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Obama Ups Ante in Health Care Debate

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Speaker Nancy Pelosi (D-Calif.) and the chairmen of the committees with jurisdiction over health care reform insist on a robust public plan, which would give all Americans the option of signing up with government insurance instead of with a private company. The “trigger” idea is strongly opposed by liberal Democrats, much of House leadership and the chairmen.

Blue Dogs voted to adopt principles restricting their support of any public option Wednesday, and they have the votes, along with Republicans, to sink health care. But Energy and Commerce Chairman Henry Waxman (D-Calif.) dismissed the trigger as “a very bad idea,” saying health care reform would not pass the House without a substantial public plan.

“We had a trigger with Medicare Part D,” Waxman said. “That just means it won’t happen.”

In the Senate, after several months of optimism that Baucus’ inclusive Finance Committee process might yield a bipartisan reform bill, Republicans this week have grown pessimistic.

Because the Baucus bill, which is expected to be somewhat moderate and fall just to the left of center on the political spectrum, must be merged with a Kennedy bill predicted to be quite liberal, Senate Republicans now expect the final vehicle to be a non-starter within their conference.

Sen. Orrin Hatch (R-Utah), who sits on both Finance and HELP, said the process appears stacked against a bipartisan outcome because of the need to meld those two bills. In fact, Hatch predicted that the costs of enacting the Kennedy bill on its own to be so great that even most Democrats would have trouble supporting it.

“Kennedy [HELP] staffers are writing the most liberal bill they can. They expect Baucus to work off of that bill,” Hatch said Wednesday. “Therefore Baucus ... is going to have to work off of a very, very liberal HELP Committee bill. ... I doubt you’ll get many, if any, Republicans to vote for that kind of a dog.”

Democratic Members of HELP were meeting with their colleagues in the Democratic Conference on Wednesday evening to walk them through the components of the Kennedy bill. The HELP Committee is scheduled to mark up a bill in about two weeks; Finance is tentatively scheduled to mark up its bill before Congress adjourns for the Fourth of July recess.

Despite Republicans’ growing uneasiness with the legislation taking shape, Sen. Barbara Mikulski (D-Md.), speaking on behalf of HELP, maintained that Democrats are interested in garnering significant Republican support for health care reform. Although there have been signs that merging the Finance and HELP bills will be difficult, Mikulski insisted that the process should go smoothly.

“I think that we will have a bill in which we can interlock,” Mikulski said.

In the House, there are political fissures to address among Democrats as well, including what taxes to raise or benefits to cut in order to pay for health care reform — not to mention the debate over the public plan.

Meanwhile, House Republican leaders have also pounded on the public plan, vowing to oppose en masse any bill that includes one. But they are largely irrelevant. The question is more whether Democrats want to work with Senate Republicans, for whom a trigger may be needed to garner support — or not.

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