House committee narrowly approves reform bill, clears way for fall vote - MedCity Morning Read, Aug. 3, 2009

WASHINGTON, D.C. — The House Energy and Commerce Committee voted 31 to 28 on Friday to approve legislation to overhaul the nation’s health care system, clearing the way for a full House vote after Congress returns in the fall after a summer break, according to the Wall Street Journal.

The vote came after changes were made to the sweeping bill to satisfy competingÂ groupsÂ in the Democratic party. Conservative Democrats got an amendment that exempts more small businesses from a mandate to offer health insurance to workers. Liberal Democrats won a provision allowing the government to negotiate directly with drug companies under Medicare, a change from current law, the Journal said.

The broader bill calls for a new public insurance plan that would compete with private insurers. The government-backed plan is aimed at expanding coverage. The gill requires all but the smallest of employers to provide health insurance to workers or pay asÂ much asÂ 8 percent of payroll toward helping workers buy insurance. The energy and commerce committee doesn’t have power over taxes, but companion legislation from a different House committee would raise more than $500 billion by levying a new surtax on the wealthy, the Journal said.

The House and Senate will adjourn for the summer on Friday, Aug. 7, without giving President Obama the health reform bill he wanted by then. But the debate so far has crystallized the battle lines over the proposals to cover more of the nation’s 46 million uninsured, as well as the areas of agreement. For instance, there is bipartisanÂ supportÂ for dramatic changes that would forbid private insurers from denying coverage for people who already are sick, accordingÂ to the Journal.

Lawmakers also largely agree that individuals and small businesses need better ways to shop for insurance. Exchanges that enable people comparison shop for insurance plans likely will end up in the final legislation. Billions of dollars in subsidies would help low- and middle-income people buy the insurance. People whoÂ don’t buy insurance would face fines unless they can prove that buying insurance would have been a hardship, theÂ Journal said.

Broadly, the debate this fall will pit Democrats and President Obama, who say health care reform is urgently needed, against Republicans in Congress who say Democratic plans will lead to excessive government control, more government spending and lower-quality care. Beyond the national politics, the effort to write overhaul legislation to which both Democrats and Republics can agree likely will come down to a handful of issues: whether to create a public insurance plan, how to pay for the overhaul legislation and how much should employers pay for workers’ insurance, the Journal said.