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**start transcript**

Nancy Watzman: Welcome everyone. I'm Nancy Watzman of the Sunlight Foundation representing BlogHer Today and their Community Journalism Initiative on Healthcare Policy.

The sunlight foundation is a non-partisan, non-profit dedicated to using the power of the Internet to catalyze greater government openness and transparency. As CEO, Lisa Stone announced BlogHer has been sponsoring a bipartisan series of telephone conference calls to connect women bloggers directly with their legislators.

Today on the call we have Senator Kirsten Gillibrand of New York. And she'll give a brief introduction of herself and then we'll go straight to question and answers. I know that we have a lot of people on the line.

Kirsten Gillibrand: Hi everybody, can you hear me?

Nancy Watzman: Yes. There's a bit of an echo, for me.

Kirsten Gillibrand: Okay. I'll get closer to the phone. Well thank you all for being part of this call. I'm very appreciative of your time. And I'm appreciative of your advocacy. The work that you do on so many of the blogs throughout the Internet are so important to the advocacy that's important to me, so I'm very grateful for your outreach.

Today we're going to talk about healthcare. I'd like to give you a brief introduction about what happened in the bill. But before I start, I really want to thank the host, the Sunlight Foundation. And I want to thank you particularly Nancy for your leadership.

As you guys know, I was the first congress member to post all my earmark requests, my schedule and my financial disclosure on my Web site. I was the first member to do that in the history of congress. And interestingly, once I did it, a bunch of other freshman congress members did it. And within two years, Speaker Pelosi decided that everybody had to put their earmark requests online.

So, you know, sometimes you don't think that change happens, but it really can, through advocacy and hard work; and that's exactly what the Sunlight Foundation has demonstrated.

We got our bill last night from Senator Reid, and it's, you know, the bill's not perfect. It's got a lot of things that I think need improving. But it's got some important pieces that I think makes this bill passable by 60 votes. It's got the public option, and it's a small public option, and not what I would like. I would prefer a Medicare for all approach.

But it has a public option which means it'll pass the house, and it doesn't have the Stupak language in it, which would have made it very difficult for a number of senators to vote for it. So keeping that language out is great. It really just continues Hyde, meaning that no federal money can go for abortions.

Some of the things that were disappointing; I would have liked a robust public option; I would have liked a Medicare for all where anybody could buy into Medicare at 5% of income. Because I think that's a good framework, Medicare only has a 3% overhead. You'd have to fix some reimbursement rates in Medicare, because a lot of our doctors and hospitals suffer from low reimbursements. But for the most part, it's a - would have been a good framework. And 5% of income is always affordable.

The affordability provisions in this bill aren't bad. They basically say you don't have to buy insurance if nothing's available at 8% of your income. And that's very helpful because that number could have been as high as 12%, and I think that's unaffordable. So I think the 8% number's good.

Some of the large structural changes that are in, that are really important; no-one gets denied coverage because of preexisting condition, no one goes bankrupt because of one illness, and all preventive care is covered.

So we had a provision that would have better on preventive care that Senator Mikulski had that would have made all preventive care for women's health entirely free. But the CBO scored it as too expensive so, we weren't able to get it entirely free. (Unintelligible). So there's going to be a subsidy, but you still have to pay a copay. So it's not ideal, but at least it covers the preventive care, which I think is so important.

So you know, what we're going to do going forward, as the Leader put it on the floor, we're going to now start the process of amendments. We're going to - we could have as many as 500 amendments, like they had in the Finance Committee.

But the Leader said that he's going to try to keep the amendments, you know, have one abortion amendment, one Acorn amendment, one, you know, keep one amendment for each major issue. And I'm hopeful that we will defeat all those amendments that are not good for America.

So I'm hopeful that we're going to get this bill done. I think we'll get it done by Christmas. And then I think it will go to conference, and they will, you know, try to merge the two bills. I think our abortion language will stay in, because a lot of House members have said that they will not vote for a bill if Stupak's in it, and I think that will ruin their majority. So I think our language will stay in. And I think the public option will definitely stay in, because that's mandatory for the House side. And we'll have the beginning of healthcare reform in this country. And I think it's a great first step. It's only a first step. I think that, you know, Medicare, Medicaid, Social Security; none of them happened in a day. This is not going to happen in a day either; it's going to require reform, and revision over the next ten years. And I hope I'm in the Senate that long so I can really be part of that, to make sure we protect women and that we protect Americans in the healthcare that they need.

