The House finished all its homework before recess, with an achievement that was messy, contentious, complicated, but at the same time historic--all three committees with jurisdiction have now passed reform legislation, E&C finishing their work last night, with minimal dissent from Blue Dogs, and of course no Republican votes.
in an unusual move before the final vote, Waxman halted the markup to have a closed-door meeting with Democrats on his panel – presumably to make sure he had the votes to pass the bill.
The final vote was 31-28, with five Democrats opposing the measure. Democrats who voted no were Reps. Rick Boucher (Va.), Bart Stupak (Mich.), Jim Matheson (Utah), John Barrow (Ga.) and Charles Melancon (La.). All Republicans rejected the bill.
Progressives on the committee achieved some compromises with the Blue Dogs to answer some of their concerns about how the Blue Dog compromise would hurt low-income Americans. The broad outlines, though, remain set.
Lawmakers of both parties agree on the need to rein in private insurance companies by banning underwriting practices that have prevented millions of Americans from obtaining affordable insurance. Insurers would, for example, have to accept all applicants and could not charge higher premiums because of a person’s medical history or current illness. All insurers would have to offer a minimum package of benefits, to be defined by the federal government, and nearly all Americans would be required to have insurance....
To avoid cutting premium subsidies for low-income people, Mr. Waxman said, Democrats found additional savings elsewhere.
Representative Diana DeGette, Democrat of Colorado, said the Blue Dog deal would hold down costs. But, she said, "it was paid for on the backs of people who cannot afford health insurance," so liberals objected.
Under the Democratic proposals, insurers would be required to get "prior approval from the government before increasing premiums over a certain amount."
Representative Tammy Baldwin, Democrat of Wisconsin, said this requirement was needed to curb the growth of premiums.
"Over the last decade," Ms. Baldwin said, "small businesses and individuals have experienced double-digit increases in premiums, and that contributes mightily to the level of uninsurance."
The Democratic amendments stipulate that "savings generated by this package must go toward making premiums more affordable for lower-income people."
Democrats on the Energy and Commerce Committee would also authorize the health and human services secretary to negotiate prescription drug prices for Medicare beneficiaries.
All three bills contain a public option, though the Blue Dog compromise in E&C somewhat weakened it, deficiences that will have to be dealt with by the committee chairs (all progressives) and House leadership during recess as they work to reconcile the three bills. As Pelosi noted:
some of the most hard-fought provisions of the healthcare bill -- including parts meant to appease conservative Democrats -- could change by the time the final measure reaches the House floor.
"I have three chairmen to deal with," Pelosi said. "We have three committees that have to look at it."
Three chairman and a Democratic caucus that is more liberal than the Blue Dogs. They don't have the proportionate numbers to influence the final floor vote that they had in E&C, so hopefully the committee chairs and leadership can undo some of the damage done, specifically delinking public plan rates from Medicare, which could weaken the plan's ability to compete and build solid provider networks. It also shifted costs to states, and to a Medicaid system already stretched to the brink.
So the heavy lifting on on this process is far from over, particularly considering members have to go out and face coordinated efforts subsidized by lobbyist-run groups Americans for Prosperity and FreedomWorks to harrass and intimidate them.