Critical Condition

Pelosi Bill: Get Ready to Grow that Enemies List

The White House seems fond of making enemies lists these days, so it seems worthwhile to look at the just-released House health package to determine who non-partisan journalists think might be joining the enemies list in the near future:

1. States — The House bill will be increasing the threshold for Medicaid eligibility from 133 percent of poverty to 150 percent. According to the Wall Street Journal, “The Medicaid expansion is likely to prompt protests from the states, who share the program’s costs with the federal government.”

2. Employers — The Journal notes that the legislation will impose a payroll tax on employers with over 500,000 in payroll who do not offer health insurance. Per the Journal, “The penalty gradually rises, and firms with payroll greater than $750,000 would pay a penalty of 8% of payroll. Senate versions of the bill have weaker penalties.”

3. Liberals — The Journal also observes that “The loss of the ‘robust’ public option tied to Medicare rates was a defeat for liberals, who had lobbied hard for the measure.”

4. Budget hawks — Per Politico: “The legislation is projected to create deficits over the second five years, a fact that should give budget hawks plenty to worry about.”

5. Conservatives, specifically pro-lifers and those worried about illegal immigration — As the Washington Post notes, “sticking points involving abortion and immigration remain unresolved.”

6. Wealthy people . . . — A CNN story explains that “the measure is financed largely through a combination of a tax surcharge on wealthy Americans  . . . ”

7.  . . . as well as Medicare and Medicaid recipients — “ . . . and spending constraints in Medicare and Medicaid.”

Politico also looks at three industry groups likely to be unhappy, specifically:

8. Pharmaceutical Companies –  “The legislation imposes as much as $150 billion in Medicare cuts on the prescription-drug industry — almost double the $80 billion cuts in the Senate bill.”

9. Medical Device Manufacturers –  “It imposes a 2.5 percent tax on medical device manufacturers, a quietly influential force on Capitol Hill,”

10. Insurers — “Health insurers, who have already agreed to end many of the practices banned by the bill, would have to compete with a government-run insurance vehicle that would put pressure on them to lower premiums.”

All told, the Pelosi approach is an impressive demonstration of coalition building . . . if you’re trying to build a coalition of opponents.