Some have interpreted Speaker Nancy Pelosi’s remarks as a signal that health reform is dead. Here’s a transcript of some of her statements today, where she expresses the need and urgency for health reform. She’s says her caucus can’t pass the Senate bill as is. But it seems like it’s a path for moving forward, but with changes. One way is to use the budget reconciliation process to make amendments. Read it for yourself:
PELOSI: Many of you have asked many questions about where we go from here. Let me congratulate the new Senator, Senator Brown from Massachusetts. While the results of the Massachusetts election may have diminished by one in the number of Senators in the Senate, last year this time there were 58 Senators, I remind you, 58 Democratic Senators, now there are 59. It has not diminished the need for affordable quality health care reform and for health care to be available to all Americans. As a right not a privilege.
The need for us to address health insurance reforms to end discrimination based on preexisting conditions, to stop rescissions, that when people are sick even though they have health insurance their policy has a rescission, to say that if you pay your premiums and do so on time and you get sick your plan will not — your insurance will not be canceled. The list goes on and on. The idea of medical loss ratio that insurance companies should pay five percent of the premiums they collect on benefits. These and other issues to hold the insurance companies accountable. The McCarran-Ferguson, repealed McCarran-Ferguson exemption to the antitrust laws for the insurance company. As I say, these and other needs are still there.
There are still 30 million people in our country without health insurance. But the most important point I think is that the present system is unsustainable. We can not afford an upward spiral of cost. Families can’t, businesses can’t, our economy can’t in terms of our international competitiveness, and certainly the Federal budget cannot. So we are going to have to continue to go in a forward direction to lower cost, to hold the insurance companies accountable, to make sure what we do is affordable to the middle class and to — as we expand access to quality affordable health care. It is still a very exciting initiative, ranks right up there with Social Security and Medicare. And we are meeting with our Members on every level — as a Caucus, in different groups of the Caucus, to hear how they perceive as the best way to go, how they would prefer to go forward, but we will go forward.
QUESTION: Madam Speaker, given the fact that there seems to be widespread unease in your Caucus about taking up the Senate bill and passing it and fixing it, is that option being discarded at this point?
PELOSI: Nothing is discarded, everything is on the table. You characterize it correctly; “unease” would be a gentle word in terms of the attitude of my colleagues toward certain provisions of the Senate bill. Let me remind you that over 80 percent of that bill, our two bills, are similar. So there are important initiatives in the Senate bill. But there are certain things that members just cannot support. For example, the Nebraska piece of it. And so what they would want to see fixed is that there be equity among states, more fairness, and that that policy shouldn’t be made on the basis of one Senator, but on the basis of one country for — to name one example. There has always been unrest in our Caucus about the excise tax on so called Cadillac benefits and so, you know, just to name a few.
So in its present form without any change, I don’t think it is possible to pass the Senate bill in the House. There is some part of our Caucus that would say let’s just take these pieces. We recognize health care has to be done — health care reform has to be done, let’s take some pieces of it and go forward. Others are saying let’s just get it done and move on. But everybody recognizes that something needs to be done.
QUESTION: Madam Speaker, does that mean the Senate bill in its present form you will not pass?
PELOSI: I don’t see the votes for it at this time, no. I mean, the Members have been very clear in our Caucus about the fact that they didn’t like it before it had the Nebraska provision and some of the other provisions that are unpalatable to them. But there is a recognition that there is a foundation in that bill that is important. So one way or another, those areas of agreement that we have will have to be advanced, whether it is by passing the Senate bill with any changes that can be made or just taking pieces of the bill. But everything is on the table. In other words, what we are doing now is very calm, we have to get a bill passed. We know that, that is a predicate that we all subscribe to. We have to pass legislation.
QUESTION: But passing the Senate bill and then trying to fix it later is not an option?
PELOSI: There are some fundamentals in there that that make it problematic for our Members. And some Members say, and I respect this, some of the concerns that were expressed in Massachusetts were about certain provision of the Senate bill. We want obviously to hear and heed what was said there and what is said across the country. What was said in Massachusetts was not news to anyone, it was just expressed in an election. But it is hard it say, well, we don’t like the special provision for [Nebraska] — and that had a lot of resonance around the country, again most recently expressed in Massachusetts. So they don’t see why something that wasn’t even a fundamental part of the bill to begin with, that has been rejected by the American people is something they should be called upon to vote for. That doesn’t sound like they heard the message of Massachusetts.
QUESTION: Just to be clear on that, you are ruling out passing the Senate bill unchanged, but are you not…
PELOSI: We are not ruling out anything. I am saying to you we are ruling out — everything is on the table and everything, every decision that we have to make — now we are legislating here now, so this may be more on the subject than you want to know. But in legislating, we have to know what our possibilities are, and that means in both Houses and with the White House. And every time you make a decision, you have to make a choice; you don’t like this but is it better than that. I am saying to you right now that the Members — in every meeting that we have had there would be nothing to give me any thought that that bill could pass right now the way it is.
QUESTION: You mentioned that as an option, the pieces. Given the unease among your Members about the Senate bill and trying to fix that, is that a more likely option?
PELOSI: Well, I don’t think anybody disagrees with, “Let’s pass the popular part of the bill,” but some of that popular part of the bill is the engine that drives some of the rest of it. But again, we are not in a big rush; pause, reflect upon what our possibilities are, see what the support is in the Caucus. We have to always go where we can build consensus. So certainly there would be great consensus to take the most popular part of the bill and advance it, but I don’t know what — and that would be positive, but we have serious other structural things that have to be done, systemic changes that have to happen to again hold the insurance companies accountable. [Sound of clock chiming.] Have we, did we get a new clock? Or have we not been here at this time of day? Oh, it is 10 o’clock? It must be Eastern time, Western, some time, other time.
But again, however we achieve it we must arrive at accountability of the insurance companies, and I talked about that package earlier, any discrimination of preexisting conditions, no rescissions, stopping them from canceling policies even though people have paid their premiums but because they get sick their policies cancel. The list goes on, medical loss ratio, McCarran-Ferguson, repealing the exemption that they have to antitrust laws. Again in the Senate bill good language that talks about if the insurance companies raise rates in this next couple of years before the exchanges are established, then they would not be able to participate in the exchange. You know, those kinds of things — accountability. Affordability is very important. Affordability for the middle class. That is one of the main purposes of bill is to make it affordable to the middle class. And so to the extent that any one of these initiatives, or the decision may be to proceed with the full bill, I don’t know, but there isn’t a market right now for proceeding with the full bill unless some changes are made in the Senate.