Progress on Capitol Hill: The Play-by-Play on Health Care

What happens today. What happens tomorrow. Whether it happens at all.

July 29, 2009, 11:40 AM

July 29, 2009— -- House Democrats appear to have made a breakthrough on a health care reform bill today by resolving differences within their own party, keeping President Barack Obama's hope alive for substantial progress before lawmakers take their summer break.

Here's a rundown on what's really happening in Washington, when Americans can expect movement on health care legislation and whether reform will actually happen this year.

Today in the House, House Democratic leadership struck a deal with some moderate Democrats on the Energy and Commerce Committee, which will now move forward with a mark-up of a health care bill this afternoon.

The president acknowledged members of both the Senate and the House for their hard work on health reform, and gave a special shout-out to the fiscally conservative Blue Dog Democrats.

"I'm especially grateful that so many members, including some Blue Dogs on the Energy and Commerce Committee, are working so hard to find common ground," Obama said in a statement released Wednesday afternoon. "Those efforts are extraordinarily constructive in strengthening this legislation and bringing down its cost."

Rep. Mike Ross, D-Ark., the leader of the Blue Dog Democrats, who have been blocking progress on the bill, said an agreement has been reached that addresses their concerns, including cutting the cost of the bill, protecting small businesses and making sure a public option is truly optional and will compete on a level playing field with private plans.

"We believe every member of Congress should have the opportunity to not only read the bill, but spend the month of August visiting with their constituents about it," Ross told reporters. "I am confident that we're going to get health care reform done this year, but let's not rush it. That's what the American people are telling us, and that's what we've been successful in accomplishing."

But, George Stephanopoulos told Elizabeth Vargas on "World News" Wednesday that the timing may still be an issue.

"I heard from key negotiators in both the House and the Senate side who said, 'Don't be surprised if we don't finish this until Christmas,'" said Stephanopoulos.

While a deal has been struck with seven moderate Democrats on the House Energy and Commerce Committee, the rest of the Blue Dogs are withholding judgment.

"Many Blue Dogs remain concerned with various aspects of the bill draft," Blue Dog co-chair Rep. Stephanie Herseth Sandlin, D-S.D., said in a statement released late today. "The 52-member Blue Dog Coalition has not taken a group position on the draft health care legislation that is working through the committee process. Today's announcement signifies that the committee process is moving forward. The committee will work its will, but the broader coalition has not ratified any agreements related to the draft legislation."

House Majority Leader Steny Hoyer, D-Md., was optimstic that the Energy and Commerce Committee will finish work on the legislation this week, but getting it to the House floor is another story.

"It's obvious that we're not going to have any bill on the floor this week, and the probability is we won't have a bill on the floor… until September. We're still talking about that," said Hoyer

That's an unwelcome reminder of the missed deadline initially put forth by the president.

But the progress made among House Democrats today is good news for Obama and Democratic lawmakers eager to head into the congressional August recess with at least a hint of momentum.

During a town hall meeting in Raleigh, N.C., to address health care reform, the president today said that in the "best-case scenario," a health care reform bill will not get voted on or signed until mid-fall, as Congress continues to hammer out details and get legislation out of committees.

"This bill, even in the best-case scenario, will not be signed -- we won't even vote on it probably until the end of September or the middle of October," Obama said. "We're just trying to get all these different bills out of committee."

While conceding that Congress and the White House missed the August deadline he first laid out, Obama said that the extra time working on the legislation means "senators, if they want to take this bill home with them during the August recess, they would have more than enough time to read it."

The president also held a town hall forum this afternoon at a Kroger grocery store in Bristol, Va., which was the first town he visited during his general election campaign. Obama focused again on consumer protections that he wants included in health care reform. He reassured people that providers won't discriminate against them for having pre-existing health conditions, nor charge sky-high prices.

In the Senate, they're still hashing it out, but there are signs of progress there as well.

Negotiators considering a bill in the Senate Finance Committee haven't yet come to an agreement, but a cost analysis of the bill revealed today is sure to move the debate forward. Today Finance chairman Sen. Max Baucus, D-Mont. , said the plan was predicted to cost less than $900 billion and lead to reductions in the deficit within 10 years.

The bipartisan gang of Finance Committee negotiators broke their closed-door negotiations for the day and as Baucus left the bipartisan meeting to meet with other Democrats, he said the bipartisan negotiators had a good day and reached tentative agreement on another outstanding issue that he would not identify.

He qualified agreement on that issue as "big T for tentative."

Most of the day, he said, was spent addressing how to make reform affordable for lower income Americans while addressing the concerns of states and governors who warn they could be bankrupted by an expansion of Medicaid.

However, no final agreement appears imminent. One of the six senators negotiating the Finance Committee bill was asked if the committee could wrap up its work by the end of next week when the Senate plans to recess for the remainder of the summer.

"It's possible, but extremely challenging," said Sen. Kent Conrad, D-N.D.

Sen. Ron Wyden, D-Ore., a key member of the Senate Finance Committee, told's "Top Line" that he and a bipartisan group of 15 senators who have signed on to his health care proposal are encouraged by the developments.

"I think we've got a lot to work with. There are positive developments today," Wyden said Wednesday. "I'm glad the president is out talking to workers who are insured. He's spending his political capital to market the case for health reform."

