(A great wrap-up of where we stand on federal health care reform and how the California delegation is doing. – promoted by Brian Leubitz)

Edited and updated from the Health Access Blog

Yesterday, Speaker Nancy Pelosi kicked off her August recess by meeting with health care providers and patients at San Francisco General Hospital, to promote President Obama’s health reform effort.

With the passage of H.R.3200 out of Energy and Commerce on Friday, and the other relevant committees earlier in July, she could rightly report historic progress. Such a health reform proposal has now moved farther than any previous attempt in the modern era, and it set the stage for a House vote in September after the August recess.

But health care reform hangs in the balance, with opponents of the President detemined to “rattle” Congressman by disrupting town hall meetings and otherwise create an anti-reform political environment. As has been stated on Calitics before, those who support health reform need to be active NOW AND THROUGH AUGUST, CALLING, WRITING, FAXING, and VISITING our California Congressional Representatives, with a positive message about reform and its various components, from a public health insurance option to minimum benefits standards to affordability subsidies to the financing that allows for the needed upfront investments.

Californians have a particularly important say in health reform in the House of Representatives, from the Speaker to key Committee Chairmen, to Caucus leaders, to the bulk of our 53-member delegation. Health reform supporters can call your member of Congress in support of health reform at 877-264-HCAN, or click here to help pass reform.

Below the fold, we’ll detail more about the bill, the process, and where California’s Congressional representatives have come down on health reform to date:

THE BILL: The House proposal, America’s Affordable Choices Act, H.R.3200, would dramatically secure and expand health coverage:

* making it more likely than people get and keep their on-the-job health benefits;

* improving and expanding public health coverage programs like Medicaid;

* providing significant subsidies for low- and moderate-income families to be able to afford health coverage; and

* placing new rules and oversight over insurers to protect consumers, from prohibiting denial for pre-existing conditions, to limiting out-of-pocket costs; to ensuring a minimum benefit package; to providing a public health insurance option for consumers to choose.

Intertwined in the overall package is a range of efforts to contain rising health care costs, from prevention and public health initiatives to better use of information technology and bulk purchasing.

Especially as this bill gets negotiated with what might come out of the Senate, there will be specific issues and advocacy around affordability, financing, employer responsibility, inclusivity, benefits, and the public health insurance option. But moving the bill is crucial to attain those goals, and the House bill, H.R.3200, is a comprehensive vehicle that is supported by dozens of leading consumer, labor, community, patient, and provider organizations, including Health Access California.

THE AUGUST RECESS AND AFTERWARDS: The August recess, as both Senators and Representatives spend more time in their states and districts, is seen by both supporters and opponents of health reform as a crucial time to sway Congressmembers on the high-profile issue.

In addition to a House vote after the recess, the Senate Finance Committee is planning to unveil and consider its’ version of health reform after the break by September 15th. Under this new timeline, a product from that committee would be joined with the Senate Health Committee passed a few weeks ago, and be considered on the Senate floor soon afterwards.

THE ACTION IN THE HOUSE: The Energy and Commerce Committee passed H.R. 3200 by a vote of 31-28. The vote was supported by all but five Democrats, and included the support of the six California Democrats on the panel: Chairman Henry Waxman, as well as Anna Eshoo, Doris Matsui, Jane Harman, Lois Capps, and Jerry McNerney. All Republicans opposed the measure, including the two California Republicans: George Radanovich and Mary Bono Mack.



This committee was the last of three committees to consider and pass out the historic legislation.

* In the House Education and Labor Committee, all the California Democrats voted for H.R.3200, including Chairman George Miller, as well as Lynn Woolsey, Susan Davis, and Judy Chu. The California Republicans voted against it, including Howard “Buck” McKeon, Tom McClintock, and Duncan Hunter.



* In the House Ways and Means Committee, chaired by Rep Charlie Rangel of New York, all the California Democrats voted for H.R. 3200, including Health Subcommittee Chairman Pete Stark, as well as Xavier Becerra, Mike Thompson, and Linda Sanchez. California Republicans voted against it, including Wally Herger and Devin Nunes.



Health advocates are urging members to THANK the members that voted for the health reform bill.

CALIFORNIANS IN CHARGE: California consumers are uniquely suited to have their voice heard in this debate. In the House of Representatives, California is well represented in this debate, from Speaker Nancy Pelosi, to key members of leadership like Representative Xavier Becerra, on down.

