Health-care: Pelosi's plan for a patch

by Mark Silva

Nancy Pelosi, the speaker of the House, has a plan for pushing a health-care overhaul through a Congress now facing a 41-vote Republican resistance in the Senate:

As our bureau's Noam Levey reports this morning, Pelosi's plan is simple: Let the House pass the health-care bill that already has cleared the Senate, and then address the remaining differences between the two in a separate "reconciliation'' bill that requires only 51 votes for passage in the Senate.

"Majority rule, we call it," Pelosi (D-Calif.) told a group of columnists Wednesday.

There's only one problem with the plan: House and Senate Democratic leaders haven't agreed on what they might agree upon for such a reconcilation end-run. And Senate Majority Leader Harry Reid (D-Nev.) hasn't signed off on Pelosi's plan.

"The politically fraught strategy might allow Democrats to salvage a version of the overhaul that senior lawmakers pushed through the House and Senate late last year,'' Levey reports. "Because budget reconciliation requires only a simple majority in the Senate, it could enable Democrats to circumvent a threatened GOP filibuster.

Some of the measures that House Democrats would want to address in that separate bill: Elimination of the Senate's new tax on high-end "Cadillac" insurance plans, bigger subsidies for low- and moderate-income Americans to buy health coverage, and more aid to help states expand Medicaid.

Altogether, that coujld add another 300 billion over the next 10 years to the cost of the Senate-passed plan, putting the total near $1.2 trillion, according to a senior Senate Democratic aide. A lot of Senate Democrats call that too high a price to pay.

See the full report on Pelosi's plan in Tribune newspapers.