House Democrats Unveil Bill That Would Create Insurance Exchange, Public Plan

Jun 10, 2009 - Kaiser Health News

House Democrats on Tuesday released an outline of their proposal to reform the health care system that would require that all Americans have insurance and that employers provide coverage or pay a penalty, The Associated Press reports. The bill also emphasized preventive care but omitted details about how to cover the costs.

"On a hotly contested issue, the emerging House plan would give individuals the option of buying insurance provided by the federal government," the AP says. The so-called public plan has been a contentious one. Democratic senators on the Health, Education, Labor and Pensions Committee didn't include a specific public-plan proposal in their legislation for now, in hopes of ironing out some disagreements with Republicans.  

Under the House plan, insurance companies would be banned from denying coverage or charging higher premiums because of pre-existing conditions. 

"'This is the year we have to do it,' said Rep. Henry Waxman, the California Democrat who chairs theEnergy and Commerce Committee. Waxman was one of several senior Democrats who outlined proposed legislation to the party's rank and file during the day" (Epso, 6/9).

Some lawmakers are worried about how to pay for the legislation, which wasn't explained in the House outline, The Hill reports: "A public option for healthcare insurance is essential for liberals in the caucus. Blue Dogs and New Democrats got less of what they wanted. Most notably, the plan ignores Blue Dogsf call for a government plan to be a 'fallback option,' if reform of private healthcare doesnft work. c 'Ifve got my concerns,' said Rep. Betsy Markey, D-Colo., a centrist lawmaker from a strongly Republican district. 'Wefve got to address cost, quality and coverage, with cost being No. 1.'" Drafts of the House bill are expected to be released by the end of the week (Soraghan, 6/9).

The Wall Street Journal: "The draft House plan, presented to House Democrats at a meeting Tuesday, would require almost all Americans to have health insurance and provide subsidies to those with annual incomes as high as four times the poverty level...The plan presented Tuesday by Mr. Waxman and other key House Democrats is likely to define the liberal end of the negotiating spectrum. It would expand Medicaid by basing eligibility solely on income, said a House aide who helped draft the proposal. Currently, someone must be both poor and a parent, or meet some other criteria, to qualify" (Bendavid and Adamy, 6/10).

President Obama met with Democratic members of the Ways and Means Committee to discuss the legislation Tuesday, Roll Call reports. "During the White House session, Obama reiterated his support for his own revenue-raising proposal, a plan to reduce deductions for higher income earners that has so far been rejected by Congress" (Koffler, 6/9).

Meanwhile, members of the racial minority caucuses are readying their own bill to compete with the top House Democrat bill, Roll Call reports in a separate story. "But they conceded that some of their ideas are already being included in the package being put together by Democratic leaders, and they said they arenft prepared to unite in opposition to that bill. The bill being introduced later this week by the Tri-Caucus — which includes the Congressional Black Caucus, the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus — focuses on the need to address racial and ethnic disparities in health care." (Bendery, 6/9)

Republicans too are voicing their opposition. NPR reports (MP3): "But all that apparent togetherness on the part of the Democrats is serving only to unite the opposition, said John Kyl, the Senate's second ranking Republican: 'We are opposed to a government plan and the sooner it's off the table the better'" (Morning Edition, 6/10).