Nancy Watzman: Okay great. Let's go to the first question. Do we have a first caller on the line?

Operator: Yes, thank you. Ladies and Gentlemen, if you'd like to register a question, please press the 1 followed by the 4 on your telephone. You'll hear a three tone prompt to acknowledge your request. If your question has been answered and you'd like to withdraw your registration, please press the 1 followed by the 3.

If using a speakerphone, please lift your handset before and during your request. Or you can also submit a question via the Chat feature on the bottom left of your screen.

And our first question comes from the line of - from Line Number X195. Please proceed with your question.

(Danine): Hi, my name is (Danine) and I'm calling from Wisconsin. And I'm calling - my question is about the public option. We haven't really heard a lot about it. Who will be eligible for the public option? What will it look like? What will the premiums be? What will the copays be? Can you talk a little bit about that?

Kirsten Gillibrand: Yeah. This is the detail we have so far. First of all it's voluntary, so nobody has to use the public plan. States can opt out if they want to, but it does require a vote by their legislature -- which is a good protection I think, than just a governor being able to say, "We're opting out." Because if that legislature for example votes against having a public option, then hopefully the people of that state can elect them out in their next election.

The rates that are negotiated, the public option will negotiate rates just like any other provider. So that means that it's not going to be a cheap. You know, if you had a Medicare for all, where you could buy it at 5%, that's just cheaper. So it's not going to be very cheap. Because if you're just with the same as all other providers it probably won't be as inexpensive as we'd like.

But Sebelius, who's our Secretary of Health and Human Services, she will determine the rates. She will determine how much it costs, she will determine what copays will be, and you know, what deductibles will be. And let me ask my staff; when does she have to do that by? Is there a deadline for - yeah. This doesn't put - go into place until 2014.

Nancy Watzman: Okay, does that answer your question?

(Danine): Okay, so did you say that this will not be very cheap, so it will be - will it be comparable to your average policy? Or will it be less or more expensive? Will it be…

Kirsten Gillibrand: It will probably be comparable to the policies that are on the exchange. Because they have to negotiate rates, just like anybody else, their cost will likely be comparable.

It will create competition. And it will drive down cost. But it's not as, I think, as exciting as a Medicare for all, where you would really drive down cost.

(Danine): Okay. So…

Kirsten Gillibrand: And the other thing that is beneficial about the public option, which is why so many of us fought for a public option; they don't have any overhead. There's no advertising budget, there's no CEO salaries, and there's no margin for profit. And so because they don't have those affects, it will lower cost, and it will create competition. So I do think it will work in the way that people have imagined the public option will work. I think it will work over time to bring those costs down.

(Danine): Okay. Thank you.

Nancy Watzman: Okay. So we have another caller on the line. We'll go to them.

Operator: As a reminder, to register a question, please press the 1 followed by the 4 on your telephone. Our next question comes from Line Number X397. Please proceed.

Woman: Hi. I realize that you're a proponent of breastfeeding, you breast fed your son well beyond the recommended standard. Breastfeeding can be shown to reduce childhood obesity, among its other benefits. Given that it can be looked at as the first step in preventative care that lasts a lifetime, how can it be part of healthcare reform? And what is the status of the Breastfeeding Promotion Act?

Kirsten Gillibrand: Well I agree with your statement that breastfeeding is very good for children. I think it - there are a lot of studies that show its - it promotes healthy eating, it limits obesity in children that are breast fed. It provides the immunities that regular milk doesn't offer.

But not all women can breast feed. So you want to make sure that women have choices about what they want to do for their child. But I breast fed because I thought it was important. And my mother breast fed me, so it's been our family tradition.

But I think what's important is that you have to provide information. If a woman did not grow up in a family where her mother breast fed, there's going to be no one to encourage her to breast feed. The most encouragement I got to nurse, was from my mother. So if you don't have a mother who nursed, then you might not have that encouragement.

So some of the things we want to do is to train doctors, to train pediatricians, to train advocacy groups. And to encourage employers to have lactation consultants that come in and meet with employees. To have lactation rooms, so there's a place for if a woman is nursing, but she's working, where she can go and pump to bring breast milk home to her baby.

