WASHINGTON - -Clearing the way for a critical vote on health care legislation in the next two weeks, House Democratic leaders plan to unveil a bill today that would create a new government insurance plan available in all 50 states but step back from the most robust version of the "public option."
According to senior lawmakers and aides familiar with the legislation, it will not dictate what the plan can pay hospitals, doctors and other providers, a goal that many liberal Democrats had hoped for as a means to control costs.
"People are coming to realize it's going to be very tough to get to that point," acknowledged House Education and Labor Committee chairman George Miller, D-Calif., a close ally of House Speaker Nancy Pelosi, D-Calif.
Instead, much as commercial insurers do now, the federal government under the House plan would have to negotiate rates with providers, a concession that Pelosi and her lieutenants are making to conservative Democrats wary of the "public option." Pelosi's decision to endorse the compromise on the public plan ends weeks of heated and difficult debate between liberal and conservative Democrats.
It also comes just days after Senate Majority Leader Harry Reid, D-Nev., threw his weight behind a slightly different "public option" compromise that would give states the ability to "opt out" of a national government insurance plan.
Reid is now working to persuade conservative Democrats to back his proposal, which would also require the plan to negotiate with providers, so that he can overcome a planned Republican filibuster.
Senate Democratic leaders believe they are just a few votes shy of the 60 they need. But with other parts of the bill still being developed, it appears increasingly unlikely that Reid will be able to move a bill through the Senate before Thanksgiving.
The House bill - which Democrats are still struggling to keep under $900 billion over the next decade - builds on legislation that House Democrats introduced earlier this year.
It will include sweeping new regulation of the insurance industry, prohibiting insurers from denying coverage to sick people. And it will provide subsidies to millions of Americans - though not all - to help them buy insurance in a new regulated insurance market, or exchange, where commercial insurers would offer plans alongside the government.
It will also require Americans to buy insurance for the first time and mandate that large employers provide their workers with health benefits.
All Americans making less than 150 percent of the federal level - or $16,245 for an individual and $33,075 for a family of four - would be eligible for Medicaid, the four-decade old joint federal-state insurance program for the poor.
