The Democratic Party showed on Friday what it's capable of when led by the majority of its members rather than its conservative wing. In stark contrast to Senate Democrats, who spent the week backpedaling on reform, unified House Democrats unveiled a draft health care overhaul bill jointly endorsed by three powerful committee chairmen.
Henry Waxman, Charlie Rangel and George Miller, chairs of the Energy & Commerce, Ways & Means and Education & Labor Committees, announced the result of six months of negotiations. The sight of three united committee chairmen in the turf-conscious House is a historically rare one.
Where the Senate Finance Committee's outline of a bill didn't include a public health insurance option for people to buy into, the House version includes a robust public plan that would operate nationally and compete with private insurers on a level playing field to keep them honest.
The public plan would be self-sustaining and not subsidized by the federal government, although an upfront infusion of capital would be needed. It would initially be tied to Medicare reimbursement rates, to capitalize on the existing infrastructure, but would evolve into a separate plan that paid higher rates. Participation by doctors would be voluntary.
Rangel described the public plan as "the best of Medicaid, best of Medicare, then kick it up a notch." The chairmen estimated the plan would cover 95 percent of Americans.
While the Senate has cowered from the debate over a public option in the face of Republican and conservative Democratic opposition, Rangel said he relishes the battle.
"I'm anxious to take on those people who oppose a public option," he said. He'll have public opinion on his side. A recent poll showed 3 out of 4 people want a public plan as part of health care reform. "We've got the momentum."
Waxman told the Huffington Post after the press conference that the public plan is "essential," when asked if reform was possible without it. "I think it's essential to the reform as outlined by the president and as the three congressional committees have set forth. I'm not gonna say nothing's off the table, because we have a lot of ideas on the table that many of us don't agree with. But from my point of view, I think it makes the health care system work to have competition, which means public choice for those who are seeking health coverage."
And, said Miller, it's what the president, who was elected in a landslide, campaigned on. The draft, he said, tries to "put language to what President Obama campaigned on in front of the American people."
Conservative Democrats in the Senate, however, have sided with the insurance industry, which put out a statement against the House plan while the press conference was still going on.
"We understand. We've read all the different positions in the Senate," said Miller. "We've had discussions back and forth, but we continue to believe this is an important, important component of real health care reform."
The three committees will hold hearings on the bill next week, with the hope of bringing it to the floor the week after the July 4th recess.
Senate Democrats have been set back by higher-than-expected cost estimates that have come back from the Congressional Budget Office, although the Senate plans were submitted without the public option, which is intended to reduce costs in the long run.
The House version will be expensive. It includes an effort to close the so-called "doughnut hole" in Medicare prescription drug coverage, which would be costly but would go a long way toward obtaining the support of seniors, who are less inclined to back a public option, according to a recent poll. They already have a public plan.
Doctors, too, get a wet kiss in the plan from Democrats, a proposal to permanently fix the "sustainable growth rate" payment system. The current public reimbursement system requires doctors to continuously lobby Congress to prevent automatic rate cuts. Members of Congress fill their coffers as a result of that lobbying and have never let the threat of a rate cut take effect. So, in effect, permanently fixing it won't cost more money but the budget office, which pretends the fix won't be made each year, will count it as an expensive provision. (Got that?)
The move by the House Friday was an effort to reassert itself. "I'm only speaking for the House. We feel very good about this," Miller told HuffPost after the presser.
Waxman dismissed the Senate fumbling. "I'm not getting alarmed by the legislative process," he said. "The Senate Finance Committee can't pass a bill into law without us. We can't pass one without the Senate. And we can't, either of us, do it together without the president."
Ultimately, the final negotiations will go on in a conference committee between the two chambers, and Miller said his body hopes to take the fight there. "We hope to take it to conference committee," he said.
If the conference committee emerged with a public plan intact, it would force Senate Republicans and conservative Democrats to take a stand for or against health care reform.
"What we had today was a good start, because the three committees are not competing. They're starting off together. We're on our way," said Waxman, raising his fist as he entered an elevator. "There's no stopping us now!"
Ryan Grim's book, This Is Your Country On Drugs: The Secret History of Getting High in America, is now on sale
How will Trump’s administration impact you? Learn more