So those are the kinds of - of - of - of innovations that we really need to promote breastfeeding in people's businesses and among families, so that they have someone to encourage them. Because sometimes breastfeeding's difficult. It's not always easy, and if you don't have someone encouraging you, often times moms will give up.

So I think it has to be a very comprehensive approach, with a lot of education. It also is related to an issue that's very important to me, which is the childhood obesity issue. When I went to a health center in the Bronx, what I thought was so important, was that the doctors were getting women when they are pregnant to start teaching them about nutrition. To encourage them to nurse, and then to teach them what foods their children should eat to stay healthy. And that a fat baby isn't necessarily a healthy baby, but an actual - feeding them proper foods is what needs to happen.

So a lot of the things I've been working on right now is tackling childhood obesity. And I have a very comprehensive program to do that with (be any chance that) making sure we pay more for our school lunches, to be able to afford more whole foods, more fruits, more vegetables, more whole grains and less processed meats and processed foods. And giving, you know, more investment to communities that get the kids active, outdoors, being athletic.

And also focus on giving the USDA authority to look at all the foods in a school -- not just what's served at the lunch counter, but also what's served in the vending machines. And I think those changes overall will make a big difference for giving parents the tools they need to keep their kids healthy. I also think we should have mandatory gym time for public schools, an hour a day.

And I also think we should have mandatory nutrition education, so kids just know what is good to eat. Because a lot of kids just don't.

((Crosstalk))

Kirsten Gillibrand: And you asked about the bill specifically, I'm a cosponsor of the Breastfeeding Promotion Act with Carolyn Maloney, which encourages breastfeeding through, you know, promotion and through education. I don't know when that'll be on the floor, but I'll research it and find out which committee it's in, and when it expects to come out of the committee.

Woman: Thank you so much.

Nancy Watzman: Okay. Let's go on to the next caller.

Operator: Our next question comes from the Line Number W998. Please proceed.

Erin Kotecki Vest: Hi, this is Erin Kotecki Vest I am with BlogHer. I'm glad to hear what you had said about breastfeeding. But I'm a little curious, because you said some of the - a lot of the women's issues didn't necessarily make it into this final senate bill. Will you be introducing any amendment? Do you see maternity care or any of those things on there?

Kirsten Gillibrand: Well I'm working with Senator Mikulski right now on that very issue. Because some of the things that Senator Mikulski wanted included, she wanted to have all preventive care covered so it will be free. Because when women don't get their pre-cancer screenings, the incident rate of ovarian cancer and, uterine cancer, and breast cancer is much higher.

So we want to have that covered completely, to really encourage preventive care to keep women healthier longer. So that was taken out, because CBO scored it and said it was too expensive. So Senator Mikulski and a number of the women are now working on what amendments we can offer to try to get the votes necessary to put that back in.

Preventive care though, is covered in the bill, we just would have to have a copay. And so we want to have no copy, so that there's no excuse for a woman to not get that mammogram, or not get that pre-cancer screening. Not get her Pap smear, for example, every year.

Erin Kotecki Vest: You know… go ahead Nancy.

Nancy Watzman: Sorry, I was just going to follow-up to that, because obviously that speaks to the recent study about mammograms. I was wondering if you had a position on that, or?

Kirsten Gillibrand: Well the study concerned me, because it created a lot of confusion for women all over the country.

And I think what needs to happen, and I've written a letter to Secretary Sebelius asking her to provide clarity to the American public about what is recommended. Because the U.S. Preventive Services Task Force is one - an outside independent panel of doctors and scientists who make recommendations, but they do not set a federal policy, and they don't determine what services are covered by the Federal Government.

I don't want to have insurance companies have an excuse to stop offering coverage for mammograms for women in their 40s. And not offer coverage for a yearly mammogram because the recommendation was for every other year in the 50s. So I have concerns, and I think it's important that we create a body of review. Because the American Cancer Society does not agree with the U.S. Preventive Services Task Force.

So Sebelius came out yesterday and she is basically saying mammograms have always been an important lifesaving tool in the fight against cancer, and they still are today. And she said, specifically she says, "Keep doing what you've been doing for years; talk to your doctor about your individual history, ask questions and make the decisions that's right for you."

