US House of Representatives votes to approve healthcare reform

Since the antiabortion amendment is unlikely to survive a vote in the Senate, that puts greater pressure on finding votes from fiscal conservatives, who accounted for most of the 39 Democratic defections in the House. Members of the so-called Blue Dog caucus worry about expanding entitlements at a time of soaring federal deficits.

“I am concerned about the impact the legislation could have on rural hospitals and doctors,” said Rep. Ike Skelton (D) of Missouri, citing the impact of proposed reductions in Medicare reimbursements in a statement after the vote. “I also oppose the creation of a new government run public option and continue to have serious concerns about its potential unintended consequences for Missourians who have private insurance plans they like.”

The nonpartisan Congressional Budget Office, which scored the House bill, estimates that enacting it would result in a net reduction in federal budget deficits of $129 billion from 2010 to 2019. But, it adds, “those estimates are all subject to substantial uncertainty.”

A wild card in the next weeks is whether healthcare groups affected by the bill will engage their corporate war chests to undermine it. The American Medical Association last week endorsed the bill, but only on condition that the House also pass a $210 billion fix to a formula that requires cuts in payments to physicians treating Medicare patients. That vote, expected the week of Nov. 16, is controversial with fiscal conservatives, because the costs are not offset.

Insurers, who stand to gain millions of new customers if the bill is passed, object to the robust public option in the House bill. “A new government-run plan will cause millions to lose their existing coverage and draconian Medicare Advantage cuts will force millions of seniors out of the program entirely,” said Karen Ignagni, president and CEO of America’s Health Insurance Plans (AHIP), in a statement after the vote.

Still, the greatest risk in the long run for Democrats may be the failure to secure bipartisan support.

“In the past, legislation that passed on straight party-line votes becomes an obstacle to acceptance of the legislation by some segments of the population,” says Ross Baker, a political scientist at Rutgers University in New Brunswick, N.J. “But Democrats have come to the conclusion that if healthcare is going to be done, it’s got to be done with Democratic votes alone – and that’s preferable to not doing it at all.”

See also:

Healthcare reform: Obama cut private deals with likely foes

On healthcare reform, House lawmakers get past the abortion hurdle

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