Published July 27, 2009
House Democratic leaders on Monday used a new congressional report to refute Republican claims that their health care reform plan would amount to a government takeover of the industry.
The report from the Congressional Budget Office suggested a government plan could coexist with private insurers without driving them out of business. The assessment was a dose of good news for Democrats whose health care reform ambitions have recently been kept in check by CBO numbers reflecting the hefty price tag associated with their proposal.
But Democratic leaders are still facing a raft of cost concerns from moderate members of the caucus. Despite the report from CBO, House Speaker Nancy Pelosi left the door wide open Monday for when she expects her chamber to complete legislation.
"We're on schedule either to do it now or to do it whenever," said Pelosi, who previously insisted that the House pass a bill before the August recess.
The House Democratic Caucus was heading into a long meeting Monday afternoon to review the bill section by section and try to better understand the concerns of members -- like the fiscally conservative Democrats known as Blue Dogs who are holding up the bill in committee.
Pelosi and her allies, though, tried to silence Republican criticism that the inclusion of a so-called public option would hand the federal government the reins of health care.
Pelosi said the CBO estimate would "refute the charges made by the Republicans and misrepresentations that they are putting out there."
"We've heard that a public insurance option would push private insurance out of the marketplace -- absolutely untrue," House Majority Leader Steny Hoyer, D-Md., said.
The CBO estimate reflected just one of several on the impact of a public option.
A widely cited study by the Lewin Group, a private health research firm, estimated that more than 100 million people would sign up for the public plan proposed by House Democrats, making it the dominant insurer in the land.
But the budget office, in a letter Sunday to a senior Republican lawmaker, said its own estimate for the same legislation is "substantially smaller."
CBO estimates that only 11 million to 12 million people would sign up for the public plan -- making it a much smaller player in the market. The government coverage would be available alongside private plans through a new kind of insurance purchasing pool called an exchange.
CBO estimated about 6 million of those enrolled in the public plan would be workers and family members of employers that joined the exchange.
The reasons the estimates are so far apart have to do with different underlying assumptions.
The CBO estimated that the public plan would offer premiums about 10 percent lower than private plans; the Lewin analysis estimates the premiums would be at least 20 percent lower. The CBO estimates that only individuals and workers in companies with fewer than 50 employees would join the exchange, while Lewin estimated the exchange would eventually be open to all workers.
As if to underscore how such estimates can vary, the Urban Institute public policy center also ran calculations -- and came up with different numbers. The Urban Institute estimated that about 47 million people would sign up for the public plan, if companies with fewer than 50 workers were allowed to join.
More than 160 million workers and family members now get health insurance through an employer.
Meanwhile, Pelosi signaled Monday afternoon that she's loosening her expectations for swift passage out of the House.
"I have said that I wanted a bill to pass before we left for the August recess," she said. "But I've also said that our members need the time they need to not only get the bill written but to have plenty of time to review it."
She said the timetable will depend in large part on when the House Energy and Commerce Committee finishes its work on the bill.
Pelosi said she'll wait for the committee to finish, even though committee Chairman Henry Waxman, D-Calif., on Friday floated the controversial option of bypassing the panel and taking the package straight to the floor - where it would face an uncertain fate.
The House Energy and Commerce Committee is the only House panel that hasn't approved the bill.
On the Senate side, only the Finance Committee is left to take action -- a bill has taken longer to pass there since it is trying to forge a bipartisan compromise.
Senate Majority Leader Harry Reid already announced that the Senate will not meet President Obama's original August deadline.
Hoyer on Friday said it "may not be possible" to pass a bill before recess, instead suggesting lawmakers would continue to work on the package during part of their recess.
Pelosi repeated Monday that when she brings the bill to the House floor, "it will win."
The Associated Press contributed to this report.