Dems win hard-fought approval of health care bill in committee, House vote in Sept.

Dems win approval of health bill in committee

WASHINGTON — President Barack Obama and congressional Democrats are looking ahead to a health care showdown on the House floor in September following a key committee’s passage of sweeping overhaul legislation.

The 31-28 vote in the House Energy and Commerce Committee Friday night was weeks later than either the White House or Democratic leaders had hoped. Nonetheless, it was a triumph for them.

The vote came after weeks of negotiations finally satisfied concerns raised by fiscally conservative Democrats — only to produce a compromise that riled liberals.

The liberal opposition was quieted with a last-minute series of changes agreed to early Friday that included limiting how much insurers can raise premiums, and giving the federal government authority to negotiate directly with drug companies for lower prices under Medicare.

“We passed a bill out that shows that we can bring together conservative, moderate and progressive Democrats,” Energy and Commerce Chairman Henry Waxman, D-Calif., said after the vote. “We’re going to need that coalition on the House floor, and I feel confident that we’ll pass a health care reform bill in the House when we come back in September.”

Five Democrats and all committee Republicans opposed the bill.

The measure is designed to extend health insurance to millions who now lack it, at the same time it strives to slow the growth in medical costs nationwide — Obama’s twin goals.

While the pace of action was slower than party leaders had hoped, it was speedier by far than the timetable in the Senate.

There, Democrats said a deadline of Sept. 15 had been imposed on marathon talks aimed at producing a bipartisan compromise in the Senate Finance Committee.

Without a bipartisan bill, Finance Chairman Max Baucus, D-Mont., would presumably have to produce a measure tailored to Democratic specifications, a step he has said repeatedly he would rather avoid. It wasn’t clear how much the deadline for the committee to start voting was Baucus’ idea, and how much it reflected growing impatience at the White House and on the part of Senate Majority Leader Harry Reid of Nevada.

The Energy and Commerce Committee was the third of three House panels to act on the legislation affecting one-sixth of the nation’s economy. A vote in the full House is expected in September, after lawmakers return from a monthlong vacation. Combining the measures produced by the three House committees could be tricky since compromises agreed to in the Energy and Commerce Committee produced a bill less reflective of liberal priorities than the legislation passed by the Ways and Means and Education and Labor committees.

The biggest example is probably the shape of a new government insurance plan that would compete with private insurers. House Democrats originally tied payment rates for providers in the plan to Medicare rates, but fiscally conservative Blue Dogs in the Energy and Commerce Committee pushed instead for rates to be negotiated with providers, as happens with private companies.

Many liberals fear that would result in higher costs to patients, and the Ways and Means and Education and Labor produced bills with public plans modeled on Medicare.

The Democrats who opposed the final Energy and Commerce bill were Reps. John Barrow of Georgia; Rick Boucher of Virginia; Jim Matheson of Utah; Charlie Melancon of Louisiana and Bart Stupak of Michigan.

Under the bill, insurance companies would be required to sell coverage to all seeking it, without exclusions for pre-existing medical conditions. The federal government would provide subsidies for lower-income families to help them afford policies that would otherwise be out of their reach.

The bill would set up so-called exchanges, in effect national marketplaces where consumers both with and without subsidies could evaluate different policies and choose the one they wanted.

The main expansion of coverage would not come until 2013 — after the next presidential election.

Even so, the political stakes are enormous for Obama and the Democrats as they strive to pass legislation that has proved elusive for years. Republicans are overwhelmingly opposed to the approach they chose, and outside groups on both sides of the issue arranged a heavy dose of television advertising over August.

Associated Press writers David Espo and Ricardo Alonso-Zaldivar contributed to this report.