Wyden is the co-author of a bipartisan bill that the Congressional Budget Office and other nonpartisan groups have said would achieve near-universal coverage without adding to the deficit.

But still no deal so far, as six Finance Committee senators, three from each side of the aisle, continue negotiating to come to an agreement. Today the panel's Democratic staff director sent an e-mail to committee members' offices saying, "Neither an accord nor an announcement is imminent." And two key senators on the Finance Committee -- one a Republican, the other a Democrat -- told ABC News that they doubt the Finance Committee can to pass a bill out of that panel before the August recess.

Sen. Mike Enzi, R-Wyo., also dismissed the idea of a breakthrough today, and added that he wouldn't agree to a deal unless he had a commitment from Senate Majority Leader Harry Reid, D-Nev., House Speaker Nancy Pelosi, D-Calif., and the White House not to undue those agreements in subsequent negotiations.

"No deal is at hand, and substantive issues, big and small, remain under discussion and need to be resolved," Enzi said in a written statement.

White House press secretary Robert Gibbs also said today that there are "many more twists and turns to go" before House and Senate versions of the legislation are reconciled into one.

The hope going into this week was for both the House and Senate panels to reach agreements before the August break. The best-case scenario for Democrats eager to change health care laws: if House lawmakers on the Energy and Commerce Committee vote on their measure this week, and if the Senate Finance panel could reach an agreement, too.

If that happens, lawmakers would return in September a major step closer to voting on comprehensive measures on each side of the Hill.

Worst case scenario for the administration would clearly be if negotiations were to collapse, if liberals were to bolt on the effort and if summer break were to come with disappointment.

The House is scheduled to begin its recess Friday, the Senate a week later.

Last Friday, Gibbs said no one involved in health care reform planning meetings has opted to take August off. Time spent back home will also allow lawmakers to hear from constituents before returning to Washington in the fall.

Regardless, decision makers will need new momentum to accomplish their goals in September.

"Whatever they do over August is still going to require almost a complete reset in September," ABC News' George Stephanopoulos said Friday on "Top Line."

How to pay for it. Some of the toughest opposition has come from within Obama's own party due to concerns about the cost of reform. Tuesday the president tried to calm those fears.

"I understand people being scared that this is going to be way too costly," Obama said at the AARP. "It's not that costly if we start making changes right now."

Late Monday night, Blue Dog Democrat Rep. Mike Ross, D-Ark., said the group talked through their cost concerns with House Energy and Commerce Chairman Henry Waxman, D-Calif., and he made the Blue Dogs an offer that night.

The public option: The deal now being considered by the Senate's six negotiators does not appear to include a government insurance option that Obama wanted. Instead, they are tweaking a proposal by Conrad to create a system of non-profit, but independent co-ops to provide insurance options outside the normal insurance industry.

Obama suggested in an interview with Time that he's amendable a co-op proposal as a way to offer a public plan.

The public option provision faces strong opposition from most Republicans, as well as from the powerful health insurance industry.

"We do not support a new, government-run insurance plan, but there is still the Senate Finance Committee," Robert Zirkelbach of America's Health Insurance Plans said on's "Top Line." "There's a real hope that we can get bipartisan reform coming out of that committee."

To be sure, everyone has an opinion on the slew of reforms being proposed.

On Tuesday 100 clergy from throughout the country came to the Capitol to urge key congressman to pass health care immediately.

A Monday letter to Senate Finance Committee leaders Baucus and Charles Grassley, R-Iowa, from the U.S. Chamber of Commerce said "the business community vitally needs better policy alternatives," and argued that the proposal being pushed by Democrats in the House would not drive down costs and would drive private insurers out of business.

"It really matters what happens here," former President Bill Clinton said Monday at a conference focused on obesity prevention. "It matters whether we save this generation of kids. It matters whether we save our country's health system."

"Congress is closer than ever before in history to passing comprehensive health insurance reform," Pelosi and Hoyer said in a joint statement Wednesday. "Over August, the three House committees will work to reconcile their versions and produce strong legislation.

The Democratic leaders also made a point to acknowledge the Blue Dog Coalition for their role in the health care negotiations.

"We want to particularly recognize the valued leadership of the Blue Dog Coalition to lower costs, to make the legislation work better for their constituents, and to assist small businesses," said Pelosi and Hoyer. "At the request of the Blue Dog Coalition, in order to allow more time to carefully review the additional proposed legislative language, we will bring the bill to the House floor in September.

To further complicate the matter, there are other ideas out floating around the House too that are less likely to gain traction. The conservative House Republican Study Committee plans to offer its reform plan on Thursday, the group's chairman, Rep. Tom Price, R-Ga., said today on's "Top Line." House Republican leadership is also crafting a separate proposal.

"What we see [among] the moderate Democrats and certainly on our side is that we believe the American people aren't behind the bill that's before us in the House of Representatives, a bill that would in essence be a government takeover of our health care system," Price said. "And that's why you're seeing this slow-down on the House side."

ABC News' Jonathan Karl, John Hendren, Jake Tapper, Karen Travers, Rick Klein, Yunji de Nies, Theresa Cook and Huma Khan contributed to this report.