year (HR 2920), which excludes several major spending items including an adjustment of pending Medicare physician rate cuts. The Medicare physician rate issue, combined with offsetting spending to fund the rate cut, has been a constant thorn in bicameral deliberations on health reform. The Senate last year failed to consider a separate measure (S 1776) to permanently block the physician rate increase and did not include it in its final health overhaul bill. The Morning Take on Wednesday reported that a new Congressional Budget Office budget outlook report specifically noted the physician payment issue impacting the growth of Medicare spending.

The House Energy and Commerce Committee on Wednesday tackled a controversy over White House closed-door negotiations with health associations and unions that crafted agreements to advance health overhaul legislation. The committee agreed to a motion to report a resolution of inquiry (H Res 983) without recommendation that requests documents on White House negotiations with various groups and specifically cites the Advanced Medical Technology Association, the American Medical Association, America's Health Insurance Plans, the Pharmaceutical Research and Manufacturers of America, the American Hospital Association, and the Service Employees International Union. CQ reported that while the committee's "no recommendation" effectively shelves the measure, committee Chairman Henry A. Waxman, D-Calif., supports the call for documents.

Today, the Senate Judiciary Committee might consider a medical expense bankruptcy protection bill (S 1624) in its regular Thursday morning markup.

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