Sunday, January 10, 2010

Pelosi Has her work cut out for her

From the Politico
PATRICK O'CONNOR & CARRIE BUDOFF BROWN 1/9/10 9:58 AM EST

Speaker Nancy Pelosi is telling her caucus not to believe stories that the House will simply roll over and accept the Senate’s hard-fought health care bill.

“That’s not true for one second,” Pelosi told her agitated rank-and-file in a call this week.

But she may not have a choice.

Any major changes to the Senate bill threaten to upset a delicate détente Majority Leader Harry Reid (D-Nev.) built over months of cautious negotiations to hold together 60 votes in his divergent caucus.

The public option is out. Employer mandates could prove too tough to change. And the president has already taken the Senate’s side in the fight over a tax on high-end health care plans.

“Each of the provisions at issue has already been negotiated ad nauseam in the Senate,” said a Senate Democratic aide. “The physics of this are unlikely to change much.”

Pelosi even seemed to concede one of her top priorities during the call – suggesting she could live with pushing the start date for reforms from 2013 to 2014, the date in the Senate bill. That alone would save $100 billion in the House bill, according
several congressional aides, money the speaker told her caucus could be plowed into making insurance more affordable.

So the ever-practical Pelosi is setting her sights on achievable goals: boosting insurance subsidies, strengthening oversight of insurers and setting up a national exchange to make sure the federal government sets minimum standards for coverage under the reforms.

Even those could prove to be a tall order.

Two key moderates – Sen. Ben Nelson (D-Neb.) and Sen. Joe Lieberman (I-Conn.) – have favored the state-based exchanges over national exchanges. The question now is whether it will prove make-or-break for either.

It’s not just the Senate. Pelosi, who relishes a good fight, finds herself locked a duel with President Barack Obama over the so-called Cadillac tax included in the Senate bill – a 40 percent levy on insurance plans that exceed $8,500 for individuals and $23,000 for families.

To win this skirmish – or any other – she needs to convince Obama her math is tougher than Harry Reid’s.
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