House bill won't have 'opt out' option

WASHINGTON -- House Speaker Nancy Pelosi plans to unveil revised health-care reform legislation today that would include a stronger government-operated insurance option than the one that the Senate plans to consider.

Senate Majority Leader Harry Reid, D-Nev., is pushing a government health insurance plan that would allow states to "opt out." Pelosi, D-Calif., is expected to support a public option with no such escape hatch. The revised measure will merge terms from three separate but similar bills that three committees in the House of Representatives passed earlier.

Though Democrats control 256 seats in the House, 38 more than the 218 needed for a majority, the vote to pass the bill is expected to be close, because conservative and moderate Democrats have raised concerns about the measure's cost, tax-raising provisions and an expansion of the government's role. House Republicans uniformly oppose the legislation.

Democratic leaders made some concessions to their restive colleagues, notably that the government plan would negotiate rates with health-care providers instead of tying reimbursement to Medicare's rates. Many lawmakers from rural areas and smaller states argued that their providers often are underpaid under Medicare. Reid's Senate plan also would rely on separately negotiated rates.

Liberals got one major concession: The measure is expected to expand Medicaid, the state-federal program for health care for the poor.

The proposal also is expected to require employers either to offer coverage to employees or pay penalties, and it would penalize individuals who didn't obtain policies.