WASHINGTON — Rep. Rick Boucher (D-Va.) is in a tough spot when it comes to overhauling the nation's healthcare system. Major hospitals in his largely rural district have told him the bill pending in the House would cripple them financially. But Boucher also believes that the need for change is painfully obvious: When a free medical clinic was offered in a remote area of his district, some 2,700 people showed up.
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Democrats walk a careful line on healthcare
Many lawmakers head home for their August recess to face constituents skeptical of Congress' overhaul plans. For Democrats in conservative districts, this could be a tough sell.
For The Record
Los Angeles Times Thursday, August 13, 2009 Home Edition Main News Part A Page 4 National Desk 2 inches; 64 words Type of Material: Correction
Healthcare overhaul: An article in Section A on Aug. 3 about congressional efforts to overhaul the nation's healthcare system said that the bill approved early this month by the House Energy and Commerce Committee would mandate that businesses with more than $500,000 a year in revenue provide health insurance for their employees. It should have said businesses with more than $500,000 in annual payroll.
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"It put an exclamation point on the fact that we have 47 million uninsured Americans," said Boucher, who was one of five Democrats to vote against the bill when the House Energy and Commerce Committee approved it Friday night, setting the stage for a House vote in the fall.
"But there are clear practical problems for rural areas. This is not about philosophy. It's about the survival of hospitals."
Those political cross-pressures were evident when President Obama visited Boucher's district last week: There were demonstrators outside the event both supporting and protesting Democrats' plans to overhaul the nation's healthcare system.
During the August congressional recess, Democrats from across the country expect to be buffeted by those same cross-currents. Their meetings with constituents are sure to be dominated by the far-reaching healthcare legislation emerging from House and Senate committees.
The bill, which took a big step forward with the Friday committee vote, is designed to expand health coverage for the poor, cut costs, and improve coverage for people who already have insurance. It would also raise taxes on high-income people, mandate that businesses with more than $500,000 a year in revenue provide health insurance for their employees, and establish a government-sponsored health insurance option.
Critics, including some Democrats, fear the government plan could dominate the market and undercut private options. Hospitals in rural areas are especially fearful that a new reimbursement system would not adequately cover their costs.
Though Obama owed his 2008 election in part to his pointed critique of the healthcare system -- and many congressional Democrats won their seats on his coattails -- the issue now is a political live wire, and Democrats are treading gingerly.
"We are getting thousands of phone calls and e-mails, many deeply angry," said Rep. Jim Cooper (D-Tenn.). "Some want to do nothing, others want to do everything. We can't distinguish between what is just grumbling about change and what is a precursor of an earthquake."