So she is pushing back on some level. I'm going to ask her to take an even stronger role, because I'd like her to create the clarity and create a body of advice to give American women. And I want her to bring together the experts to make that determination.

Nancy Watzman: Okay. Let's go on to the next question.

Operator: Our next question comes from Line Number 20 - X208. Please proceed.

(Gina Carroll): Hello, this is (Gina Carroll), I'm calling from Houston, Texas. And your response just really covered my question, because my questions were related to the new announcement by the federal panel regarding testing. I guess my biggest concern is in the informational realm; the fact that the study is saying that the risk of the testing doesn't justify regular testing in that way.

Kirsten Gillibrand: Right.

(Gina Carroll): I'm wondering how, you know, we can undo that damage. Because there are a lot of women out there who (unintelligible) to have that justification, and really do have a fear about the risk of testing.

Kirsten Gillibrand: Right. Well, you know, I didn't even know about the risks of testing for myself. You know, I just did a public service announcement, it's urging women to get their yearly mammogram. I'm 42, I've had two so far. My doctor wants me to have another one this year. I'll get mine, but you know, I didn't know what risks there were. No one told me there was a risk with getting a mammogram every year.

So, there's a lot of misinformation, and I'd like to know what the risks actually are now. And you know, am I endangering myself by getting mammograms? I just don't know. So I think the confusion that's been called is doing a grave disservice to American women.

And I think it's important that Secretary Sebelius take a leadership role here, and create clarity so women know what the risks are, and they can weigh those risks with their doctor, and make a determination what's best for them.

Nancy Watzman: Okay. Does that answer your question?

(Gina Carroll): It does, thank you.

Nancy Watzman: Okay, so on to the next caller.

Operator: Ladies and Gentlemen, as a reminder, to register a question, please press the 1 followed by the 4. Our next question comes from Line Number X397. Please proceed.

Woman: Hi, I'm the one that asked about the Breastfeeding Promotion Act. I had a follow-up question.

Kirsten Gillibrand: Okay.

((Crosstalk))

Woman: …center case that just went through the Supreme Court this year found that breastfeeding is not a condition related to pregnancy, which is just ludicrous. Is there a way to undo that damage through the healthcare reform?

Kirsten Gillibrand: I know nothing about that decision, could you email my staff the information and I'll review it? But that sounds very alarming to me. How could breastfeeding not be related to pregnancy?

Woman: And, I know, it was a split decision, and of course the female justices were a little alarmed that they weren't tackling that issue. The issue was that a breastfeeding mom was fired for pumping without permission to pump.

Kirsten Gillibrand: Unbelievable, unbelievable. That makes me so angry. Let me give you my Healthcare Allies email, it's Shari -- S-H-A-R-I_S-W-A-A-L-E-Y@gillibrand, G-I-L-L-I-B-R-A-N-D.senate.gov. If you could email her, we'll be in touch because that is extremely alarming to me and I'll come up with an idea about how to fight back on that.

Woman: Thank you so much. Can I read that email back to you?

Kirsten Gillibrand: Yep.

Woman: It's shari_swaaley, S-W-A-L-L-E-Y.

Kirsten Gillibrand: S-W-A-A-L-E-Y. Two A's.

Woman: A-A-L-E-Y, okay, thank you so much.

Kirsten Gillibrand: Welcome.

Nancy Watzman: Okay, Senator Gillibrand, I would like to ask a quick question on Sunlight Foundation's behalf, which is, you know, you spoke at the beginning eloquently about the importance of transparency and how - I'm just curious how you see its role in the current healthcare debate and whether you think the process has been transparent enough? And whether you think there should be any improvement?

Kirsten Gillibrand: Yeah, I think the process has been transparent enough. You know, the process is very traditional. You know, you take a bill through the Finance Committee, take a bill through the Health Committee. Those committees get to work on what their bill will look like. They issue those bills, everybody gets to review them. Then Senator Reid takes the two bills and creates a compromise.

The compromised version - between the two committees, the compromised version is now out and publicly available. It's going to be online, it's going to be read out loud. I'm going to put it on my Web site so my constituents have an easy button to push if they want to read it.

It's not as long as people think it is. They say it's 2000 some odd pages, but it's like double spaced, big fat print. It would be much smaller if it was normal print, it would be like, I don't know, 500 pages. But, you know, something that's well worth reading and going through. Particularly for advocates, you know, who know what the fine print means, how it will actually affect policies.

