WASHINGTON House Democrats on Thursday unveiled an $894 billion package to remake the health care system and celebrated by holding an outdoor rally at the Capitol where they asserted that tens of millions of Americans would soon gain affordable insurance.
The 1990-page measure which was months in the making would broadly expand Medicaid the state-federal insurance program for the poor by offering subsidies to moderate-income Americans to buy insurance either from private carriers or a new government-run plan.
It is with great pride and with great humility that we come before you to follow in the footsteps of those who gave our country Social Security and then Medicare and now universal quality affordable health care for all Americans" Speaker Nancy Pelosi told a crowd of several hundred people.
The 83-year-old dean of the House Representative John D. Dingell of Michigan stole the show with a combative speech in which he assailed insurance companies and Republicans who have been warning that the legislation would slash Medicare.
By expanding coverage and reining in health costs Mr. Dingell said the bill would meet the greatest humanitarian need this country confronts and the greatest economic problem."
The only citizens who will have to worry about their participation in Medicare being cut are the insurance companies" Mr. Dingell said.
Members of the House Democratic leadership team estimated that the bill which they said could reach the floor next week would provide coverage to 35 million or 36 million people and cut more than $150 billion over 10 years from payments to private Medicare Advantage plans.
Democrats solicited testimonials from five people who said they would benefit from the bill. They included a 70-year-old New Hampshire woman who said she would get cheaper prescription drugs; a small business owner from Chicago; a 33-year-old woman who said she had been denied insurance because of infertility; and a 27-year-old law student with an autoimmune disorder.
House Democrats said the provisions of their bill expanding coverage would cost $894 billion over 10 years meeting President Obamas goal of holding the cost under $900 billion.
Democrats lowered the cost of their bill in part by splitting off provisions to increase Medicare payments to doctors. Those provisions which would cost more than $200 billion over 10 years were put into a separate bill also introduced on Thursday.
Republicans said the mammoth bill would saddle the government with new financial obligations that would prove unsustainable. With Medicares hospital insurance trust fund projected to run out of money in eight years they said the government cannot afford the commitments it has.
The House Republican leader Representative John A. Boehner of Ohio denounced the bill as costly and unsustainable."
Instead of listening to the American people" Mr. Boehner said Democrats hid behind closed doors and came back with a bill designed to appease the liberal special interests."
Under the bill the government would sell health insurance in competition with private insurers. Ms. Pelosi said the competition would hold down premiums but Republicans said the public plan could eventually drive private insurers from the market.
The measure includes a new provision that would require the secretary of health and human services to negotiate drug prices on behalf of Medicare beneficiaries a proposal that is anathema to pharmaceutical companies.
It would require most Americans to obtain insurance and would require employers to provide health benefits to workers or pay a penalty. Small businesses would be exempt from the employer mandate if they had payroll less than $500000 a year double the threshold in the Democrats original bill introduced in July.
In the House bill as in the Senate version insurers would have to accept all applicants could not deny coverage because of a persons pre-existing conditions and could not charge higher premiums because a person was sick. Under a new provision of the House bill children could stay on their parents insurance through the age of 26. A bill approved by the Senate health committee offers a similar guarantee for children through age 25.
The major House and Senate bills would establish insurance exchanges or markets where individuals families and small businesses could shop for insurance complying with new federal standards. The exchanges would have to be in operation by 2013.
President Obama welcomed the House bill as a historic step forward" and said it met two of his criteria. It is fully paid for and will reduce the deficit in the long term" he said.
But Representative Mike Pence of Indiana the No. 3 Republican in the House said the Democrats bill looks like another freight train of big government with more taxes more mandates and more spending." That he said is not what the American people want."
Republicans noted that the new House bill had 1990 pages nearly twice as many as the earlier version.
The new bill like an earlier version retains a surtax on high-income people but increases the thresholds. The tax would hit married couples with adjusted gross incomes exceeding $1 million a year and individuals over $500000 just three-tenths of a percent of all households Democrats said. The original thresholds were $280000 for individuals and $350000 for couples.
Ms. Pelosi described the new proposal as a millionaires tax."
The government insurance plan would negotiate rates with doctors and hospitals as private insurers do. Payments would not be based on Medicare rates as Ms. Pelosi had wanted. Democrats from rural areas balked at the use of Medicare rates saying they were so low that hospitals could not survive on them.
Scores of lobbyists were cordially invited" to attend the rally in e-mail messages sent Wednesday by Ms. Pelosi.
On Monday the Senate majority leader Harry Reid Democrat of Nevada that he too had decided to include a government plan with negotiated rates in the bill he intends to take to the Senate floor for weeks of debate.
For now House Democrats do not have firm commitments from enough lawmakers to guarantee passage of their bill. But their aggressive schedule suggests they are confident they can round up the votes they need. Speaker Pelosi evidently fell well short of the votes needed for the robust" public option.
A whip count prepared Tuesday shows that 47 House Democrats opposed that approach while 8 more were leaning no." That suggests that Ms. Pelosi had lined up at most 201 votes of the 218 she would probably need.
