Health reform sticking points
Posted: Friday, November 06, 2009 5:03 PM by Domenico Montanaro
From NBC's Doug Adams
With word that the healthcare reform vote may slip in the House, it's clear that Democrats are still scrambling to get to enough of their members on board. With the assumption that no Republicans will support the bill, Democrats (who now number 258) need to keep their defections to under 40 in order to get to a bare majority of 218 votes.
There are a couple of different factions. Many of the moderate Blue Dog Democrats think the overall bill is too expensive and chances are a big handful of them will vote against the bill. Then, there are some Democrats in marginal districts who are worried about their re-election race -- in some cases the leadership could give them a pass to oppose.
And two policy sticking points have emerged -- abortion and immigration.
Here's a short primer on those two bugaboos:
ABORTION: A group of pro-life Democrats are concerned the bill does not go far enough to ensure that taxpayer money will not be used to pay for abortions. There are at least two dozen pro-life Democrats in the House and while not all of them are threatening to vote against the bill, there are enough that it's become a problem for the House leadership.
Mike Doyle (D-PA) and Brad Ellsworth (D-IN) are trying to work out a compromise. Ellsworth's amendment would strengthen the language and, among other changes, would specifically ban the "public option" from covering abortion. But some pro-lifers want to go farther, and they favor even tougher language in an amendent by Bart Stupak (D-MI) who wants to block coverage of abortion services from both the public option AND private insurance plans that get federal subsidies. The Stupak language, say abortion rights supporters, is so strong it could mean health insurance providers that cover abortion won't even be able to participate in the public exchange (where tens of millions of customers would shop for insurance).
The U.S. Conference of Catholic Bishops is lobbying hard on this issue, and many members won't back anything the Bishops oppose. And the USCCB does not support the Ellsworth compromise.
IMMIGRATION: With opponents of health reform whipping up the spectre of illegal immigrants getting free health care, some moderates are pushing to bolster immigration restrictions. But that's a big problem for some Hispanic members who think the language is already strong enough.
The House bill already bars illegal immigrants from enrolling in the public option, and from recieving subsidies for health plans. But the Senate bill goes further, also barring illegal immigrants from shopping in the "public exchange." THAT restriction goes too far for many in the Congressional Hispanic Caucus, and they want to make sure the House bill isn't changed to match the Senate languague.
Rep. Xavier Becerra, the only Hispanic member of the House Democratic leadership, is trying to work out a compromise. The Hispanic Caucus has 27 members, a big block of votes that Democrats can't afford to lose.
On the other side of the issue are a signficant number of moderates, mostly from conservatifve districts, who say they need reassurances about illegal immigrant restrictions.
