Memo Purportedly Urges Dems to Keep Quiet on Critical Health Care Topics

As the leadership in the House tries to persuade fence-straddling Democrats to push health care reform over the finish line, a "talking points" memo is being widely circulated in Washington that purports to show that those same leaders and the Obama administration are secretly planning to push for an increase in Medicare payments -- an increase that would alter the cost of the bill.

The "From" line of the memo is scratched out, and Democrats emphatically deny sending it. A spokeswoman for House Majority Leader Steny Hoyer described it as "suspicious."

"It appears to be a fake. ... All I can say is it did not come from us. And yes, I do think it is suspicious that the 'From' line is redacted," spokeswoman Stephanie Lundberg told

Click here to see the memo. 

Another Democratic congressional staffer told that he could not tell whether the memo came from a Democratic office.

But the congressional staffer who leaked the document to said that it illustrates that the Democrats are worried about aspects of the health care debate and are trying to conceal them.

If the memo is authentic, it shows Democratic leadership instructing staffers not to allow the congressmen they represent to talk publicly about the details of the Congressional Budget Office's analysis of the health care reform bill. It also acknowledges that Congress and the administration will push for "doc fix" next spring -- which would increase Medicare payments to doctors above those currently planned at the cost of $371 billion over 10 years.

It further notes that if the fix were part of the current health care reform bill, it would "undermine reform's budget neutrality." It adds that "we do not want that policy discussion discussed at this time."

Asked whether the memo was a hoax, House Republicans dismissed the question Friday. Minority Whip Eric Cantor of Virginia said the real "hoax" is the claim that the bill will bring down deficits.

"Who cares about a memo?" Wisconsin Rep. Paul Ryan said, arguing that the "doctor fix" renders Democrats' cost estimates inaccurate. "All this claim of deficit reduction is false."

The staffer who leaked the memo said it is evidence that the health bill's supporters are "vulnerable on Medicaid expansion, no SGR (the "doc fix"), and all of CBO's caveats about deficit neutrality. This memo makes it look like they may be scared those arguments have resonance with House 'Blue Dogs.'"

The memo reads: "Do not allow yourself (or your boss) to get into a discussion of the details of CBO scores and textual narrative."

The staffer added that "it highlights how much they don't want to talk about the uncertainty of the CBO scores. ... And they're putting all their faith in that. It just points out the budget gimmicks (they're using.)"

The staffer said that one gimmick was the "doc fix." According to the memo:

"Most health staff are already aware that our legislation does not contain a 'doc fix' ... The inclusion of a full SGR repeal (doc fix) would undermine reform's budget neutrality. So, again, do not allow yourself (or your boss) to get into a discussion of the details of CBO scores and textual narrative. Instead, focus only on the deficit reduction and number of Americans covered.

"As most health staff knows, Leadership and the White House are working with the AMA to rally physicians support for a full SGR repeal later this spring. However, both health and communications staff should understand we do not want that policy discussion discussed at this time, lest it complicate the last critical push to pass health reform."

Another part of the memo warns that "anti-reform extremists are making a last-ditch effort to derail reform. Do not give them ground by debating details. ... Again, instead focus only on the deficit reduction and number of Americans covered. In the critical remaining hours of the debate we must drive the narrative of 'health reform is deficit reduction.'"

Hoyer's spokeswoman said that she was checking with the majority leader for his take on the content of memo. House Speaker Nancy Pelosi's office and the Senate Finance Committee did not respond to requests for comment.