Health bill changes may sway Perriello

Bryan McKenzie

Oct. 31, 2009 (McClatchy-Tribune Regional News delivered by Newstex) -- After pushing party leadership for changes to a proposed health care reform bill, U.S. Rep. Tom Perriello, D-Ivy, is debating whether he will support the measure when it comes to a vote.

Perriello on Friday said the bill, expected to go to a vote next week in the House of Representatives, now comes closer to meeting his requirements for support.

"We're definitely heading in the right direction but I'm not dedicated to a yes vote yet," Perriello said. "I'm proud of the fact that we were able to take our time, slow down the process and work on it. I think we got a much better result out of it."

Perriello's announcement that he would consider voting yes met with criticism from conservative community organizers of Tea Party groups in his district. They said Perriello indicated to them that he would vote against the plan if it included coverage of abortion and because the plan would cost too much.

"I'm not surprised that Perriello is wavering on what he's going to do on the health care bill, by saying one thing one day and something the next, depending on his audience," said Bill Hay, of the Charlottesville-based Jefferson Area Tea Party.

Perriello and nine other freshmen Democrats pushed party leaders to reconsider various portions of the bill, calling for modifications to existing antitrust protections for insurance companies and possible limits on medical malpractice lawsuits. The Democrats also wanted to find ways to decrease the costs of the bill's programs.

"We touched the third rail of Democratic politics by looking at medical malpractice issues in the bill and we wanted the bill to include wellness and prevention," he said. "We wanted a health bill, not just a health care bill."

Included in the bill are changes that Perriello said would help rural areas retain doctors and shore up local hospitals. Among those changes are studies of Medicare reimbursements rates by geographic area and revising payment rates from the federal program based on those studies.

The bill would also provide incentive payments for primary care doctors who practice in rural areas.

"I've been a headache to [Democratic] leadership, but I think they've understood," Perriello said. "The [other] freshmen felt very strongly about deficit neutrality of the bill and fiscal responsibility. We've cut the cost of the bill so it reduces spending over time and it wasn't just a game you play where you shove all of the fuzzy math into the next decade to make it look like you're cutting expenses."

The House bill contains a public insurance option plan allowing those who cannot afford insurance to purchase it through the federal government. The House bill would cover only American citizens and legal aliens and not undocumented or "illegal" aliens.

Perriello said getting more people covered by insurance would help decrease medical costs and insurance premiums.

"One of the highest drivers of premium increases now is the system shifting the cost of uninsured patients to insured patients," Perriello said. "[Providers] have to make up the costs somewhere and it leads to higher costs and premiums. If we can more people covered, costs and premiums will go down."

The House health care bill would provide coverage to about 96 percent of Americans under age 65, compared with 83 percent now, according to the Associated Press. About a third of the remaining 18 million people left uninsured would be illegal immigrants.

The expected cost of the bill for the next 10 years is $1.055 trillion with a net cost of $894 billion, factoring in penalties by individuals and employers who don't comply with new requirements, according to the Congressional Budget Office.

That figure, however, excludes additional costs from added prescription drug coverage for seniors under Medicare and other changes, according to the AP. No official estimate of the legislation's total cost has been made.

A variety of income methods are planned to offset costs of the programs over the next decade, according to the Congressional Budget Office and the AP. Those include $460 billion from new income taxes on single people making more than $500,000 a year and couples making $1 million; $400 billion in cuts to Medicare and Medicaid; $20 billion in fees levied on medical device makers; $13 billion from limitations on flexible spending account contributions; sizable penalties paid by individuals and employers who don't obtain coverage; and a mix of other corporate taxes and fees.

A similar bill hammered out in the Senate has not been made public.

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