WASHINGTON — Efforts to pass health care reforms took a major step forward late last month when House Democratic leaders reached an agreement with fiscally conservative members of their party.
The so-called Blue Dog Coalition, a group of fiscally conservative House Democrats, had objected to the legislation’s estimated $1 trillion cost over 10 years and said a vote by representatives would have to wait until after Labor Day.
“The American people want to take a close look at this legislation,” Tennessee Rep. Jim Cooper said last month about the Blue Dogs’ reasoning behind delaying a vote on the bill until after Congress’ August recess.
As part of their deal with the Blue Dogs, Democratic leaders agreed to defer a vote by the full House until September, giving lawmakers time to gauge public reaction to the proposal.
The agreement between the Blue Dogs and Democratic leaders, which was brokered by White House officials, ended a 10-day impasse and set the stage for the House Energy and Commerce Committee to resume work on the bill. The committee expected their efforts to be completed by July 31.
Under the House agreement, the federal government would still establish a public insurance plan to compete with private insurers, but the public plan would not use Medicare fee schedules to pay physicians and hospitals, as was proposed in the original House bill.
Instead, the public plan would negotiate rates with health care providers, as private insurers often do.
The Blue Dogs said the change reduced the likelihood that the government plan would compete unfairly with private insurers by forcing providers to accept below-market rates.
As part of the deal, states could also set up nonprofit cooperatives to offer coverage to individuals, families and small businesses.
Rep. Mike Ross of Arkansas, the chief negotiator for the fiscally conservative Democrats, says the concessions his group won would bring the 10-year price tag down to under $1 trillion, a goal shared by lawmakers in the Senate.
Under the compromise bill in the House, most employers would still be required to provide health insurance to workers or pay a new federal tax, but more small businesses could qualify for the exemption, which would be available to businesses with annual payrolls of $500,000 or less, compared with a threshold of $250,000 in the original House bill.
The maximum tax rate, 8% of wages, would apply to employers with payrolls exceeding $750,000, rather than the original threshold of $400,000.
Ross said the changes were “a huge win for us.”
“We have cut the cost of the bill substantially,” Ross remarked. “We have delayed a floor vote until September. We have protected small business.”
But in making allies out of the conservative members of their party, Democratic leaders have infuriated the party’s left-leaning members.
Members of the Congressional Progressive Caucus say they fear the new agreement would severely weaken the public insurance plan.
“We do not support this,” stated Rep. Lynn Woolsey (D., Calif.), cochairwoman of the Progressive Caucus. “It’s a nonstarter.”
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