Each of the three committees of jurisdiction for health reform has a senior Californian in a top leadership position: Rep. Henry Waxman chairs the Energy & Commerce Committee; Rep. George Miller chairs the Education & Labor Committee, Representative Pete Stark is the second senior member of the House Ways & Means Committee, and the chairman of the health subcommittee. Given this leadership and authorship, H.R.3200 can be seen as “made in California.”

Californians were also integrally involved in the back-and-forth that led to the final agreement allowing passage from the final committee in the House.

California also has the largest contingent of “Blue Dogs” Democrats, who are self-described as more conservative, and who have been advocating concerns and changes to the health care legislation. However, of the seven California Blue Dogs, five have generally been supportive of health reform. By the beginning of the year, California Representatives Joe Baca, Mike Thompson, Jane Harman, Loretta Sanchez, and Adam Schiff signed on in support of Health Care for America Now! principles, and have been supportive of health reform in general and of the public health insurance option in specific. These five members declined to sign a “Blue Dog” letter that opposed health reform without specific changes.

The two other California “Blue Dogs” are Representatives Jim Costa and Dennis Cardoza, both of the Central Valley , and both signed onto that letter urging changes to the health reform. While neither was on a relevant committee, the signing of the letter gave support to the group that did negotiate for a delay in the house floor vote and that got amendments to the bill, including on the public health insurance option and reducing affordability subsidies. Ultimately, a compromise was reached where some (but not all) of the “Blue Dogs” on the Ways and Means Committee agreed to support the bill.

That compromise was a concern to progressive members, including many Californians. A letter signed by 57 members (14 from California!) of the Progressive Caucus and the Tri-Caucus circulated in the last week gave strong support to health reform but warned “we will not support a weakened public option.” In addition to the leadership of Progressive Caucus Chair Lynn Woolsey, Black Caucus Chair Barbara Lee, and Asian Pacific American Caucus Mike Honda, other California Representatives who signed the letter included Lucille Roybal-Allard, Laura Richardson, Maxine Waters, Judy Chu, Diane Watson, Jackie Speier, Bob Filner, Linda Sanchez, Grace Napolitano, Sam Farr as well as Pete Stark.



Further negotiations ensued between Chairman Waxman, Blue Dogs, and Progressives who were concerned with the Blue Dog compromise, leading to additional “unity amendments” to the bill that sought to bridge the differences, most notably to find savings to maintain the affordability subsidies for low- and moderate-income families.

ACTIONS: Health and consumer advocates, including Health Access California and Health Care for America Now!, are urging Californians to CALL, WRITE, AND VISIT their Congressional representatives this week and through August in support of health reform. Opponents are mobilizing to chip away at the support for health reform, and we need to be clear about the urgency, the need, and the popularity of reform.

Call Congress at 877-264-HCAN, or click here write to help pass reform.

* In particular, Californians should THANK the members of the various committees that voted for H.R.3200, including: Henry Waxman, George Miller, Pete Stark, Xavier Becerra, Anna Eshoo, Doris Matsui, Jane Harman, Lois Capps, Jerry McNerney. Lynn Woolsey, Susan Davis, Judy Chu, Mike Thompson, and Linda Sanchez.



* Californians should THANK the Progressive members that are advocating strongly for a robust public health insurance option and for affordability subsidies for low- and moderate-income Californians, including: Lynn Woolsey, Barbara Lee, Mike Honda, Lucille Roybal-Allard, Laura Richardson, Maxine Waters, Judy Chu, Diane Watson, Jackie Speier, Bob Filner, Linda Sanchez, Grace Napolitano, Sam Farr and Pete Stark.

* Californians should THANK the “Blue Dogs” that have distanced themselves from that caucus to be supportive of health reform, of the Health Care for America Now! principles, and of the public health insurance option, including Joe Baca, Mike Thompson, Jane Harman, Loretta Sanchez, and Adam Schiff.



* Finally, and most importantly, Californians should URGE California Representatives Jim Costa (D-Fresno/Bakersfield) and Dennis Cardoza (D-Merced/Modesto) to come out in support of health reform and H.R.3200. The Blue Dogs got key amendments that should address their concerns, and nowhere in the state or nation is in more need of health reform than the Central Valley of California.

* While you are at it, call California Senators Barbara Boxer and Diane Feinstein in support of health reform as well.

Call your member of Congress at 877-264-HCAN, or click to help pass reform.