Share
WASHINGTON U.S. Rep. Patrick McHenry strode onto the stage at one of his first town hall meetings last month and dropped the 1,000-page health care overhaul bill at his feet with a thud.
Charlotte psychotherapist Edie Irons took a quieter stand – lighting a candle at a vigil to memorialize patients who died lacking health coverage.
The August political theater season has ended, and now activists and politicians turn to Washington, as Congress returns after a five-week break to see whether it can do anything to overhaul the nation's health-care system.
President Obama is expected to lay out his vision for a new health-care system when he speaks to a joint session of the House and Senate on Wednesday night.
“I'm disappointed the president hasn't come out and demonstrated greater leadership on this,” said Irons, an independent who voted for Obama last November and supports a public insurance option.
Before the recess, congressional Democrats were working on plans that included a “public option,” where a government insurance plan would be offered as an alternative to private plans. The plans moving through the House and Senate differ in some respects, but both would bar private insurance companies from refusing to cover people because of pre-existing conditions.
But new questions have emerged during the recess: Will an overhaul still include some sort of public option? How would the package be paid for? Should Democrats try for a smaller, bipartisan effort? Or will they try to push through their preferred package by taking advantage of parliamentary rules?
To do that, they face strong opposition from Republicans bolstered by frustrated and vocal constituents.
“The consensus of my constituents is we must have reform of the health-care system, but they don't like the plan being currently proposed,” said McHenry, a Cherryville Republican who conducted 11 town hall meetings over the recess.
“But to have the federal government get into health care even more, my constituents vocally oppose that,” he said.
Much work remains before any bill becomes law.
In the House, three committees that passed nearly identical overhaul bills must tweak the remaining language. That legislation is expected to go to the House floor this month, and would pass with the support of moderate Democrats as long as liberals don't drop it.
House Budget Committee Chairman John Spratt, the dean of the S.C. delegation with a quarter-century in Congress, will try to enforce his pledge that any new health-care program not increase the federal deficit.
Making good on that pledge could entail cutting other programs or raising taxes, though the York County Democrat believes that current deficits will decrease as temporary financial-rescue programs end and the economy improves.
Meanwhile, a Senate version passed in the health committee this summer along party lines, with N.C. Sens. Kay Hagan, a Democrat, and Richard Burr, a Republican, splitting their votes.
The Senate bill now rests in the finance committee, where – until recently – negotiators from both sides of the aisle had been working out details.
Republican Sen. Lindsey Graham of South Carolina has joined 14 other senators, split roughly between the two parties, to back new federal mandates. Instead of creating a government plan, the plan would require private insurance companies to cover pre-existing conditions, ban them from denying coverage of catastrophic illness and enable people to maintain coverage if they lose their jobs.
Fellow Republican Sen. Jim DeMint of South Carolina has helped rally national opposition to “Obamacare,” urging conservative activists to use health care to defeat the president politically and “make it his Waterloo.”
N.C. delegates reflect debate
North Carolina's delegation mirrors much of the debate in Washington.
At one end are conservatives such as McHenry, who called any public option an “enormous government takeover” of health care. Burr, a free-market advocate, wants to give Americans tax credits to buy their own coverage in the private sector.
At the other end of the spectrum sit liberals such as Democratic U.S. Rep. Mel Watt of Charlotte, who signed a letter before the recess saying the negotiated House bill was “unacceptable” because its public option wouldn't lower costs for working-class families.
U.S. Rep. Brad Miller, a Raleigh Democrat, said he won't vote for any plan that doesn't rein in insurance companies – the opposite approach to what conservatives are pushing.
In the middle are moderates such as Hagan, who voted for a public option backup plan in a Senate health committee but said she won't sign off on the larger overhaul bill until she knows how it would be paid for.
Voters are split
Voters' opinions vary as well.
A national McClatchy/Ipsos poll conducted last week found 45 percent of respondents opposed the health-overhaul plans now being discussed, with 40 percent in support.
The poll also found division around support for a public option, with 49 percent of respondents saying a public insurance option would be needed to ensure quality access to health care for all Americans. Forty-six percent disagreed.
The poll had a margin of sampling error of plus or minus 3 percentage points.
Republican Rep. Sue Myrick of Charlotte said Obama can bring more House members on board if he starts small. That could include allowing patients to buy health insurance across state lines and prohibiting companies from excluding people based on pre-existing conditions.
“There are 10 to 12 things we can pretty much agree on. Why not tackle those?” Myrick asked. “There are 7 to 8 million people who truly, truly do need help, and even giving subsidies to help them would do a lot to help them.”
In the Senate, Parliamentary rules would allow Senate Majority Leader Harry Reid to tack much of the overhaul program onto a budget bill in mid-October. They would need just 51 votes to pass such a measure, and Democrats now control 59 seats.
But Democrats might not want to pass a major overhaul using such a partisan maneuver.
If legislation passes in each chamber, the real negotiations then come in a conference committee. There, Senate and House negotiators go behind closed doors to merge the two bills into one. They might not emerge with a final product until close to the end of the year. And that measure would again have to go through the House and Senate.
Still, Hagan said health legislation can be done this year.
“What I feel is before the end of the year, we will have health care reform,” she said. “I can't tell you everything that's going to be in it until I see what we do when we get back from recess. But we will have health care reform.”
James Rosen of McClatchy Newspapers contributed
bbarrett@mcclatchydc.com or 202-383-0012
