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High-Ranking House Democrat Predicts Health Bill This Year

Even as House Democrats turn their attention to jobs and the economy, House Education and Labor Committee Chairman George Miller predicted Thursday that Congress will pass health care overhaul legislation this year.

In an interview with Kaiser Health News, the California Democrat, a close ally of House Speaker Nancy Pelosi, D-Calif., said negotiations with the Senate are continuing. "We're going to get it done this year," Miller said.

"It would have been much easier to pass it in July. It would have been easier to pass it in November. But again, as the president said, it's hard," Miller said. "We don't give up just because things are hard in this country. And we shouldn't give up – elected officials and leaders in the Congress should not give up just because it's hard."

Miller's committee is one of three in the House that passed health care legislation, which was merged into a measure the chamber passed in November.

Miller said much of the discussion between the House and the Senate is focusing on the rules of each chamber and what may be allowed in budget reconciliation, a fast-track process that allows legislation to pass in the Senate with 51 votes but is limited to provisions dealing with the budget. Reconciliation also sets strict protocols for consideration of the bills in both chambers.

One scenario is to have the House pass the Senate bill as well as a separate reconciliation package that would change some of the bill's provisions. This could possibly be in the areas of subsidies provided to help low-income Americans purchase health care coverage, which could make the legislation more acceptable to the House. Another option, Pelosi said Thursday, is to move individual elements of the larger bill separately.

Miller stressed that no final decisions have been made. "There's just a lot of technical questions, given the process, that have to be answered," he said. One potential problem with moving some pieces of the bill as stand-alone legislation is that "to get the little pieces to work you've got to have the main pieces of legislation that holds those together."

He declined to say when the House would act on health care and instead repeated the words that Pelosi and other Democratic leaders have uttered numerous times before: "We'll go when we believe we have a bill that holds together and achieves the goals of reform and has the votes."

House Republicans have advanced their own approach to health care, which they say will improve coverage and reduce health care costs at less expense to the public. Democrats have dismissed it as too limited.

Looking back on the last year, Miller said the slow deliberations of the Senate, coupled with its rules that require 60 votes to break a filibuster, bogged down consideration of health legislation. In addition, deals like one on Medicaid that Senate Majority Leader Harry Reid, D-Nev., cut with Sen. Ben Nelson, a Nebraska Democrat, outraged a public that "began to see a process that was starting to deteriorate," Miller said.

Miller also said the White House wasted too much time trying to win Republican support for the bill. "I think they were late in coming to the realization that the Republicans were never interested in the success of this measure, that [the GOP was] heavily vested in its failure."

This story was produced through collaboration between NPR and Kaiser Health News (KHN), an editorially independent program of the Henry J. Kaiser Family Foundation, a nonpartisan health-care policy research organization. The Kaiser Family Foundation is not affiliated with Kaiser Permanente.

Copyright 2023 Kaiser Health News. To see more, visit Kaiser Health News.

Mary Agnes Carey