WASHINGTON — Speaker Nancy Pelosi said Thursday that House Democrats were considering a "windfall profits tax" on insurance companies to help pay for legislation that would provide coverage to most of the uninsured.
The idea, she said, is to capture some of the profits that insurance companies might reap if the government required nearly everyone to have insurance and subsidized premiums for millions of low- and middle-income people.
Pelosi's comments came as Senate Democrats said they were increasingly confident about passing health legislation in the face of staunch Republican opposition. The Senate Finance Committee plans to vote Tuesday on its version of the legislation.
The Senate Democratic leader, Harry Reid of Nevada, said the effort to pass a bill had gained momentum from a report Wednesday by the Congressional Budget Office. The report said that a bill drafted by the Finance Committee would provide coverage to 29 million people, but reduce deficits over the next decade because the costs would be offset by new taxes and fees and cutbacks in Medicare.
Sen. Blanche Lincoln of Arkansas, a centrist Democrat who had expressed concern about the potential cost of the bill, said the report had shored up her support for it.
"It's real positive," Lincoln said. "You know, we all set goals and we really, really, really worked hard to stay within those goals of making sure that it was deficit-neutral, and we even got a
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higher score of deficit reduction in there."
The budget office said the Finance Committee bill would reduce deficits by $81 billion in the next 10 years and by much more in the following decade.
Sen. Evan Bayh of Indiana, a moderate Democrat, said: "The deficit reduction figures were definitely good news. But we need an enforcement mechanism to make sure those savings are achieved. I worry that people will come back and ask for relief in future years, and Congress will knuckle under."
Reid said "we stand closer than ever to fulfilling the promise of Sen. Ted Kennedy," a champion of universal insurance coverage, but he added it would be "far from smooth sailing" because of Republican opposition.
Senate Republicans were sputtering with frustration at the report from the budget office, which they said gave an overly rosy picture of the bill.
Sen. John Thune, R-S.D., said the price tag put on the bill — $829 billion over 10 years — understated the costs because the most expensive provisions would not take effect until 2013 and 2014.
The No. 3 Republican in the Senate, Lamar Alexander of Tennessee, said the budget office findings were "too good to be true." He recalled how a big expansion of Medicaid had caused a fiscal crisis in his state.
The chairman of the Senate health committee, Tom Harkin, D-Iowa, said he would fight to make sure the Senate bill included a government-run health insurance plan, to compete with private insurers.
"The majority of people and the majority of Democrats are in favor of it," Harkin said, "and that's why I say, the bill we send to the president will have a public option in it."
The Finance Committee twice rejected proposals for a public plan last week. But Pelosi said Thursday that, "It's very clear from our consultations with members that the votes are there for a public option" in the House.
President Barack Obama has said he wants a public insurance plan, but not if its inclusion would doom passage of a bill this year.
Pelosi said House Democrats were considering the tax on insurance company profits because the companies stood to gain from the legislation.
"I thought that there was more that insurance companies could contribute to this health care reform," Pelosi said. "After all, they are going to get 50 million new consumers, many of them subsidized by the taxpayers, and we think they can put more on the table."
Robert E. Zirkelbach, a spokesman for America's Health Insurance Plans, a trade group, said the tax "would lead to higher premiums for families and businesses," because insurers could pass on the expense.
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