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Price Tag Is One Focus of Health Care Talks, Levin Says

By Rebecca Adams, CQ Staff

March 10, 2010 -- Democratic leaders are down to "five to 10 substantive issues" on health care overhaul legislation, and most of them involve the measure's price tag, House Ways and Means Chairman Sander M. Levin said Wednesday.

Levin said House Democrats are waiting for Congressional Budget Office (CBO) cost estimates of some potential provisions in a budget reconciliation bill that would make agreed-upon changes to Senate-passed health care legislation (HR 3590).

The CBO scores will help members decide whether they need to revise provisions that would pay for the more generous subsidies and other expansions their proposal would offer. "Clearly we're looking at the Medicare tax," Levin, D-Mich., said. "Would that need to be increased? Depends on what the score is."

President Obama's Feb. 22 blueprint called for raising the Medicare payroll tax on individuals who earn more than $200,000 or married couples with incomes above $250,000. It would increase the tax on earned income, such as salaries, by 0.9 percent and add a tax of 2.9 percent on unearned income such as interest, dividends and capital gains.

But that tax may need to increase further if lawmakers adjust other parts of the legislation in ways that prove more costly than anticipated. Levin and others have sought to increase the federal subsidies that would make health care coverage more affordable to individuals without employer-provided insurance.

House leaders are also considering changes involving "responsibility," he said, apparently referring to provisions that would fine employers who refuse to provide health coverage if their workers then get federal subsidies to buy insurance on their own, as well as to mandates requiring individuals to buy insurance or face fines.

Some lawmakers are concerned that some of the offsets slated to pay for health care are being recycled from legislation intended to create jobs. One example is a provision that would save money by changing the Medicare improvement fund, an account created in 2008 that allows the Department of Health and Human Services to increase hospital and outpatient Medicare benefits. Another duplicative offset would prevent "black liquor," a byproduct of the paper manufacturing process, from being eligible for the cellulosic biofuels producer tax credit.

Democratic leaders involved in health care talks said that they hoped to get CBO estimates in time for a meeting Wednesday night of key players from both chambers.

House Speaker Nancy J. Pelosi, D-Calif., said in a brief interview that she did not know when the CBO estimates would be ready, noting that it is an independent agency.

When asked who she was meeting with Wednesday, Pelosi smiled and said, "Everyone."

Pelosi later said that lawmakers were focusing on items that CBO won't have to score. "We are meeting on an ongoing basis to discuss non-CBO issues," she said. Presumably, that list would include the thorny matter of abortion language that could prompt a small but vital group of Democrats to bolt if their demands are not met.

Pelosi said the CBO scores are coming along. "Much of it is being resolved because we need a solution. We have no more time to do it. The time is here," Pelosi said.

Edward Epstein contributed to this story.

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