And so we're going to have it online for quite awhile before we have to vote on it. And in fact, I don’t think we're going to vote on it until after Thanksgiving, so we'll - everyone will have more than a week -- more than 10 days even -- to sit down and read it.

And then we'll also have three weeks of debate. So that will, you know, to do all those amendments. That will give us additional time to poke and prod it, and see what's good, see what's bad, and then come up with amendments to fix whatever we think's wrong in it. So I think the process is okay, it's just a traditional process.

((Crosstalk))

Nancy Watzman: I'm sorry?

Kirsten Gillibrand: Do you think it's not okay, did you feel you didn't get enough…

Nancy Watzman: Well, you know, (Kris) we’re concerned that the legislation, you know, any final version obviously would be available for at least 72 hours before any kind of debate. So, you know, if the bill changes again, you know, it always ends up being at the very end obviously, when things change quickly and things get rushed and then it's not available. So, you know, that would be our big concern.

Kirsten Gillibrand: There will be 72 hours before the cloture vote on the final bill on the final bill. So you will get 72 hours to see all the amendments and what it finally is going to look like.

Nancy Watzman: Right. Well, we'll be watching.

((Crosstalk))

Nancy Watzman: …just one more question? Next caller.

Operator: And our next question comes from Line X195, please proceed.

Woman: My question actually goes a little bit back to - Nancy's question about the bill being available for 72 hours, (unintelligible) was the Stupak language, and how it was inserted. It seemed to be inserted right before the final vote. Some of the (unintelligible) are really, really concerned that, you know, with its - you know, there's been some concern that Senator Hatch may introduce similar amendments.

How worried to we need to be about that? Are the votes there to add it?

((Crosstalk))

Kirsten Gillibrand: I don't think the votes - I don't think he's got 60 votes. He will offer an amendment, it will be Stupak, and I do not think he has 60 votes. And my job is to make sure that the Senators who are Democrats do not vote for it, particularly the Conservative Democrats, because if their view is they want to continue - excuse me - in they're view. I'm sorry I've got a terrible cough.

If their view is they want a continuation of Stupak, this goes far beyond Stupak. And so I'm going to try and make that case to them one-on-one, so we don't have - excuse me, it goes far beyond Hyde. So I'm going to make case to them one-on-one that they should not vote for any amendment. Whether I'll be successful or not, I don't know, but they - I do not think they have 60 votes. We've been counting it for a while and no one believes we have 60 votes to overturn what Harry Reid put in the bill.

Woman: Okay, so what should we be doing?

Kirsten Gillibrand: I think you should be lobbying the Conservative Senators.

((Crosstalk))

Woman: So that would be …

Kirsten Gillibrand: Conservative Democrats who have sometimes voted for pro-life bills, I would lobby them and tell them, particularly if you can get people from the state, to call and to write and do letters to the editor, do television interviews, you know, blog; whatever you can do to get your views know, so that your Senator in your state says, "Well, you know, there's quite a groundswell against Stupak, and they feel comfortable with Hyde."

So that is what needs to happen. We need to get our advocacy ringing loud and clear in the states where those votes are still in question.

((Crosstalk))

Nancy Watzman: Okay, I think we have one more question. We'd like to squeeze in, so…

Kirsten Gillibrand: Last one?

Nancy Watzman: …why don't we go to that. Next - the next caller.

Operator: Our next question is from Line W998, please proceed.

Erin Kotecki Vest: Hi this is Erin Kotecki Vest again from BlogHer. I know that you've talked a bit about preventative care and preventative measures when it comes to this stuff. And one of the things that you've championed is food safety, as well as the child obesity issue. Can you talk a bit about food safety and why it's so important in all of this?

Kirsten Gillibrand: Yes, it's a huge concern. You know, 1 in 300 lots of ground beef have E.coli in it. If you get ground beef that has E.coli it can result in death. Thousands of children are made sick every year throughout America, and a number of people die.

So my concern is that we need better testing of - the meat is not tested before its ground, so it's very hard to trace where the bad meat comes from. And it's not acceptable for producers to send out meat that has E.coli and just say well it needs to be cooked at 160 degrees, or whatever the number is.

