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US Speaker of the House of Representatives Nancy Pelosi (D-CA) - Source: Reuters -
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A final push to deliver a sweeping US healthcare overhaul to
President Barack Obama begins this week as House of Representatives
Democratic leaders prepare for difficult negotiations with the
Senate.
House Speaker Nancy Pelosi is set to meet with House committee
chairmen to map out strategy and set their priorities for landmark
healthcare reform legislation that the congressional Democrats hope
to deliver to Obama within weeks.
The House passed its healthcare bill on November 7.
The Senate passed its bill on December 24.
There are some significant differences between the bills that
must be ironed out as Democrats merge them into a single bill that
the House and Senate would have to pass before sending it to Obama
to sign.
Healthcare reform is Obama's top legislative priority.
Republicans solidly oppose it and have threatened new procedural
roadblocks in the Senate to slow things down.
Negotiations between the House and Senate Democrats must resolve
differences between the two bills over abortion funding
restrictions, new taxes to pay for the overhaul, and whether to
include a new government-run health insurance program.
Democrats hope to secure final congressional passage perhaps before
Obama delivers the annual State of the Union address to Congress
later this month or in early February.
That would allow Obama and his fellow Democrats to turn to other
issues ahead of November's congressional elections in which they
will try to protect their majorities in the House and Senate.
These include trying to lower the US unemployment rate and to
address national security concerns following the botched December
25 bombing attempt aboard a US airliner.
The stakes are high for businesses, the $3.4 trillion US healthcare
industry, Democrats and Obama.
Businesses that provide coverage to employees have been struggling to cope with steadily rising insurance costs.
Polls show that the public is wary of the proposed overhaul and
what it could mean for their household budgets and medical
coverage.
Democrats are anxious to settle their differences, deliver a major
legislative victory to Obama and begin highlighting the benefits of
healthcare reform, which aims to rein in rapidly increasing costs
and would prohibit insurance companies from excluding people from
coverage due to pre-existing conditions.
As quickly as possible
Democratic leaders could bypass a formal conference between the
House and the Senate, shutting out Republicans and avoiding
potential partisan procedural roadblocks, to work behind closed
doors in concert with the White House to strike a compromise.
"Millions of Americans are looking forward to new tax credits to
help them afford the healthcare coverage and new rules putting
patients ahead of insurance companies," said Senate Finance
Committee Chairman Max Baucus, who played a major role in writing
the Senate version of the bill.
"That's exactly what health reform will do and we are eager to get
our reform bill to the president's desk as quickly as possible,"
Baucus added.
Democrats have little room to manoeuvre as they strive to maintain
the 60 votes in the 100-seat Senate and at least 218 in the
435-seat House that are needed to pass the legislation.
"I think they will get this done," said Ron Pollack, executive
director of Families USA, a healthcare reform advocacy group.
"There are some difficult issues, for sure, that need to be
worked through."
One key difference is over a proposed new government-run insurance
program to compete with private insurers.
The House bill includes it. The Senate bill does not.
With conservative Democratic Senator Ben Nelson and independent
Senator Joe Lieberman threatening to withdraw their support if the
final bill includes this so-called public option, the proposal is
unlikely to be included.
Democrats also must resolve differences over abortion language.
The Senate bill includes a compromise between Nelson, an
abortion opponent, and abortion rights supporters that prohibit
public money from being used for abortions.
The House bill includes even more restrictive language backed by a
bloc of Democrats who have vowed to withhold support from the final
bill if it is changed.
There also are large differences over financing of the bill.
The House version includes a 5.4% surtax on millionaires.
The Senate bill includes a tax on high-cost health plans, a provision opposed by labour unions.
The Senate bill also increases the Medicare payroll tax on high
earners.
There also are a lot of similarities between the House and Senate
bills.
Both would create exchanges in which people without employer-sponsored coverage as well as small businesses could shop for insurance.
The Senate bill calls for state-based exchanges while the House calls for a national exchange.
