The Treatment

House Not Inclined to Roll Over, Play Dead

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My Washington decoder ring isn't the most finely tuned. But I think it's good enough to translate the message House leadership was trying to send yesterday: Don't take us for granted.

The message came most loudly, and most clearly, from Ways and Means Chairman Charles Rangel. For the last few weeks, observers (this one included) have been suggesting that keeping the requisite sixty senators in line will be difficult--and that, as a result, final legislation will look a lot more like the Senate version than its House counterpart.

That would mean, regrettably, covering fewer people and guaranteeing less comprehensive coverage than the House bill would. It'd also mean a lesser requirement on employers, taking less money from the drug and insurance industries, and accepting some sort of tax on the most expensive health benefits.

But Rangel, in an interview with Roll Call, suggested that straying too far from the House bill could also threaten the bill's success, because the original House bill barely passed--and House liberals, in particular, are in no mood to roll over for the Senate.

We’ve got a problem on both sides of the Capitol. A serious problem. ... The difficulty in hashing out an agreement between the two chambers is largely due to there being so many different factions with a stake in the matter ... Normally you’re just dealing with the Senate and they talk about 60 votes and you listen to them and cave in, but this is entirely different ... I’m telling you that never has 218 been so important to me in the House.

It wasn't just Rangel saying this.

In background interviews yesterday, several sources on and around Capitol Hill sent the same message. "Our math is just as hard as theirs," one House staffer told me. These sources also suggested, rather pointedly, that the challenge of finding a bill 218 representatives would find acceptable was threatening to drag out negotiations, pushing final passage and signing well into February.

What's going on here? Notwithstanding yesterday's statements, some progress is being made. On Capitol Hill, a steering committee with top staff from leadership, the committees, and the administration is stitching together the legislative language--dividing the bill up by issue (i.e., Medicaid expansion, delivery reforms, etc.) and assigning smaller working groups to hash out the details of each one. The bigger issues, naturally, require direct negotiations among the members and top administration officials, including the president himself.

The steering committee has already sent off some material to the Congressional Budget Office for scoring. And agreement on at least one of the most divisive issues--the role of employers--seems near. The Associated Press and Boston Globe are reporting that House and Senate are ready to embrace the Senate's model, which would impose weaker requirements on employers. (Austin Frakt explains what it means.)

Still, the tension between the chambers is real. The House has signaled a willingness to live without even some of its most cherished ideas, starting with the public option, as long as the Senate makes some concessions too. In particular, the House has indicated it wants a national exchange and improved affordability protections.

And while the House hates the Senante's tax on benefits, House leaders have hinted they could live with some form of it, as long as negotiators scale it back and then replace the lost money--and, ideally, add a bit to the bill's total--with some combination of higher taxes on the wealthy and larger cuts to the health care industry.

Such a deal would make perfect sense, for reasons I explained last week. But the Senate, so far, hasn't signaled it's ready to meet the House halfway--or even a quarter of the way. The usual suspects, Senator Ben Nelson and members who think like him, oppose both the national exchange and putting more money on the table. (According to Hill sources, Nelson is pushing hard against a national exchange.) So House leadership is playing the cards it has, suggesting that political circumstances will force it to hold out for a better deal.

Threatening delay should get the attention of the White House. And that is almost surely the point. The administration desperately wants to settle health care before the State of the Union--which, you may have noticed, still isn't on the schedule. By holding out, the House gives President Obama and his advisors reason (and an excuse) to push the Senate harder.

Of course, it's not clear whether House leadership is simply posturing, to show rank-and-file members that it's putting up a fight. And even if Obama does push harder, it's not clear he'll succeed.

Leadership is meeting with Obama right now, as I post this. So perhaps we'll learn more later today.

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