Nearly a year after Democrats introduced legislation to reform the health care industry - first by flirting with the prospect of having a government-run program to compete with private insurers and then floating a proposal to expand Medicare to a younger demographic - House Speaker Nancy Pelosi said Friday that Congress is ready to vote on a final bill as early as next week that doesn't include either of those plans.
The legislation will expand health care coverage to 31 million uninsured Americans, but it also includes a mandate requiring Americans to purchase health insurance or face a penalty. The measure does not have the support of a single Republican, and in recent days some progressive and conservative Democrats have been on the fence about whether or not they will support the legislation when it comes up for a vote.
But Pelosi said she was confident she will have enough votes to ensure the bill passes. She said she hopes Congress will vote on the bill before March 21, the date President Obama leaves for his trip to Asia. Earlier Friday, the White House announced that Obama's trip, originally scheduled for March 18, would be delayed.
"I'm delighted that the president will be here for the passage of the bill," Pelosi said. "It's going to be historic. And it would not be possible without his tremendous, tremendous leadership, his persistence, his concern for the American people, always guided by his statement that we will measure our success by the progress being made by America's working families. This legislation not only makes history, but it will make progress for America's working families."
Pelosi added that the March 21 date is not a firm deadline, but she is "hoping it will be in that time frame."
The House Budget Committee is expected to take up the bill Monday and from there it is expected to reach the floor for a final vote next Friday or Saturday. The legislation would then be sent to Obama for his signature. From there, lawmakers would vote on legislative changes introduced in a separate bill.
Pelosi noted, however, that Democrats are still waiting for a final cost analysis from the Congressional Budget Office (CBO). Until that comes through, they cannot move forward on a vote, as they need the CBO estimates to begin drafting legislative language.
"Of course, we're eagerly awaiting the final word from" the CBO, Pelosi said at a news conference Friday. "And when they do [sic], then we will be able to send a bill to the Budget Committee, the Budget Committee will pass that out, we'll go to the Internet with that and discuss the specifics of the legislation with our members, and we'll take whatever time is required for us to pass the legislation."
Pelosi added, "It's important to note that what we are doing is reconciliation... We'll be acting upon the Senate bill with changes that were in the House bill reflected in the reconciliation. So in order to have the Senate bill be the basis and build upon it with the reconciliation, you have to pass the Senate bill, or else you're talking about starting from scratch.
"So we will pass the Senate bill. Once we pass it, whether the President signs it or doesn't, people would rather he wait until the Senate acted, but the Senate Parliamentarian,...said in order for them to do a reconciliation based on the Senate bill, it must be signed by the President..."
On Thursday, Senate Majority Leader Harry Reid formally notified Sen. Mitch McConnell that he he will use the budgetary process of reconciliation to try to pass a final round of changes to the health care bill in the Senate with a simple majority and avoid a Republican-led filibuster.
"We plan to use the regular budget reconciliation process that the Republican caucus has used many times," Reid told McConnell in a letter he sent to the Senate Minority Leader Thursday. "Keep in mind that reconciliation will not exclude Republicans from the legislative process."
Pelosi said Friday that any attempt by progressive Democrats to include a public option, a plan she said she has strongly supported, would fail.
"I have supported - when I say support, signs in the street, advocacy in legislatures - I have supported single payer for longer than many of you have been - since you've been born, than you've lived on the face of the earth. So I think, I have always thought, that was the way to go, A. B, the public option, it isn't without a little sadness that I view that it is not in the bill.
"But in fighting for the public option, which is, I think, a fight that was led in the House, and we had it in our bill, we improved what is going to be in the final product, because while we may not have a public option, we have the purpose of the public option served by the exchanges and what they allow by the rate reviews, which we insisted upon, insurance rate reviews, and by saying that insurance companies, should they be raising rates between now and the onset of the exchanges, may be prohibited from participating in the exchanges.
"What we will have in reconciliation will be something that is agreed upon, House and Senate, that we can pass and they can pass. So I'm not having the Senate, which didn't have a public option in its bill, put any of that on our doorstep. We had it, we wanted it; they didn't have it, it's not in the reconciliation. But it has nothing to do with whether we initiated it here. We did initiate it. [The Senate] didn't."
The provision was removed from the Senate version of the bill when it passed last December. That's the version of the bill, along with a package of changes the Senate will also pass via reconciliation, that the House will vote on.
Last week, however, Sen. Sherrod Brown (D-Ohio) said he would lobby heavily to include a public option in the final round of legislative changes that will be proposed in a separate bill during the reconciliation process.
"I still hope we get it on this. If we don't get it on this, we can give it a try," Brown said.
On Friday, Senate Majority Whip Dick Durbin (D-Illinois) said he would also push for the public option to be included in the separate bill. And in recent weeks 41 Senators have signed a letter calling for a public option when the reconciliation process begins.
But the provision has been unpopular with conservative Democrats in the Senate whose votes were contingent that it not be included in the final piece of legislation. And Obama didn't include it when he unveiled his own legislative suggestions to the health care bill a couple of weeks ago.
One of the other sticking points that delayed passage of the bill last December was tougher language on the use of federal funds for abortion, which conservative Democrats, such as Rep. Bart Stupak (D-Michigan), demanded be inserted into the bill in order to win their support. The language was included. But House Majority Leader Steny Hoyer said Friday the abortion language will not be included in the reconciliation version of the bill, despite Stupak's previous stance.
"We don't want to go without their votes but we do want to forge ahead," Hoyer said Friday. "And as you know, Mr. Stupak has made it very, very clear that he's very strongly in favor of seeing health care reform in this Congress, and I think a lot of his colleagues feel the same way. We are hopeful that we will get a majority and we believe we will get a majority."