Informal negotiations on health bill are likely instead of conference

Aide cites threat of procedural obstacles in leadership's decision to bypass formal conference committee to hammer legislative differences.

The House and Senate will not set up a formal conference to work out differences in the chambers' healthcare overhaul bills, a Democratic leadership aide said on Monday.

Senate Majority Leader Harry Reid, D-Nev., spoke over the weekend with House Speaker Nancy Pelosi, D-Calif., to begin the informal negotiations. Discussions are expected to be ongoing among leaders, key committee chairmen and White House officials as the House is likely to negotiate some changes to the more conservative Senate bill and send it back to the upper chamber for final approval -- a so-called pingpong process.

Leaders blame their decision to bypass a formal conference on Senate Republicans, who pledged to use procedural hurdles required with a conference committee to hamper passage of a final overhaul bill. "We have to work around that," the aide said.

Senators are not in town this week, but House leaders and key committee chairmen plan to meet on Tuesday to discuss melding the bills. House Democrats also plan to caucus on Thursday, some by phone, to discuss priorities and process, House leadership aides said. House staff would not confirm a formal conference committee is off the table.

The Senate bill does not include a public option like the House bill. In addition, it is less restrictive on federal abortion funding and taxes high-cost "Cadillac" insurance plans to help pay for the overhaul rather than taxing the wealthy, as the House bill does.

A senior Democratic leadership aide said the House is prepared to accept a Cadillac tax as long as the threshold for premiums considered high cost is raised so union plans are exempt, while some of the funding gap from the change will be filled in with the House's tax on the wealthy, only with a raised floor for what is considered wealthy.

The House bill imposes a 5.4 percent surtax on individuals earning at least $500,000 and families earning at least $1 million. The Senate bill imposes a 40 percent excise tax on the value of premiums that exceed $8,500 for individuals and $23,000 for families.

The chambers will need to work out disagreements over how to fill a gap in Medicare prescription drug coverage, known as the doughnut hole, and a Senate-created commission meant to make cost-cutting decisions in Medicare. The House is reluctant to give up jurisdiction over Medicare funding.

The White House would prefer the bill be on the president's desk by the State of the Union address in late January. After the Senate passed its version Dec. 24 on a 60-39 vote, Senate leaders were skeptical they could finish the negotiations by early February.