UPDATED: Friday, April 13, 2012 - 9:53am
WASHINGTON - House Speaker Nancy Pelosi, piqued with White House pressure to accept the Senate health reform bill, threw a rare rhetorical elbow Tuesday at President Barack Obama, questioning his commitment to his 2008 campaign promises.
A leadership aide said it was no accident.
Pelosi emerged from a meeting with her leadership team and committee chairs in the Capitol to face an aggressive throng of reporters who immediately hit her with C-SPAN’s request that she permit closed-door final talks on the bill to be televised.
A reporter reminded the San Francisco Democrat that in 2008, then-candidate Obama opined that all such negotiations be open to C-SPAN cameras.
“There are a number of things he was for on the campaign trail,” quipped Pelosi, who has no intention of making the deliberations public.
People familiar with Pelosi's thinking wasted little time in explaining precisely what she meant by a “number of things” — saying it reflected weeks of simmering tension on health care between two Democratic power players who have functioned largely in lock step during Obama’s first year in office.
Senior House Democratic leadership aides say Pelosi was pointedly referring to Obama’s ’08 pledge not to raise taxes on the middle class, which she interprets to include a tax on so-called Cadillac health care plans that offer lavish benefit packages to many union members.
The House aides, speaking on condition of anonymity, said Pelosi has been miffed with Obama’s tilt toward the Senate plan and his expectation that the House would simply go along with the Senate bill out of political necessity.
A Pelosi aide later downplayed the remark, saying, "It was a quip, not a jab at anyone."
“She’s setting up for the conference,” said a leadership staffer. “It’s strategic. She’s staking out her territory.”
It wasn't the first time she's done so.
Pelosi has repeatedly expressed her frustrations about the inclusion of the Cadillac tax in the Senate bill and has sparred with Obama about the issue during face-to-face meetings. Her hope now, House aides say, is to get the administration to accept a tax that starts on family plans worth $28,000 — $7,000 more than the threshold favored by Obama and Senate Majority Leader Harry Reid (D-Nev.).
The White House has shown a clear preference for the Senate product in the months-long, bifurcated health care debate. And Reid holds the two best trump cards in the form of Sens. Ben Nelson and Joe Lieberman, two wavering moderates who have already threatened to vote against a final compromise if it deviates significantly from legislation the Senate passed late last year.
That means the speaker needs to play her cards wisely — even if it means directing some well-timed fire at the president.
All year, liberal Democrats have been clamoring for Obama to get more involved in the health care negotiations, hoping he would weigh in to push their top priority — the public option. The president is now promising to take a much more active role in these final negotiations — his staff will convene a meeting with House and Senate aides as early as Wednesday to start laying the groundwork for the talks. But that might not be a good thing for the speaker or her liberal colleagues because of the White House preference for the Senate bill.
During a White House meeting Tuesday, Obama told the speaker and other congressional leaders that he would like to see them approve a final bill by his State of the Union address, set for late January or early February. Earlier in the day, House Democrats weren't convinced they could meet that deadline — and seemed ambivalent about whether they even wanted to try.
Emerging from a Tuesday afternoon huddle with her leadership team and a quartet of critical chairmen, Pelosi seemed to concede the public option won’t be in the final bill, telling a clutch of reporters that “there are other ways” to increase competition and “hold the insurance companies accountable.”
And she has clearly set her sights on making sure the final bill provides sufficient subsidies for lower- and middle-income Americans.
“We want our final product — as I’m sure everyone in the House and Senate would agree — to insure affordability for the middle class,” Pelosi told reporters after her leadership meeting.
The House bill sets aside more than $600 billion in affordability credits for people who make less than 400 percent of the federal poverty poverty line — or roughly $43,320 for an individual and $88,200 for a family of four. The Senate bill offers those same people tax credits that cost $436 billion over the new program's first six years. The House also sets much lower caps on out-of-pocket expenses for people at the lowest end of this income spectrum.
Democrats in the House are intent on forcing their counterparts in the Senate to shift money from other programs to make mandatory insurance coverage more affordable.
“The key issue for us is to make sure people have affordable health insurance,” said Maryland Rep. Chris Van Hollen, a member of the Ways and Means Committee who also heads the Democrats' campaign arm in the House.
Reid struggled for months to corral all 60 members of his caucus to move a health care bill through the Senate. That gave individual senators, such as Lieberman and Nelson, the influence to command major concessions from the rest of their colleagues. Their demands, particularly Lieberman’s insistence on scrapping the public option, rankled Democrats in the House.
At one point during the Tuesday afternoon press conference, Ways and Means Committee Chairman Charlie Rangel (D-N.Y.) quipped: “The Senate should know that we need 218 votes.”
But the fact is that House Democrats have little recourse to impose their will in negotiations with the Senate unless they make realistic demands.
Party leaders were even forced to break from the traditional means for negotiating with the Senate because it would create additional roadblocks for Reid — and give Republicans more chances to derail the bill.
On Tuesday, the speaker and her colleagues were both forced to defend charges from their own rank and file that these abbreviated negotiations betrayed their own campaign promises to make deliberations public.
“There has never been a more open process,” a testy Pelosi told reporters in response to repeated questions about a request by C-SPAN chief Brian Lamb to allow cameras in the House-Senate negotiations.
As the negotiations begin, House and Senate Democrats have plenty of differences to resolve, but both bills seek to achieve the same fundamental goals: expand health coverage to millions of uninsured Americans and impose new restrictions on the insurance industry that bar companies from discriminating against people who are ill.
Beyond that, differences abound.
The two chambers use different methods to pay for the final bill, and House Democrats seem willing to accept the Senate proposal to tax high-end health care plans as long as they can raise the threshold for plans that qualify.
But they would have to find a way to pay for the lost revenue. One idea being circulated is to raise the amount of money wealthy Americans would be forced to pay for Medicare. The Senate bill already uses the tax to raise that money, and it touches on the House plan to impose a surtax on people with the highest annual salaries.