House Democratic leaders, pledging to meet the president's goal of health care legislation before their August break, are offering a $1.5 trillion plan that for the first time would make health care a right and a responsibility for all Americans. Left to pick up most of the tab were medical providers, employers and the wealthy.
"We cannot allow this issue to be delayed. We cannot put it off again," Rep. Henry Waxman, D-Calif., the chairman of the House Energy and Commerce committee, said Tuesday. "We, quite frankly, cannot go home for a recess unless the House and the Senate both pass bills to reform and restructure our health care system."
In the Senate, Majority Leader Harry Reid said he wanted floor debate to begin a week from Monday. With the Senate Finance Committee still struggling to reach consensus, that timetable could slip. Even so, it underscored a renewed sense of urgency.
Obama himself was driving the action, going off-script to push the issue during a speech in Michigan and scheduling a Rose Garden news conference for Wednesday to make more comments on the topic.
"There's going to be a major debate over the next three weeks," Obama said in Warren, Mich., deviating from his prepared text on new spending for community colleges. "And don't be fooled by folks trying to scare you saying we can't change the health care system. We have no choice but to change the health care system because right now it's broken for too many Americans."
All involved were mindful of the dwindling days before Congress leaves town. Obama wants legislation through the House and Senate before then to slow rising costs and extend coverage to some 50 million uninsured Americans.
Under the House Democrats' plan, the federal government would be responsible for ensuring that every person, regardless of income or the state of their health, has access to an affordable insurance plan. Individuals and employers would have new obligations to get coverage, or face hefty penalties.
The legislation calls for a 5.4 percent tax increase on individuals making more than $1 million a year, with a gradual tax beginning at $280,000 for individuals. Employers who don't provide coverage would be hit with a penalty equal to 8 percent of workers' wages, with an exemption for small businesses. Individuals who decline an offer of affordable coverage would pay 2.5 percent of their incomes as a penalty, up to the average cost of a health insurance plan.
The liberal-leaning plan lacked figures on total costs, but a House Democratic aide said the total bill would add up to about $1.5 trillion over 10 years. The aide spoke on condition of anonymity to discuss the private calculations.
Three House committees will begin voting on the bill Thursday. Changes in the legislation are likely to satisfy a group of moderate and conservative Democrats who are withholding support.
The 1,000-page bill is unlikely to attract any Republican backing, and business groups and the insurance industry immediately assailed it as a job-killer.
The business groups also warned that the U.S. health care system could be damaged by adding a government-run insurance plan and a federal council that would make some decisions on benefits, as called for in the legislation. Thirty-one organizations signed the letter, including the U.S. Chamber of Commerce, the Business Roundtable representing top corporate CEOs and the National Retail Federation.
The House bill seemed unlikely to win broad backing in the Senate, where the Senate Health, Education, Labor and Pensions Committee was expected to finish its version of the legislation Wednesday in what was looking to be a party-line vote.
The Finance Committee was striving to produce a bill by the end of the week, though the committee's chairman, Sen. Max Baucus, D-Mont., acknowledged it would be a challenge to meet Obama's timeline.
"I think it's a lift but one we could accomplish, one we could handle," Baucus said. "I'm not going to guarantee that it's going to happen."
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