Speaker Nancy Pelosi, D-Calif., is expected to reveal Thursday the final House version of sweeping health-care legislation that would create a government-run insurance plan.
The bill emerges after a deal between moderate and liberal Democrats to create a government insurance benefit open to all Americans, as liberals want, but to be more generous in paying doctors and hospitals than liberals had intended.
Instead of tying reimbursement rates under the public option to those of the senior citizens health program Medicare, medical service providers would be able to make their own deals with the government for payment.
“It will likely be negotiated rates,” a top Democratic aide said.
The move is sure to displease the 80-plus-member liberal bloc. But the leadership had little choice because moderate House members were less willing to bend on the issue than their liberal counterparts.
Liberals wanted the health-care bill to reimburse doctors and hospitals at a rate 5 percent higher than Medicare, which they said would make insurance coverage more affordable. Medicare typically reimburses at a much lower rate than private insurers and sets rates based on regional costs.
But moderates — particularly members from rural areas with low reimbursement rates — balked at the deal. Liberals, though, seem willing to go along for the sake of having a public option.
“There is no point pushing back, asking for what can't be done,” Progressive Caucus member Rep. Jerrold Nadler, D-N.Y., said.
Nadler and other liberals wanted what they call a “robust public option” — by which they mean a government plan open to all with uniform rates for medical services. But even without the set rates, they believe it will still make government insurance substantially cheaper than private insurance.
On Wednesday, Pelosi was working with other Democratic leaders to try to resolve abortion funding language in the bill, which is another major point of contention for moderate Democrats.
Rep. Bart Stupak, D-Mich., wants language in the bill that would ensure no federal funding is used for abortions.
He said on C-SPAN on Tuesday that 40 House Democrats would stand behind him in forcing a vote on an amendment that would insert prohibitive language.
The Democratic aide said leaders were working on a way to placate Stupak. “I don't think we are there yet,” the aide added.
Now that the House is about to finalize a bill, leaders will work to gather the 218 votes needed for passage. The plan will include a more accessible government-run insurance program than the Senate version, posing potential obstacles to passage.
House Majority Leader Steny Hoyer, D-Md., said he was hoping for a House vote by the second week in November.
The legislation would then have to be merged with any bill that emerges from the Senate, where a vote could still be weeks away.