Democrats begin work to finalize health bill

WASHINGTON — President Barack Obama and congressional Democrats embarked Tuesday on the tough work of ironing out differences between House and Senate health care legislation with the aim of quickly approving a bill as midterm elections near.

"Now is not the time to get stuck on any one point," Rep. John Larson, D-Conn., said as he headed into a meeting with Speaker Nancy Pelosi and other House leaders to discuss their priorities for the final bill. "The important thing for us now is to close ranks behind the president and get a bill done."

Both houses have passed legislation to remake the health care system, extending coverage to millions who lack it while cracking down on industry practices such as denying insurance on the basis of pre-existing medical conditions.

There are numerous differences between the two bills, include provisions on illegal immigration and abortion, a dispute over a government-run insurance option — the House wants one, but the Senate bill omitted it — as well as the size and extent of federal subsidies to help lower-income families afford coverage.

Pelosi, D-Calif., suggested Tuesday that House members wouldn't insist on the federal "public option" as long as the final bill provided "affordability for the middle class, accountability for the insurance companies ... accessibility by lowering cost at every stage."

"I'd prefer to call it the public's option, an option for the public to hold the insurance companies accountable and to increase competition," Pelosi said. "There are other ways to do that, and we look forward to having those discussions as we reconcile the bill."

The House bill is more generous with subsidies than the Senate measure, and many House Democrats are concerned with ensuring that insurance will be affordable since the legislation will require most people to buy it. At the same time, some moderate Senate Democrats don't want the bill's price tag to grow. At nearly $1 trillion over 10 years, the House bill is more expensive than its Senate counterpart.

"The affordability credits is going to be a critical part of this discussion," said Rep. Chris Van Hollen, D-Md.

The president planned to begin work with congressional leaders Tuesday to resolve those and other thorny issues. Following the meeting of House leaders, Obama was to meet with Pelosi and Majority Leader Steny Hoyer in the Oval Office, with Senate Majority Leader Harry Reid and Assistant Majority Leader Dick Durbin joining the meeting by phone.