WASHINGTON House Democrats on Thursday unveiled an $894 billion package to remake the health care system and celebrated by holding an outdoor rally at the Capitol where they asserted that tens of millions of Americans would soon gain affordable insurance.
The 1990-page measure which was months in the making would broadly expand Medicaid the state-federal insurance program for the poor by offering subsidies to moderate-income Americans to buy insurance either from private carriers or a new government-run plan.
It is with great pride and with great humility that we come before you to follow in the footsteps of those who gave our country Social Security and then Medicare and now universal quality affordable health care for all Americans" Speaker Nancy Pelosi told a crowd of several hundred people.
The 83-year-old dean of the House Representative John D. Dingell of Michigan stole the show with a combative speech in which he assailed insurance companies and Republicans who have been warning that the legislation would slash Medicare.
By expanding coverage and reining in health costs Mr. Dingell said the bill would meet the greatest humanitarian need this country confronts and the greatest economic problem."
The only citizens who will have to worry about their participation in Medicare being cut are the insurance companies" Mr. Dingell said.
Members of the House Democratic leadership team estimated that the bill which they said could reach the floor next week would provide coverage to 35 million or 36 million people and cut more than $150 billion over 10 years from payments to private Medicare Advantage plans.
Democrats solicited testimonials from five people who said they would benefit from the bill. They included a 70-year-old New Hampshire woman who said she would get cheaper prescription drugs; a small business owner from Chicago; a 33-year-old woman who said she had been denied insurance because of infertility; and a 27-year-old law student with an autoimmune disorder.
House Democrats said the provisions of their bill expanding coverage would cost $894 billion over 10 years meeting President Obamas goal of holding the cost under $900 billion.
Democrats lowered the cost of their bill in part by splitting off provisions to increase Medicare payments to doctors. Those provisions which would cost more than $200 billion over 10 years were put into a separate bill also introduced on Thursday.
Republicans said the mammoth bill would saddle the government with new financial obligations that would prove unsustainable. With Medicares hospital insurance trust fund projected to run out of money in eight years they said the government cannot afford the commitments it has.
The House Republican leader Representative John A. Boehner of Ohio denounced the bill as costly and unsustainable."
Instead of listening to the American people" Mr. Boehner said Democrats hid behind closed doors and came back with a bill designed to appease the liberal special interests."
Under the bill the government would sell health insurance in competition with private insurers. Ms. Pelosi said the competition would hold down premiums but Republicans said the public plan could eventually drive private insurers from the market.
The measure includes a new provision that would require the secretary of health and human services to negotiate drug prices on behalf of Medicare beneficiaries a proposal that is anathema to pharmaceutical companies.
It would require most Americans to obtain insurance and would require employers to provide health benefits to workers or pay a penalty. Small businesses would be exempt from the employer mandate if they had payroll less than $500000 a year double the threshold in the Democrats original bill introduced in July.
In the House bill as in the Senate version insurers would have to accept all applicants could not deny coverage because of a persons pre-existing conditions and could not charge higher premiums because a person was sick. Under a new provision of the House bill children could stay on their parents insurance through the age of 26. A bill approved by the Senate health committee offers a similar guarantee for children through age 25.
The major House and Senate bills would establish insurance exchanges or markets where individuals families and small businesses could shop for insurance complying with new federal standards. The exchanges would have to be in operation by 2013.
President Obama welcomed the House bill as a historic step forward" and said it met two of his criteria. It is fully paid for and will reduce the deficit in the long term" he said.
But Representative Mike Pence of Indiana the No. 3 Republican in the House said the Democrats bill looks like another freight train of big government with more taxes more mandates and more spending." That he said is not what the American people want."
Republicans noted that the new House bill had 1990 pages nearly twice as many as the earlier version.
The new bill like an earlier version retains a surtax on high-income people but increases the thresholds. The tax would hit married couples with adjusted gross incomes exceeding $1 million a year and individuals over $500000 just three-tenths of a percent of all households Democrats said. The original thresholds were $280000 for individuals and $350000 for couples.
Ms. Pelosi described the new proposal as a millionaires tax."
The government insurance plan would negotiate rates with doctors and hospitals as private insurers do. Payments would not be based on Medicare rates as Ms. Pelosi had wanted. Democrats from rural areas balked at the use of Medicare rates saying they were so low that hospitals could not survive on them.
Scores of lobbyists were cordially invited" to attend the rally in e-mail messages sent Wednesday by Ms. Pelosi.
On Monday the Senate majority leader Harry Reid Democrat of Nevada that he too had decided to include a government plan with negotiated rates in the bill he intends to take to the Senate floor for weeks of debate.
For now House Democrats do not have firm commitments from enough lawmakers to guarantee passage of their bill. But their aggressive schedule suggests they are confident they can round up the votes they need. Speaker Pelosi evidently fell well short of the votes needed for the robust" public option.
A whip count prepared Tuesday shows that 47 House Democrats opposed that approach while 8 more were leaning no." That suggests that Ms. Pelosi had lined up at most 201 votes of the 218 she would probably need.
