Pelosi Wants Excise Tax Stripped From Senate Health Care Bill

Speaker of the House Nancy Pelosi (D-CA)
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After an afternoon meeting with House leaders and health care principals yesterday, Speaker Nancy Pelosi spoke in vague terms about what reform must accomplish: Affordability, accountability, and accessibility. “A triple ‘A’ rating,” as she described it.

But aides say she’s particularly steamed that the White House wants her to largely adopt the Senate bill in its entirety. And she’s particularly unhappy that the White House has thrown its weight behind the Senate bill’s chief funding mechanism: an excise tax on so-called “Cadillac” insurance policies, which she and many in her caucus have long believed violates President Obama’s pledge not to raise taxes on the middle class. According to one aide, that–not the public option–was likely the reason she ribbed Obama at her press conference yesterday, quipping, “there were a number of things he was for on the campaign trail.”

The House proposes paying for its bill by imposing a surtax on high-income Americans. And though there’s been speculation for months that the final reform package will include a combination of both sources of revenue, Pelosi, who’s already had to accept the demise of the public option, wants the excise tax gone.

That will be a tough sell with the White House, which has endorsed the Senate’s measures. But other issues are coming into focus as House priorities as well. The House bill organizes insurance exchanges at the national level, while the Senate bill requires states to erect their own. Pelosi’s proposal would also make mandatory insurance more affordable for individuals below 300 percent of the poverty line, require insurance companies to cover a greater percentage of health care costs, and would implement most major benefits a year earlier than would the Senate bill.

Pelosi and House Majority Leader Steny Hoyer met with Obama yesterday to continue negotiating what shape the final bill–which will be based on Senate legislation–will take. (Senate Majority Leader Harry Reid and Majority Whip Dick Durbin participated via conference call.)

This afternoon–after another meeting with members–the principal authors of the House bill will convene at the White House. What happens at that meeting will be key. Tomorrow afternoon, leadership will brief the House Democratic Caucus on the state of affairs. And weary congressional progressives–still bruised over the loss of the public option–will want to hear some good news for a change.

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