Congress fights healthcare fatigue to finish bill

Facing an electorate more worried about jobs and the economy than healthcare, House and Senate Democrats have stepped up efforts to get a compromise bill to President Obama by the end of the month.

“Healthcare: Get it over with,” is the message Rep. Marcy Kaptur (D-Ohio) said she got from voters in her economically ravaged district over the holiday recess. “Do it, but fix what’s wrong with the bigger picture here.”

On Tuesday, House leaders gathered to discuss potential changes to the bill. That chamber is expected to slightly modify the legislation Senate Democrats passed last month by the narrowest of margins, before sending it back across the Capitol for a final vote.

House Democrats -- who must resolve delicate differences over issues such as abortion and taxes -- emerged from their meeting without announcing any agreements. And while it is unlikely that any major changes could survive a second vote in the Senate, interest groups have not stopped lobbying for their priorities.

Labor leaders, for example, met Tuesday with senior House Democrats to press their desire to strip out a tax on “Cadillac” health plans proposed by the Senate. Unions argue that the tax would penalize members who negotiated generous medical benefits in lieu of higher pay.

Lawmakers involved in the talks said that one alternative being considered was lifting the threshold at which the tax would be implemented to ensure that middle-class Americans would not be affected.

Meanwhile, consumer groups and other advocates of a “public option” are continuing to push for more oversight of the insurance industry, in anticipation that the final legislation will not include a government-run health plan to compete with commercial insurers.

“With the public option apparently off the table . . . it is more important than ever for the House to insist on comprehensive regulation of the industry to ensure affordability and accountability for Americans who will now be required to buy private insurance,” California-based Consumer Watchdog said Tuesday in a letter to House Speaker Nancy Pelosi (D-San Francisco).

Many consumer groups also are calling for tougher requirements on employers, although few anticipate they will be able to retain provisions in the House bill that would require larger companies to pay a minimum share of their employees’ premiums.

The influential seniors group AARP is lobbying lawmakers to limit how much more insurance companies can charge older customers than younger ones.

And the insurance industry is fighting to head off new federal regulation in favor of provisions in the Senate bill that give states more responsibility to oversee the industry.

Over the last year, many of these issues sharply divided Democrats in the House and Senate, sparking bitter disputes between liberal and conservative wings of the party.

But the desire to avoid new brawls and finish healthcare -- especially with polls showing that joblessness is weighing heavily on voters’ minds -- is expected to help defuse once-contentious issues.

It is clear that the healthcare bill lawmakers have spent so much time debating is unpopular with large segments of the country.

According to the most recent Gallup survey, just 49% of Americans said they would advise their congressional representative to vote for a healthcare bill. The economy, polls show, now is identified as the top issue confronting the country by nearly half of respondents. By comparison, just 15% in a recent CNN/Opinion Research Corp. poll identified healthcare as the nation’s most important issue.

“Moving on to job creation is absolutely essential,” Rep. James P. Moran (D-Va.) said Tuesday. “You’ve got to eat your spinach before you move on to dessert. Job creation is political dessert because, if we could do it, that’s what we’re going to get the most satisfaction from.”

On Tuesday, U.S. Chamber of Commerce President and Chief Executive Thomas J. Donohue barely mentioned healthcare during his annual address on the “state of American business.” Instead, Donohue focused on free trade, infrastructure and energy, while threatening to challenge in November’s midterm elections those lawmakers who oppose the chamber’s agenda.

Further fueling the push to finish up healthcare is sheer weariness. The yearlong battle has left many Democrats with little appetite for a fight as they hammer out a final bill.

“There is definitely fatigue,” said Rep. Joe Courtney (D-Conn.). “There’s skepticism this place can absorb another massive . . . debate.”

noam.levey@latimes.com

janet.hook@latimes.com