U.S. House Democrats reached a tentative accord on major health reform but negotiations remained unsettled in the Senate, which means Congress is expected to take up the issue again after it returns from August recess.
President Obama earlier had pushed for passage of a reform bill before the break, but Democratic leaders said they now hoped to get something to the president for signature by the end of the year.
After a two-week impasse, the House Energy and Commerce Committee on Friday worked into the evening to vote out H.R. 3200. The logjam was broken after changes or assurance that bought support from both the fiscally conservative Blue Dog Coalition and members of the party’s Progressive Caucus.
Liberal Democrats said Friday that they were pleased that House Speaker Nancy Pelosi had promised they would get the chance to offer the option of a single-payer health system once the bill goes to the full House for a vote. They also were assured that the subsidies included in the measure to help moderate-income persons buy private health insurance would remain largely intact.
An earlier version of the bill would have provided subsidies to households that paid more than 12 percent of annual income for insurance premiums. But Blue Dogs pushed for less and got that percentage reduced.
After more haggling with the Progressives, that percentage was set at 11 percent.
The Blue Dogs, a coalition that includes 3rd District Kansas Congressman Dennis Moore, also succeeded in their demands that the public health insurance plan included in the bill not be coupled to the Medicare fee schedule. The Blue Dogs had insisted that the public plan instead negotiate reimbursement rates to hospitals and doctors just as private insurers do to control costs.
They also got provisions that could lead to higher Medicare reimbursements in rural areas, which Blue Dogs complained are currently inadequate and out of balance with payments made to urban medical providers.
The concessions were spelled out during the Energy and Commerce markup on Friday.
Democrats also told Republican members of the committee that they would work with them to later modify provisions in the bill that GOP members said were onerous to doctor-owned or specialty hospitals.
“The pending bill for some reason is punitive on these types of facilities and would at a minimum prevent their expansion and in all probability would cause some of them to close,” said U.S. Rep. Joe Barton of Texas, the ranking Republican on the committee.
Republican members said the changes to the bill to accommodate the Blue Dogs were less than they had expected and expressed disappointment it still included a public plan option.
“You let the Blue Dogs in to pick the color of the lipstick going on this pig,” said U.S. Rep. Mike Rogers, R-Mich.