WASHINGTON — House Speaker Nancy Pelosi is expected to unveil a health care reform bill today that includes a government insurance option and a historic expansion of Medicaid, although sticking points involving abortion and immigration remain unresolved.
Senior Democratic House aides said the bill would likely include a version of the "public option" preferred by moderates and may raise Medicaid eligibility levels to 150 percent of the federal poverty level for all adults, a steeper increase than in earlier drafts.
The House legislation aims to provide health insurance of one form or another to almost all Americans at an expected cost just below $900 billion over 10 years, without increasing the federal budget deficit for at least 20 years, House Democrats said. Pelosi was awaiting official data from the nonpartisan Congressional Budget Office, but was aiming to release the legislation at an event this morning.
Lacking the votes to pass it, House leaders abandoned an effort to include a public option backed by liberals that would establish reimbursement rates to providers based on Medicare. Rural Democrats strongly opposed that approach because of the potentially ruinous effect on doctors and hospitals in their districts, where Medicare rates are generally well below the national average.
Instead, Pelosi is expected to offer a more moderate alternative in which rates would be negotiated between providers and federal health officials, similar to the way in which private insurance operates. Majority Leader Harry Reid of Nevada said he would include a similar provision in the Senate bill, although with an "opt out" clause for states that don't want to participate.