WASHINGTON (Dow Jones)--House Democratic leaders aim to introduce legislation next month to overhaul U.S. health care, but still haven't figured out how to pay for it, a senior advisor to House Speaker Nancy Pelosi said Thursday.
"I think all options are on the table," Wendell Primus, a senior policy advisor to Pelosi, D-Calif., told the National Economists Club in an address on health care reform.
One option would be to tax employer-provided health care benefits as income. Although some dismiss the idea, Primus said lawmakers may need the tax revenue to provide health insurance to those who can't afford to buy it.
Higher taxes on wealthy Americans and fines on firms that don't offer health insurance to employees are other likely funding sources, Primus added. He didn't rule out options such as a "sugar tax" on fattening foods, but said that could unleash a "public outcry."
President Barack Obama has pushed for a health care overhaul, and Primus said House leaders plan to unveil a single bill in mid-to-late June, move it through the relevant committees in July, and bring it to a vote by the full House by August.
House Education and Labor Committee Chairman George Miller, D-Calif., House Energy and Commerce Committee Chairman Henry Waxman, D-Calif., and House Ways and Means Committee Chairman Charles Rangel, D-N.Y., are working to develop the bill, but figuring out how to pay for it could be a hitch.
The Congressional Budget Office has provided preliminary estimates of potential savings and revenue should the bill become law, and the numbers "are not as high as I would have thought," Primus said. He estimated that filling the gap will require raising "hundreds of billions" of dollars over a ten-year period, on top of the $634 billion allocated by Obama's budget over the same ten-year period.
House Democratic leaders want to see just how big the gap is before determining how to fill it, Primus added. He said congressional budgeters will need more details on the bill to provide a final price tag, and acknowledged the give-and-take could delay the ambitious timetable.
Broad outlines are in place, however. Lawmakers look to expand the current health care system by requiring individuals to have health insurance for themselves and dependent children, with federal subsidies to help low-income earners afford to buy such coverage.
Employers likely will have a choice to "pay or play," so those who currently offer health insurance to employees will be encouraged to continue doing so, and those who don't will pay fines that help cover the nation's health-care tab.
Existing private health care insurance would remain, but Primus expects House lawmakers will create a new "public plan option" for those currently uninsured, and substantially expand Medicaid, the federal health program targeted to the poor.
Hospitals that get federal payments to offset costs of treating the uninsured could see those payments cut or eliminated under the plan, and Primus said, "believe me, they will scream" at the prospect.
Drug companies likely will take a hit as well. Among other things, Primus said lawmakers want to end preferential treatment for biologics, saying they offer drug makers "a life-time monopoly" unlike patents on chemical compounds that eventually expire, allowing competition from cheaper generic producers.
Tobacco companies won't be targeted, even though critics say the industry's products are a leading cause of costly heart and lung diseases.
"We've done as much as we're going to in the tobacco arena," said Primus, noting Congress recently slapped a hefty tax on cigarettes to fund expanded health care for uninsured children, and the House adopted a bill that would allow the Food and Drug Administration to regulate the tobacco industry.
While the U.S. spends far more than any other developed country on health care, reform advocates say it doesn't always get high-quality treatment, particularly for the 50 million who lack health insurance. Rapid increases in spending on Medicare programs for the elderly and on Medicaid are another worry for lawmakers facing a mounting federal budget deficit.
Primus conceded the debate on health care is highly partisan and that industry lobbying groups are flexing their muscles to protect their interests.
"I'm not going to tell you they don't have influence," he said of lobbyists. But, he added, "we're going to write a very good health care bill despite them."
-By Judith Burns, Dow Jones Newswires; 202-862-6692; Judith.Burns@dowjones.com
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(END) Dow Jones Newswires
May 07, 2009 16:21 ET (20:21 GMT)
Copyright (c) 2009 Dow Jones & Company, Inc.- - 04 21 PM EDT 05-07-09
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