TOPICS > Health

House Health Care Bill Features Public Option Compromise

October 29, 2009 at 6:17 PM EDT
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House Speaker Nancy Pelosi unveiled an $894 billion health care reform bill Thursday that would expand insurance coverage to as many as 36 million people. In a nod to moderates, the plan includes a public option in which rates are negotiated with doctors and hospitals. Betty Ann Bowser reports.

BETTY ANN BOWSER: Flanked by fellow Democrats and with the Capitol dome as her backdrop…

REP. NANCY PELOSI, D-Calif, speaker of the house: Good morning.

BETTY ANN BOWSER: … House Speaker Nancy Pelosi today unveiled the long-awaited details of her party’s health care reform bill.

NANCY PELOSI: Affordability to the middle class, security for our seniors, responsibility to our children. It reduces the deficit, meets President Obama’s call to keep the cost under $900 billion over 10 years, and it insures 36 million more Americans — 36 million more.

BETTY ANN BOWSER: The House bill, a retooled version of three committee proposals, would cost an estimated $894 billion over the next decade.

It includes a government public insurance option, calls for a significant expansion of Medicaid, raising eligibility levels to 150 percent of the federal poverty level. That’s about $16,000 a year for individuals. It requires nearly every American to sign up for health coverage by 2013 and mandates almost all employers offer coverage to their workers, or face financial penalties.

NANCY PELOSI: It covers 96 percent of all Americans, and it puts affordable coverage in reach for millions of uninsured and underinsured families, lowering health care costs for all of us.

WOMAN: And does this hurt at all when we flex your foot? Good.

BETTY ANN BOWSER: The bill would create a new government-regulated insurance exchange, where people and small businesses could shop for insurance from private companies or from the government-run plan.

Federal subsidies would be made available to help low-income people afford coverage. And, under the legislation, insurance companies would be barred from denying coverage to Americans with preexisting conditions.

Money to pay for the overhaul would be raised through a combination of cuts in future Medicare payments to providers and a 5.4 percent income tax surcharge to be levied on the wealthiest Americans, people making $500,000 a year and couples making $1 million.

House Republicans responded swiftly with criticism. None are expected to vote for the bill.

Ohio’s John Boehner is minority leader.

GOP opposition

REP. JOHN BOEHNER, R-Ohio, house minority leader: This bill is pretty clear. It's going to raise the cost of Americans' health insurance. It's going to kill jobs with tax hikes and new mandates in it. And it's going to cut seniors' health care benefits. And if all that isn't bad enough, the -- the mandates on states will bankrupt what -- what are already states that have huge financial problems today.

BETTY ANN BOWSER: Speaker Pelosi made several significant adjustments to make sure the bill would get 218 Democratic votes, the number she needs to pass it on the House floor.

A key change will allow doctors and hospitals to negotiate more favorable reimbursement rates with the government-run public option.

One moderate Democrat who once said he would never vote for a bill with a public option wasn't so sure which way he would vote today, Idaho's Walt Minnick.

REP. WALT MINNICK, D-Idaho: I'm still not a great fan of the public option. I do think it's important that whatever health bill we pass be affordable, reduce costs, and increase access, so that everyone will have the ability to get comprehensive, affordable health insurance.

BETTY ANN BOWSER: Most liberal caucus members said they were disappointed, but, like New York's Anthony Weiner, they felt they had to compromise.

REP. ANTHONY WEINER, D-NY: It's not as strong as I would have liked, and I think that some members of Congress are going to have to explain why they wanted less competition, less choice, and more cost for taxpayer. But it's hard not to call the success of the public option a victory.

Both parties asking for more

BETTY ANN BOWSER: There were some danger signs for Pelosi. Congressman Raul Grijalva co-chairs the Democratic Progressive Caucus, and said he still wants to see a more robust public option.

So, are you disappointed enough to vote against it?

REP. RAUL GRIJALVA, D-Ariz.: We -- we are -- we're going to be asking leadership. And the answer is, I'm leaning no right now, absolutely. And that's this individual. We're going to -- our whole caucus is going to meet and figure what our strategy is.

But we're going to ask leadership to give us a vote up or down on a robust public plan. We think that's important for that to be on the record, and for many Americans who advocated for that, to let them have their day in the sun and see what happens.

BETTY ANN BOWSER: Some Republicans, like Michigan's Dave Camp, attacked the way the bill was put together.

REP. DAVE CAMP, R-Mich.: Americans' health is too important and too complex to risk on one gigantic piece of legislation. And, in the three months that they have been negotiating behind closed doors and in secret, they have added 1,000 pages to the bill that none of us have seen yet. Obviously, we will be looking through this in great detail in the next days that we have.

BETTY ANN BOWSER: Speaker Pelosi expects to have the bill on the floor next week...

NANCY PELOSI: Onward to passing the bill in the Congress.

BETTY ANN BOWSER: ... and wants a final vote to come before Veterans Day on November the 11th.

JIM LEHRER: There's a link to the full House bill on our Web site, And we have extended interviews with two key Republican senators, Susan Collins and Olympia Snowe, about what they would support.