Washington Senior House Democrats have largely abandoned hopes of including a government-run insurance option in the final compromise health care bill taking shape, according to several officials, and are pushing for other measures to rein in private insurers.
House Speaker Nancy Pelosi and other senior Democrats told President Barack Obama in recent meetings they want the legislation to strip the insurance industry of a long-standing exemption from federal antitrust laws, officials said. That provision is in the House-passed measure, but was omitted from the bill that the Senate passed Dec. 24.
They also want the final measure to include a House-passed proposal for a nationwide insurance exchange, to be regulated by the federal government, where consumers could shop for private coverage. The Senate bill calls for a state-based system of exchanges.
Additionally, House Democrats want to require insurers to spend a minimum amount of premium income on benefits, thereby limiting what is available for salaries, bonuses, advertising and other items. The House bill sets the floor at 85 percent; the Senate-passed measure lowers it to 80 percent for policies sold to small groups and individuals.
The officials spoke on condition of anonymity because the negotiations are private.
The maneuvering comes as the White House and majority Democrats intensify efforts to agree on a final measure, possibly before Obama delivers his State of the Union address late this month or early in February.
Government intervention into the insurance market is one of the most contentious issues to be settled. Others include the fate of a Senate-passed tax on high-cost insurance plans, bitterly opposed by some labor unions; the extent to which abortions could be covered by insurance to be sold in the new exchanges; and the amount of money available to help lower-income families purchase coverage.
Meanwhile, the Senate’s plan to expand health coverage to 34 million more Americans would raise costs slightly, government economic experts said in a report Saturday.
Over time, cost-cutting measures could start to reduce the annual increases in health care spending, offering the possibility of substantial savings in the long run. At the same time, however, some of the Senate’s Medicare savings could be unrealistic and cause lawmakers to roll them back, according to Medicare’s top number crunchers.
Health and Human Services Secretary Kathleen Sebelius said the report shows the Senate bill would slow the rate of health care costs, strengthen Medicare and provide millions more people with insurance coverage.
President Obama used his weekly radio and Internet address Saturday to play up the brighter side of the overhaul he hopes to sign in time for his first State of the Union address to a joint session of Congress in a matter of weeks.
He said it would ban “the worst practices of the insurance industry” even as he acknowledged it would take several years — until 2014 in some instances — for some of the changes to be fully in place. That has disappointed consumers and their advocates.