The House health care bill is getting cheaper, but Democrats aren’t boasting just yet. Because when they ultimately break silence the hope is to present conservative Democrats in both chambers with a bill that will walk the walk of fiscal responsibility–including a public option, which is projected to save the government billions.
As always, the legislative process is unpredictable, and the Senate is operating in isolation from the House. But with the public option potentially in the balance, Speaker Pelosi’s goal is this: present conservative Democrats in both chambers with a Hobson’s choice between a public option bill and a potentially more expensive Senate bill that may have no public option at all.
On Friday, the Washington Post ran with leaked CBO numbers, showing that House health care leaders have reduced the price tag of their bill by at least $100 billion. The numbers were preliminary–not reflective of the current state of the legislation, which is changing constantly–but they showed a definite downward trajectory in the overall cost of its reform plan.
Still, leadership was not pleased.“These numbers are outdated and are by no means final as we will send new policy specifications to CBO,” said Brendan Daly, spokesman for House Speaker Nancy Pelosi. “But they do confirm, as the Speaker has said, that the coverage provisions of the House bill will be under $900 billion and we will have a public option. No final policy decisions have been made on how to proceed.”
Why the long face when the news is ostensibly quite good? Because the hope, politically speaking, is to make the news better.
The Senate Finance Committee bill clocks in at about $829 billion in new spending–an extremely low number for a project so ambitious–and it has the added bonus, in a legislature that fetishizes fiscal responsibility, of being a deficit reducer. But even if the House can’t get it’s final health care package below that mark, it may still be able to make quite a splash when official CBO numbers are released in the weeks ahead. The ideal scenario is a House bill that’s cheaper in absolute terms than the final Senate bill, without gutting subsidies. But at the very least the House bill will cover more people than the Senate bill, at a comparable price, providing the government more bang for its health care buck.
How would that work? Crucially, the Senate Finance Committee bill isn’t the bill that’s coming to the Senate floor. It still has to be merged with the more expensive Senate HELP Committee package, and when some of the HELP proposal’s pay-fors are incorporated into the final Senate bill, the price tag could be higher than the stand-alone Finance package. Inasmuch as the House and Senate bills are viewed as competitors, it’s the bills that come to the floor that ultimately count. The House bill will almost certainly cover more people, and the hope (though it may not be possible) is to do so while matching, or perhaps besting, the Senate bill’s bottom line. And that could put conservative Democrats in a bit of a pickle: What if the progressive House bill, complete with a public option, is actually cheaper–or, at least, cheaper per consumer–than its counterpart in the Senate?