Health Bill Inches Forward In House

House Democrats pushed ahead with a compromise health overhaul Thursday over liberals' complaints, intent on achieving tangible - if modest - success on President Barack Obama's top domestic priority ahead of a monthlong summer recess.

"We've got to pass the bill. Not only do we have to, but we're going to," said Rep. Henry Waxman, D-Calif., chairman of the Energy and Commerce Committee, the last of three House committees to act on the sweeping legislation.

In the Senate, months of bipartisan negotiations were at a crossroads, Republicans balking at an agreement before lawmakers leave the Capitol for a month, Democrats considering whether to allow more time or possibly produce legislation crafted to their own specifications.

Sen. Charles Grassley, R-Iowa, said in a statement the talks have made very good progress and may result in a deal. "But that'll never happen if Democrat leaders tell Republicans to take a hike by forcing the committee to move on an all-Democrat bill," he said.

A meeting of the six negotiators was set for late in the day.

Both chambers already jettisoned plans for floor votes before the summer break, and Democrats are now aiming just to get bills out of the final House and Senate committees that have yet to act.

Even that much has turned into a protracted struggle but Democratic leaders said it had to happen. Returning to their home districts with Obama's top issue in disarray on Capitol Hill was not an option.

Waxman's committee resumed work Thursday, with the goal of finishing Friday, after a week-and-a-half delay caused by objections from fiscally conservative Democrats. That rebellion was quelled with an agreement Wednesday that would protect more small businesses from a requirement to provide insurance to their employees, and restructure a new public insurance plan so it could pay higher rates to doctors and other providers, among other changes.

But the concessions Waxman made to the so-called Blue Dog Democrats infuriated House liberals. They denounced the proposed new structure of the public plan, which was originally designed to be based on Medicare rates. The new structure says rates would be negotiated with providers as occurs now with private companies, which could result in more expensive care.

"This agreement is not a step forward toward a good health care bill, but a large step backwards," 53 Progressive Caucus members said in a letter to House leaders Thursday. "Any bill that does not provide, at a minimum, for a public option with reimbursement rates based on Medicare rates - not negotiated rates - is unacceptable."

At a news conference liberal lawmakers threatened to vote against the bill if it comes to the floor without a stronger public plan. Rep. Anthony Weiner, D-N.Y., an Energy and Commerce member, said liberals probably had enough votes to block the Blue Dog deal in committee.

Some details of the deal remained murky. As part of the agreement the Blue Dogs are insisting they won't vote for a bill that costs more than $1 trillion over 10 years, but that would require Democrats to make more cuts or raise more money. It wasn't clear how much, or how it would be accomplished.

As Energy and Commerce lawmakers worked methodically through piles of Republican and Democratic amendments, Waxman's shaky majority was on display early, when the committee voted 29-28 to defeat a Republican amendment to strengthen ID requirements designed to prevent illegal immigrants from getting Medicaid benefits.

Speaker Nancy Pelosi of California expressed confidence the committee would approve the bill, and said the full House would follow suit in the fall. She also signaled flexibility on key issues, saying that despite her own backing for abortion rights, she would not allow the issue to torpedo legislation.

Pelosi provided House Democrats with talking points to take back to their districts. The headline - "Health Insurance Reform to Hold Insurance Companies Accountable" - showcased Democrats' stepped-up efforts to cast insurance companies as villains in the debate, as polls show a public increasingly wary of the health care effort.

House Minority Leader John Boehner of Ohio warned that Democrats who support the legislation are "likely to have a very, very hot summer."

Highlighting the frenetic activity the overhaul has spurred in Washington, health interests have reported spending $262 million lobbying in the first six months of 2009, more than any other portion of the economy, according to the nonpartisan Center for Responsive Politics.

That was $23 million more than health-related companies and groups spent lobbying during the first half of 2008.