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Pelosi: Dems close on health care agreement

ST. CHARLES, Mo. (AP) - Democrats claimed momentum Wednesday in
their drive to enact the sweeping health care legislation sought by
President Barack Obama, citing near agreement on crucial issues
despite persistent Republican efforts to knock them off stride.
Obama himself, rallying support outside Washington for the
second time this week, shouted to a crowd in Missouri, "The time
for talk is over. It's time to vote."
At the Capitol, House Speaker Nancy Pelosi said that after days
of secretive talks, key Democrats were "pretty close" to accord
on additional subsidies to help lower-income families purchase
insurance, more aid for states under the Medicaid program for
low-income Americans and additional help for seniors who face a
coverage gap under current Medicare drug plans.
Pelosi, D-Calif., offered no details, and other officials
cautioned that any final deal would hinge on cost estimates under
preparation at the Congressional Budget Office.
Several officials in both houses also said Democrats were likely
to impose a new payroll tax of as much as 2.9 percent on investment
and dividend income earned by wealthy taxpayers. In addition, any
legislation is expected to include a tax on high-cost insurance
plans, along the lines of an agreement the White House negotiated
late last year with organized labor.
House Budget Committee Chairman John Spratt, D-S.C., said
legislation that embodies the agreements among congressional
Democrats and the president could move through his panel next week.
Leaders planned to brief rank-and-file lawmakers Thursday.
At stake is the fate of Obama's call to expand health care to
some 30 million people who lack insurance and to ban insurance
company practices such as denial of coverage on the basis of
pre-existing medical conditions. He also hopes to begin to reduce
the rise in the cost of health care nationally.
Almost every American would be affected by the legislation,
which would change the ways people receive and pay for health care,
from the most routine checkup to the most expensive, lifesaving
treatment.
Pelosi made her comments as Obama followed his
campaign-reminiscent Pennsylvania trip of Monday with an appearance
near St. Louis, pushing hard in the home stretch of the marathon
battle to pass his signature domestic legislation.
"The time for talk is over. It's time to vote. It's time to
vote. Tired of talking about it," he told the crowd.
With his shirt sleeves rolled up, Obama denounced waste and
inefficiency in the government's health care system, and he
announced that he had signed an executive order directing Cabinet
secretaries and agency heads to intensify their use of private
auditors to root out fraud.
House and Senate Democrats are working on a complex rescue
mission for the health care legislation that appeared on the cusp
of passage late last year, before Senate Republicans gained the
strength to sustain a filibuster that could prevent final passage.
The current hope of the White House and Democratic leaders is
for the House to approve the Senate-passed bill from late last
year, despite serious objections to numerous provisions. Both
houses would then pass a second bill immediately, making changes in
the first measure before both could take effect. The second bill
would be debated under rules that bar a filibuster, meaning it
could clear by majority vote and without Democrats needing to amass
a 60-vote supermajority that is beyond their reach.
Republicans have vowed to do everything they can to thwart the
plan, and to go after Democratic supporters in next fall's midterm
elections. In the Senate, the GOP rank and file issued a letter
pledging to strip out any provision that does not adhere
scrupulously to complex rules.
In addition, GOP leaders sought to stoke the fears of House
Democrats who worried that the Senate would not approve the second
bill. Even so, Sen. Jon Kyl, R-Ariz., the second-ranking Senate GOP
leader, conceded, "We can't delay a bill for months. We might
delay it for a few hours."
After meeting with top congressional Democrats and White House
aides Wednesday night, Senate Majority Leader Harry Reid, D-Nev.,
told reporters he believes "that health reform is going to be
done. We don't have it all worked out, but we made a lot of
progress." He said "a lot of decisions were made" at the
meeting.
Congressional Democrats and the White House are grappling with
several issues as they maneuver toward a final vote.
Pelosi and other House Democrats want to include Obama's
proposed overhaul of the nation's student loan programs in the
second, fix-it health care bill. The measure would require the
Education Department to originate all student assistance loans,
effectively eliminating a role for banks and private lenders.
That idea has run into opposition from several Senate Democrats,
and while officials said the controversy was debated at length in a
closed-door meeting Tuesday night, no decision was made.
Additionally, some House Democrats are hoping to avoid a
straightforward vote on the Senate-passed health care bill.
Instead, they want a procedural vote that would simply declare the
measure to have passed at the moment the Senate cleared the fix-it
bill.
Rep. Louise Slaughter, D-N.Y., chairwoman of the House Rules
Committee, said that approach was under discussion. But other
officials said no decisions had been made.
To the annoyance of some Democrats, the White House is pushing
for a vote by the House before Obama leaves on a foreign trip at
the end of next week.
Several officials said one of the thorniest issues to be
resolved in the House-Senate negotiations was a demand from a dozen
states for additional funds under Medicaid.
These states, New York, Pennsylvania and Massachusetts among
them, already provide coverage under the low-income program for the
poor that other states do not but would be required to if the
legislation passes. The 12 are concerned that they will effectively
be penalized for having been more generous than the rest of the
country.
The legislation that passed the Senate late last year included a
new Medicare payroll tax of 2.3 percent on wages for upper-income
Americans. The White House wants to extend the tax to dividends and
interest, at a higher rate of 2.9 percent.
Much of the proceeds would offset changes in an excise tax the
Senate approved on high-cost insurance plans. Responding to
criticism from labor leaders, the White House agreed over the
winter to scale it back significantly. Officials said the revised
proposal would raise about $120 billion less over a decade than the
measure the Senate passed.
---
Espo reported from Washington. Associated Press writers Ricardo
Alonso-Zaldivar, Erica Werner, Alan Fram and Charles Babington
contributed to this report.

(Copyright 2010 by The Associated Press. All Rights Reserved.)


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