House leaders backed further away from a measure that would create a national insurance plan and instead pledged to shape a final overhaul package focused on delivering affordable care to more people while keeping the insurance industry in check.
House Speaker Nancy Pelosi (D-Calif.), after emerging from a closed-door meeting where differences between the House's reform package and one passed last month by the Senate were discussed, reframed the public option as a package of health insurance reforms aimed to drive down costs rather than a government health insurance plan.
“There are other ways to do that, and we look forward to having those discussions as we reconcile the bill,” she said. “I contend that whatever we have coming out of this bill will hold them accountable, and they'll be crying out for a public option one of these days.”
House staffers have outlined more than two dozen differences between a reform bill they crafted vs. one hashed out in the Senate, detailing the difficulty yet to come as leaders from both chambers begin to meld the legislation into something that is passable.
In an 11-page memo, staffers cite everything from major differences, such as the inclusion of a public option, implementation dates and tax hikes, to the relatively minor, such as gaps in the ways both bills would change how care is delivered by hospitals and doctors.
Paying for the legislation has proven a particularly thorny issue. The House plans to defray the cost of its 10-year, $1 trillion package largely with a tax on the wealthy. The Senate, however, has culled together a number of new fees, though it primarily relies on a tax on high-valued insurance plans to help defray the cost of its $871 billion bill.
So far, neither chamber is entirely happy with the taxes.
House Ways and Means Committee Chairman Charles Rangel (D-N.Y.) said that other taxes could be considered during the informal conference process. “It's very possible,” he said, but declined to say what type of fee could pass muster with the House.
“We haven't figured out anything except that we are not going to leave here unless we have accountability, access and make certain the House has expressed its will,” Rangel added. “It's going to be a difficult conference, but it's doable because most of the things are compatible in terms of what we want.”
Pelosi and other members of her leadership team are expected to meet with President Barack Obama later tonight.
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