Pelosi's new tack on healthcare - target big insurance

The House Speaker needs to address public concerns about changing the system. So do lawmakers headed home for their August break.

With public support for healthcare reform losing steam, House Democrats head home for the August break with a new theme: Hold insurance companies accountable.

House Speaker Nancy Pelosi says she is bracing for “carpet bombing, shock and awe” from insurance companies directed at members of her caucus.

“We have no illusions about what insurance companies will do to hold on to their power to exploit patients or about how much money they have to spend on it and what they have at stake,” she told reporters at a round-table discussion in her Capitol Hill office Friday.

At issue is a slight change in phrasing that signals a major shift in strategy.

Most Americans like their current healthcare plans and are afraid that the healthcare reform legislation now in the works across five House and Senate committees will threaten it.

'Health insurance reform'

So the new tack is to frame the heath debate around “health insurance reform.” That means holding insurance companies accountable -- “putting you and your doctor back in charge -- not the insurance companies -- to guarantee stability, lower costs, higher quality, and more choices of plans.”

That’s the headline on the blue-and-white laminated card of talking points that the Speaker’s office prepared for members heading back to their districts. On the back of each card, members are invited to fill in data from a new report, released this week, that shows the impact of proposed reforms in each member’s district.

These include: the number of small businesses expected to receive tax credits to provide coverage to their employees, the number of seniors expected to avoid the “donut hole” gap in prescription coverage in Medicare Part D, the number of families that could escape bankruptcy each year due to unaffordable healthcare costs, the number of uninsured constituents expected to gain access to health insurance, and so on.

Democrats had hoped to head into the August recess with a healthcare plan having passed both the House and Senate. Instead, Speaker Pelosi and committee chairs have to meld the work of three panels, then present a comprehensive bill to lawmakers in the fall.

“We intend to come back ready to review the blending of the bills that we hope to do over August and to move to successfully bring a bill to the floor,” she said. “It will be easier when the bills are blended, but in order to get to where we need to be, we have to build consensus, go through the legislative process. It has to be handled with care and judgment.”

Senate committees working the issue too

Where House committee jurisdictions overlap, there is about 80 percent agreement over policy, she says. Moreover, the “public option” in the House Education and Labor Committee’s version of the bill is very similar to that in the bill voted out by the Senate Health, Education, Labor and Pensions Committee.

But on the all-important issue of how to pay for a reform expected to cost at or just below $1 trillion, all eyes are on the Senate Finance Committee, which announced this week that it is unlikely to come to agreement before the Senate breaks for recess next week.

“We’re still trying to squeeze as much cost out of the system as possible,” Pelosi said. “Frankly, I had hoped we would have seen more from the Senate Finance Committee.”

The House Energy and Commerce Committee appeared to be close to wrapping up their markup Friday evening. The House Ways and Means committee and the House Education and Labor committee have already completed their work.

Pelosi says that she also had hoped to get more cooperation from the Republicans on this legislation, “but you’re either with the insurance companies or you want something new.”