Pelosi: Congress Very Close on Health Bill

The House and Senate are "very close" to finalizing historic legislation revamping the nation's health care system, House Speaker Nancy Pelosi said Wednesday after she and other Democratic leaders met with President Barack Obama at the White House.

Pelosi's optimistic prediction came after days of frantic work by staff members, lawmakers and the president himself to iron out the differences between sweeping bills passed by the House and Senate before Christmas. Obama wants final legislation on his desk in time for his State of the Union address early next month, and Democratic leaders are rushing to deliver despite the numerous discrepancies between the bills.

Obama is taking a more direct role than ever, convening Oval Office meetings Tuesday and Wednesday of House Democratic leaders, who have to compromise the most so that Majority Leader Harry Reid, D-Nev., can get a bill through the Senate with his fragile 60-vote majority.

Pelosi, D-Calif., was enthusiastic after emerging from the White House late Wednesday afternoon with the chairs of four key committees.

"We've had a very intense couple of days," Pelosi said. "After our leadership meeting this morning, our staff engaged with the Senate and the administration staff to review the legislation, suggest legislative language. I think we're very close to reconciliation."

House Energy and Commerce Committee Chairman Henry Waxman, D-Calif., said the House would like to pass a bill by the end of this month.

Under a fast-track process worked out with Obama, lawmakers are bypassing the usual negotiations between the two chambers in the interest of speed, and the House will work off the Senate's version, amend it and send it back to the Senate for final passage.

The bills passed by the House and Senate both would require nearly all Americans to get coverage and would provide subsidies for many who can't afford the cost, but they differ on hundreds of details. Among them are whom to tax, how many people to cover, how to restrict taxpayer funding for abortion and whether illegal immigrants should be allowed to buy coverage in the new markets with their own money.

The House bill tops $1 trillion over 10 years while the Senate bill is cheaper.

House Democrats are reluctant to abandon elements of their legislation favored by liberals but rejected by Senate moderates, but face doing just that. That means no new government insurance plan, which the House wanted but the Senate omitted, and changes to the House's preferred payment scheme. The House wants to raise income taxes on individuals making more than $500,000 and couples over $1 million. The Senate would slap a new tax on high-cost insurance plans. Although the Obama administration supports the Senate's insurance tax as a cost-saver, labor unions, which contribute heavily to Democratic candidates, oppose it.

The House is looking at accepting the insurance tax if it hits fewer people than the Senate's design now calls for. And in place of a new government insurance plan House Democrats are working on stronger affordability measures for middle- and lower-income people, something Obama has agreed to help them with.

"What we're talking about is affordability and accountability, and I think in both of the bills are the makings of great legislation," Pelosi said. "It's not a question of adopting this or that. It's about addressing the needs of the American people."

House members also wants the Senate to agree to revoking insurers' antitrust exemption as a way to hold insurance companies accountable in absence of direct competition.

A conference call of the full House Democratic caucus is scheduled for Thursday.

In California, Gov. Arnold Schwarzenegger, who in October praised Obama's efforts toward reforming health care, delivered a stinging indictment of the legislation.

"Health care reform, which started as noble and needed legislation, has become a trough of bribes, deals and loopholes," Schwarzenegger said in his State of the State address in Sacramento. "You've heard of the bridge to nowhere. This is health care to nowhere."

Schwarzenegger urged California lawmakers to vote against the bill unless they can negotiate a special deal to get more Medicaid money, as did key centrist Sen. Ben Nelson, D-Neb., for his state.