A House panel passed its health care reform bill late Friday, preparing the ground for a critical vote on President Obama's health care reform plan after the August recess.
The Energy and Commerce Committee's passage of the bill, after two days of marathon markup sessions, represents the latest and most significant hurdle that comprehensive health care reform has cleared so far. It's a major accomplishment for the president's agenda, even though it comes weeks later than the White House and congressional Democrats originally had planned.
"I would have liked to have passed the bill on the House floor before we left, but it really only sets us back a matter of days, because when we get back in September, the House can act, the Senate can act, and we can go right into conference," said the committee chairman, Rep. Henry A. Waxman, California Democrat.
The bill passed 31-28, with five Democrats breaking ranks to oppose the measure, leaving major question marks hanging over the effort on both ends of Capitol Hill.
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Reps. Bart Stupak of Michigan, Jim Matheson of Utah, Charlie Melancon of Louisiana, John Barrow of Georgia and Rick Boucher of Virginia are the five Democrats who opposed the measure.
The House action gives Democrats a boost heading into the month-long recess, but lawmakers returning to their districts this weekend are certain to be greeted with support and attack ads from the national political parties and health industry groups. The most critical test may come from voters who, based on national polls, appear to be reeling from national spending fatigue.
The situation is even more uncertain in the Senate, where critical bipartisan talks in the Senate Finance Committee have yet to produce a draft bill for the panel to debate. Chairman Max Baucus, Montana Democrat, set a Sept. 15 deadline on Friday for the small group of six negotiating senators to strike a deal.
When the House returns from recess in September, House Democratic leaders plan to merge the bill's three strands - from the Energy and Commerce, Education and Labor, and Ways and Means committees. Then the combined package could face a difficult floor vote.
The bill's passage in the Energy and Commerce Committee, the third and last House committee with jurisdiction, marks significant progress - the failed health care effort led by Hillary Rodham Clinton in the early 1990s never even made it that far.
But that progress so far has not come easily.
Democrats in the committee kept their health care reform plan alive with a package of amendments designed to cut costs to please Blue Dog fiscally conservative Democrats while preserving liberal support.
The series of amendments would revise the way drugs are priced in the taxpayer-funded "public" insurance option that the plan would create. It also would introduce significant change to insurance rates, prohibiting companies from increasing rates by more than 1.5 times the annual rate of medical inflation unless the government grants a waiver.
Changes would come to Medicare as well, allowing the government to negotiate directly with pharmaceutical companies in an effort to drive down drug prices.
The moves are designed to save money at the expense of the bottom line in the insurance industry, which some lawmakers argue has made obscene profits as health care costs have soared and coverage has been cut back.
"We would like those cuts to come from someone ... who has done well the last couple of years," said Rep. Jane Harman, California Democrat.
Under the deal between liberal and conservative Democrats, liberal members also won an agreement to hold a floor vote on establishing a single-payer health care system when the House returns in September. The single-payer system, used in Canada, was never seen as politically viable and was not given serious consideration in the Congress until now.
The Blue Dogs, who held the balance of power in light of near-universal Republican opposition, had threatened to vote against the bill in committee unless the structure of the public plan was changed and more cost-cutting measures were introduced.
Progressives balked at a deal between the Blue Dogs and Mr. Waxman earlier this week that would have eliminated $100 billion in subsidies over the next decade. The new plan would restore to the bill about $50 billion, which would be put back into the plan as subsidies for low-income people, said Rep. Tammy Baldwin, Wisconsin Democrat.
The markup ended late Friday night with about 60 outstanding amendments, according to Mr. Waxman. The remaining amendments will be considered under a separate bill in September, under an agreement between Mr. Waxman and ranking member Rep. Joe L. Barton of Texas.