Pelosi suggests maneuver to pass healthcare overhaul

Laying out a possible path to approving healthcare legislation, House Speaker Nancy Pelosi (D-San Francisco) said Wednesday that the House should pass the Senate’s version and then use a process known as “budget reconciliation” to make the changes some lawmakers are demanding.

The politically fraught strategy might allow Democrats to salvage a version of the overhaul that senior lawmakers pushed through the House and Senate late last year. Because budget reconciliation requires only a simple majority in the Senate, it could enable Democrats to circumvent a threatened GOP filibuster.

“Majority rule, we call it,” Pelosi told a group of columnists Wednesday.

But House and Senate leaders have not agreed on what later changes to make to the Senate bill.

Among other things, House Democrats have demanded elimination of a new tax on high-end “Cadillac” insurance plans. They also want more subsidies to help low- and moderate-income Americans buy health coverage, and more aid to help states expand Medicaid. The Senate version of the bill would give that extra aid only to a few states, including Nebraska.

Altogether, those changes could increase the cost of the healthcare overhaul by $300 billion over the next 10 years, bringing it to a total of nearly $1.2 trillion, according to a senior Senate Democratic aide.

Numerous Senate Democrats have labeled that price tag as too high, and Senate Majority Leader Harry Reid (D-Nev.) has not publicly endorsed the reconciliation approach.

Pelosi spokesman Brendan Daly disputed the $300-billion figure, saying, “There is no set cost.”

At the same time, many rank-and-file Democrats, wary of public opposition to the legislation, have said that they would prefer a new, more limited healthcare bill that might win some Republican support. Democratic leaders also are considering that approach.

But a growing number of overhaul supporters -- including doctors, consumer groups and labor unions -- have stepped up calls for Democrats to push forward with a more ambitious plan. So too has President Obama.

On Wednesday, Sen. Ben Nelson of Nebraska, a conservative Democrat who has opposed reconciliation in the past, indicated that he would not necessarily oppose that strategy with healthcare.

“If I support a bill, then I will vote for it regardless of whether it takes 50 votes to pass or 60 votes to pass,” Nelson said on a call with reporters from his home state.

On the other end of the Democratic spectrum, Rep. Lynn Woolsey of Petaluma, Calif., a leading member of the House Progressive Caucus, said she would consider backing the Senate healthcare bill and a reconciliation package.

“It is something that has been done many times over. Why should we be bullied out of doing something that could improve healthcare?” she said.

Republicans used the reconciliation process to pass former President George W. Bush’s tax cut packages in 2001 and 2003.

noam.levey@latimes.com

Doyle McManus contributed to this report.