abortion

By James Rowley and Kristin Jensen Oct. 30 (Bloomberg) — House leaders are facing criticism from business groups and wading through contentious issues such as abortion and undocumented immigrants as they try to secure votes for legislation overhauling U.S. health care. Speaker Nancy Pelosi yesterday unveiled a plan that would create a government-run insurance program, require employers to cover workers and impose a new tax on the wealthiest Americans. Lawmakers may vote as early as next week on the legislation, which would cost $894 billion over 10 years and cover 36 million uninsured Americans. The bill has no Republican support, and some Democrats object to both the cost and the idea that federal dollars might help undocumented immigrants buy insurance. The head of a group of 82 Democrats complained that the government insurance plan was too weak. And about 40 other House Democrats are concerned that government money might be used to pay for abortions. “Is it settled? No. Close? Yes,” said South Carolina Representative James Clyburn , who counts votes for Democrats. The legislation represents the most sweeping health-care changes since the 1965 creation of the Medicare program for the elderly. It would put new restrictions on insurers , encourage greater use of preventive medicine and require Americans to buy coverage, with subsidies if needed. After passing a bill in the House, leaders would work with senators on a compromise before a new round of votes, a process that might take months. Reid’s Struggles First, Senate Majority Leader Harry Reid has to find consensus on issues including the government program, or public option, which would compete with insurers such as Hartford, Connecticut-based Aetna Inc. Reid, a Nevada Democrat, is pushing a government plan that would let individual states opt out. Even after House lawmakers watered down their version of the public option, they face opposition from groups who have backed overhaul efforts. The Business Roundtable , which says its member companies provide health benefits for more than 35 million people, said it can’t support the House bill. The public option will shift costs and “stifle innovation,” according to a statement from John Castellani , president of the group, whose members range from New-York based Pfizer Inc. to JPMorgan Chase & Co. Pelosi’s Compromise Lacking votes for her proposal to tie the public option’s reimbursements to doctors to the lower rates paid by Medicare , Pelosi settled on requiring the plan to negotiate rates with providers, as private insurers do. The measure still drew fire from insurers, who would also lose an antitrust exemption. “A new government-run plan would bankrupt hospitals, dismantle employer coverage” and shift more costs to consumers, said Karen Ignagni , president of the Washington trade group America’s Health Insurance Plans , in a statement. Not all lawmakers are happy either. Leaders of the 82- member Congressional Progressive Caucus have pushed for the strongest form of the public option. A group co-chairman, Arizona Representative Raul Grijalva , expressed “deep disappointment” in a statement. “I will push to allow for a vote on a robust public option amendment,” Grijalva said. The compromise did pull in more Democrats, including self- described fiscal conservatives known as the Blue Dogs . North Dakota Representative Earl Pomeroy estimated that about half the 52 Blue Dogs would now support the bill. Pomeroy won applause yesterday when he said he had decided to vote for it. Rural Lawmakers “Moving toward negotiated rates brings along many of us from rural areas where Medicare underpays,” Pomeroy said. The House measure is the product of work by three committees and White House officials. President Barack Obama has made a health-care overhaul his top domestic priority and asked Congress to finish work this year. Hospitals, doctors, drugmakers and medical device manufacturers would also be affected. The bill calls for fees on device makers, recommendations from the independent Institute of Medicine on how to fix the Medicare payment system and a new procedure for Medicare to negotiate drug prices, potentially driving down prices. The bill would extend coverage to 96 percent of Americans, according to the Congressional Budget Office. Because government money would be used to help buy insurance, critics said some might go toward abortions. House members are still discussing whether to allow undocumented aliens to use their own money to purchase private insurance sold on the so-called exchange, a regulated market to be set up in 2013. Abortion Issue Michigan Democrat Bart Stupak contends that 40 members would unite to block House consideration of the legislation unless the abortion issue is resolved or they are given a chance to introduce an amendment during floor debate. Another controversy may be waiting because of provisions that call for end-of-life counseling. During the summer, critics charged that Democrats planned to set up “death panels” that would decide who got care. The new bill says nothing in it would “presume the withdrawal of treatment.” House Democrats included a surtax on couples who make more than $1 million a year. And the bill contains about a dozen other smaller tax increases on businesses and individuals. One Blue Dog, North Carolina Representative Heath Shuler , said House leaders made “significant improvements,” though he’s still undecided. “We need to get health care done,” Shuler said. To contact the reporters on this story: James Rowley in Washington at jarowley@bloomberg.net ; Kristin Jensen in Washington at kjensen@bloomberg.net