Liberals Push Last-Minute Changes to Health Bill

As House Democrats prepare to press their demands for health care with the Senate and the White House, liberal health care advocates are urging them to insist on keeping the House bill's stronger consumer protections and its federal exchange network, over the Senate's looser rules.

The House returned to work in Washington today, and Democrats are holding a meeting tonight to discuss the health care negotiations currently ongoing between the two chambers, Roll Call reports. President Obama will meet with House Democrats Thursday, the Associated Press reports.

House Democrats are seeking "a host of changes and tweaks to the final package that would collectively make it tougher on insurance companies and the rich and easier on the wallets of the middle class," Steven Dennis of Roll Call reports, including a national health insurance exchange system rather than the collection of 50 state-based exchanges that state governments would be called upon to create under the Senate bill.

With the so-called "public option" out of the cards, liberal advocates for reform are insisting that a federal exchange system is needed to ensure consumers can find affordable, quality health care plans.

"The exchanges are supposed to be a more organized, stronger marketplace" where consumers can compare plans and use subsidies and tax credits to buy insurance, Karen Pollitz, director of the Georgetown University Health Policy Institute, said today in a conference call with reporters. "For that reason, building it right is very important."

Adopting the state-based exchange system proposed by the Senate, Pollitz said, would amount to "throwing up a jump ball and letting 50 states figure out how it works." Special Report: Health Care

Furthermore, the quality of state-based exchanges would depend on the state's insurance commissioner, said Michael McGarvey, a former Blue Cross chief medical officer and former state regulator. The process of establishing state exchanges would also be complicated by the states' current budget problems.

"As a former regulator, I can tell you simpler and unified is better than diverse and complex," McGarvey said.

Groups like Health Care for America Now are also pushing for the regulatory system proposed by the House. The Senate bill would exempt group insurance plans with more than 100 employees from some reforms intended to prevent the insurance industry from charging higher premiums based on characteristics such as gender or age.

"The Senate's plan would leave tens of millions of working Americans subject to insurance company abuses," McGarvey said.

Richard Kirsch, the national campaign manager for Health Care for America Now, said House Speaker Nancy Pelosi has been a champion on these issues and expects her to make them a priority.

When President Obama meets with House Democrats at their issues retreat at the Capitol this Thursday, he will surely address the ongoing negotiations. (In a gesture of bipartisanship, the president also intends to speak to House Republicans at their issues conference later this month.)

Whether the House can greatly influence the final legislation depends largely on what the president is willing to do, an unnamed House aide told Roll Call. Given that Senate Majority Leader Harry Reid needs all 60 Senate Democrats to support the bill in his chamber, the final version of the bill is expected to closely resemble the bill that the Senate already approved. Still, Pelosi is insisting her chamber will have a say in the final bill, Politico reports, and could gain more leverage by threatening to draw out the negotiation process.