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WASHINGTON — The drive to remake the nation's health care system suffered yet another setback in Congress on Thursday when a pivotal group of House Democrats demanded changes in legislation the leadership was drafting on a fast track.
The emerging bill “lacks a number of elements essential to preserving what works and fixing what is broken,” 40 members of the Blue Dog Coalition of moderate to conservative Democrats wrote party leaders. To win their support, they said, any legislation would need to be much more aggressive in reining in health care costs as well as in addressing a disparity in Medicare payments they said adversely affects rural providers.
A group of the moderates met into early evening with House Speaker Nancy Pelosi and Majority Leader Steny Hoyer and arranged to sit down with committee chairmen on Friday to go over proposed changes. Officials said the public release of the bill, originally set for Friday, would occur no earlier than Monday.
It was the second setback in three days for President Barack Obama's top domestic priority, although it was unclear whether it would amount to anything more than a brief delay for a bill of enormous complexity and controversy.
There was upheaval earlier in the week in the Senate, where the Democratic leadership is intent on scuttling a proposed tax on health care benefits that has long been key to attempts at a bipartisan compromise.
As an alternative to the benefits tax, Democrats are considering raising taxes on wealthy investors to help pay for health care legislation, along with numerous other options, according to officials who spoke on condition of anonymity.
Despite some success — the nation's hospitals agreed to a cut of $155 billion in projected Medicare and Medicaid payments — progress has been scant and internal differences magnified.
In general, any bill that emerges from Congress is expected to follow Obama's blueprint for reining in health care costs overall while extending coverage to 50 million who lack it.
Another objective is to make sure that insurance companies can no longer deny coverage or raise premiums to unaffordable levels to individuals with pre-existing medical conditions.
But literally hundreds of details are involved in drafting legislation, and gaining a consensus even among Democrats is proving to be remarkably — if predictably — difficult, despite their large majorities in both houses.
The emerging bill “lacks a number of elements essential to preserving what works and fixing what is broken,” 40 members of the Blue Dog Coalition of moderate to conservative Democrats wrote party leaders. To win their support, they said, any legislation would need to be much more aggressive in reining in health care costs as well as in addressing a disparity in Medicare payments they said adversely affects rural providers.
A group of the moderates met into early evening with House Speaker Nancy Pelosi and Majority Leader Steny Hoyer and arranged to sit down with committee chairmen on Friday to go over proposed changes. Officials said the public release of the bill, originally set for Friday, would occur no earlier than Monday.
It was the second setback in three days for President Barack Obama's top domestic priority, although it was unclear whether it would amount to anything more than a brief delay for a bill of enormous complexity and controversy.
There was upheaval earlier in the week in the Senate, where the Democratic leadership is intent on scuttling a proposed tax on health care benefits that has long been key to attempts at a bipartisan compromise.
As an alternative to the benefits tax, Democrats are considering raising taxes on wealthy investors to help pay for health care legislation, along with numerous other options, according to officials who spoke on condition of anonymity.
Despite some success — the nation's hospitals agreed to a cut of $155 billion in projected Medicare and Medicaid payments — progress has been scant and internal differences magnified.
In general, any bill that emerges from Congress is expected to follow Obama's blueprint for reining in health care costs overall while extending coverage to 50 million who lack it.
Another objective is to make sure that insurance companies can no longer deny coverage or raise premiums to unaffordable levels to individuals with pre-existing medical conditions.
But literally hundreds of details are involved in drafting legislation, and gaining a consensus even among Democrats is proving to be remarkably — if predictably — difficult, despite their large majorities in both houses.
