Now the final phase begins, where we see what House liberals can achieve within the confines of a broken system that gives a handful of senators fro
December 24, 2009

Now the final phase begins, where we see what House liberals can achieve within the confines of a broken system that gives a handful of senators from sparsely populated states a disproportionate power to shape legislation:

Democrats are already outlining a strategy to achieve a final compromise that can satisfy the more liberal House without upsetting the painstakingly assembled coalition of 60 Senate Democrats and independents.

Central to those talks, House leaders said, will be the search for an acceptable substitute for a government-run insurance plan that those without medical coverage could purchase, a provision the House designed to compete with private insurers and force them to rein in costs. While the Senate has decisively rejected the "public option," House leaders say they will demand other concessions to ensure that Americans can afford the insurance they will be required to buy if the bill becomes law.

[...] House Speaker Nancy Pelosi (D-Calif.) has signaled approval for the Senate's solution: the creation of at least two nationwide insurance plans run by private companies but overseen by the Office of Personnel Management, the same federal agency that handles health insurance for members of Congress. In a conference call Wednesday, Pelosi also assured rank-and-file Democrats that they would not be asked to rubber-stamp the Senate bill and began soliciting ideas to improve it.

Among the options under discussion: pressing the Senate to increase the federal subsidies that would be offered to low- and middle-income people who do not have access to affordable coverage through an employer; having a single national marketplace for people buying insurance, rather than 50 state-based exchanges, as the Senate prefers; and moving up the launch date of those marketplaces and subsidies to 2013, one year earlier than under the Senate bill.

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