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A Breakthrough? UPDATE: Nope.

July 24, 2009 - by Donny Shaw

UPDATE: Looks like Waxman spoke too soon in calling his concession on Medicare disparities a “breakthrough.” Here’s the latest from Congress Daily ($) on where things stand with Waxman and his committee’s Blue Dogs:

Rep. Mike Ross, D-Ark., today said negotiations between Blue Dogs and House Energy and Commerce Chairman Henry Waxman on healthcare overhaul legislation fell apart this afternoon.

Ross, who chairs the Blue Dog Coalition’s Health Care Task Force, said there is no chance for a deal following a final meeting this afternoon with Waxman and that Waxman does not have the votes to get the House Democrats’ overhaul bill out of committee.

Waxman laid down his final offer today to the Blue Dogs on one of their concerns, but Ross said not before he reneged on two agreements reached Tuesday with President Obama and the coalition to include a provision that would create a panel to set Medicare payment rates rather than leave the responsibility to Congress.

Ross also said that at the Tuesday meeting with Obama Blue Dogs were promised the House would use Senate Health, Education, Labor and Pensions Committee language on the public option, but that Waxman reneged on that deal as well.

Sounds to me like Waxman has basically given up on negotiating with the Blue Dogs on his committee and is now focused on shoring up support among non-Blue Dog Democrats from rural districts so that he can bring the bill to the floor without needing too many Blue Dog votes.

Original post below:

I was just going to post on this piece from The Hill about how Rep. Henry Waxman [D, CA-30] is preparing to skip his committee’s faltering markup of the health care bill and bring the bill straight to a vote by the full House. But, now in my RSS reader, I’m seeing this piece from CQ – “House Leaders Say They’ve Met Concerns of Dissident Democrats”:

Declaring a “significant breakthrough” in efforts to meet the concerns of dissident Democrats, House leaders are preparing to move forward with their health care overhaul next week.

“There has been a significant breakthrough in resolving the outstanding issue of regional disparities in Medicare and therefore in the public plan,” said Energy and Commerce Chairman Henry A. Waxman , D-Calif.

He said Speaker Nancy Pelosi , D-Calif., convened “extensive negotiations and invited everyone with concerns to participate.”

The talks were aimed at satisfying the concerns of fiscally conservative Blue Dog Democrats and others within the caucus about the differing rates that Medicare uses to pay doctors, hospitals and other health care providers.

Many members from rural areas say those rates are unfairly low, and they have refused to endorse a bill that does not address the problem — both in Medicare and in a new public insurance option the bill would create to compete with private insurers.


Under the deal outlined Friday by Waxman and others, the Institute of Medicine would conduct an analysis of regional disparities in Medicare rates and then send its assessment to the Department of Health and Human Services, which would implement the study’s recommendations.

The Institute of Medicine is a non-profit organization of health policy experts chartered by Congress in 1970 as a component of the National Academy of Sciences. It provides independent analysis and guidance to Congress and others in government and the private sector.

“We assume there would be a change in rates,” said Education and Labor Committee Chairman George Miller , D-Calif.

Ways and Means Committee Charles B. Rangel , D-N.Y., said Congress would have the option to block the new rates once the commission reports back.

With that, the Democratic leadership seems pretty optimistic that there will be enough votes for the bill to pass the House next week. The House Energy and Commerce Committee Chairman is planning on resuming the markup with this new “breakthrough” in place, but if it’s not enough to win over the Blue Dogs that have been blocking work on the bill, he’s still open to bypassing his committee entirely. It takes at least 30 votes to get a bill out of the 59-member Energy and Commerce Committee. There are 36 Democrats on the Committee, which means that Waxman’s committee could pass the bill if just one of the 7 Blue Dogs that have been blocking it, switches his vote based on the new plan for addressing the Medicare payments issue.

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