So what I'm - I have a bill, it's called the E. Coli Eradication Act that will require testing before, and I introduced it yesterday, it requires testing before meat is ground. And then one more time, it requires two levels of testing before grinding and after grinding. So that we know that the meat that reaches our kitchen tables, our school cafeterias, our family's homes is safe.

We also have to better by our schools. There is very little notification if the - if a supplier has tainted foods or if there's been a recall; our schools are the last to know. They are not notified if there's a recall of a product nationwide.

And so it mandates recalls going straight to the school. It also mandates that where you buy your meat, or buy your produce, that there has to be a sign right where you buy it on your supermarket shelf.

So if you buy hamburger and there's been a recall and you go to the freezer section, and it says, "This kind of hamburger meat was just recalled," you will know to go back to your own freezer and make sure you don't have any old hamburger meat there, so you can throw it away. So that kind of notification, I think, will make a big, big difference.

The FDA is not testing any fruits and vegetables, but we also have a bill, the FDA Modernization Act that I co-sponsored, and it passed yesterday through committee, and that will change that. So we'll have testing of E.coli of all our meats, we will have testing of fruits and vegetables through this new bill. And I just think that will go a long way to keeping our kids safe and keeping the food that they eat safe.

Our parents need a lot more tools, they need a lot more notification. And it needs to be more transparent because when a child gets sick, you know, the facts can be devastating. You know, the New York Times story about a month ago, where it talked about a young woman who was a dancer who had a bad hamburger and she's now paralyzed from the waist down.

I met with some physicians and they told me stories about 6 month olds, and 6 year olds coming into their emergency rooms, and then barely surviving because of tainted food. So it - you know, anything can be tainted. It could be peanut butter, it could be fruits and vegetables, it could salads, it could be chicken, it could hamburger, anything, and we need to do better.

And these processes we have in place are 100 years old. So we need to do better. We need to revise our processes, and reform them so the food we feed our children, and our families, is safe.

Nancy Watzman: Okay. Thanks so much Senator Gillibrand. That wraps up today's call with Senator Gillibrand and BlogHer. Thank you for participating and thanks for bloggers for joining us.

((Crosstalk))

Kirsten Gillibrand: Thanks so much, really appreciate it.

Nancy Watzman: So no, yeah, definitely. Please keep an eye on blogher.com for the audio and transcript of this call and an announcement of any new calls.

Kirsten Gillibrand: Thank you.

Nancy Watzman: And we will - to give everybody another opportunity to talk about healthcare reform with legislators.

Kirsten Gillibrand: Great, thank you so much.

Nancy Watzman: Bye-bye.

Kirsten Gillibrand: Take care.

Operator inro and outro have been removed.

**end transcript**

Though broadly similar to the House bill, Mr. Reid’s proposal differs in important ways. It would, for example, increase the Medicare payroll tax on high-income people and impose a new excise tax on high-cost “Cadillac health plans” offered by employers to their employees. Mr. Reid’s bill would not go as far as the House bill in limiting access to abortion. And while he would require most Americans to obtain health insurance, he would impose less stringent penalties on people who did not comply. Many provisions of Mr. Reid’s bill, including the creation of insurance markets, or exchanges, would take effect in 2014, a year later than similar provisions of the House bill.

Of course, despite the bill's many nuances...it all comes down to money. Think Progress has a handy-dandy chart to show the budget differences between the House and Senate bills. The bottom line? The Congressional Budget Office report says the Senate bill would extend coverage to 31 million uninsured people while reducing the federal deficit by nearly $130 billion over 10 years. The Washington Post's Ezra Klein says there's more to it than that though,

If this piece of the bill was passed on its own, it would be the most important cost control bill ever considered by the United States Congress. But you could never have passed it on its own. You needed the coverage to make the grand bargain work. Republicans like to call this bill a trillion-dollar experiment to expand the health-care system, and in some ways, it is. But it's also a multitrillion-dollar experiment to cut costs in the health-care system, and it deserves credit for that, and support from fiscal conservatives. It's easy to talk about cutting costs, but this is the chance for people to actually do it.

But it's not only about money. Carrie Budoff Brown at Politico reports one of the significant differences in this bill is the delay of reform until 2014.

This is bad news for lawmakers who will need to explain to constituents why the elements that have attracted the most attention -- the public plan, the Medicaid expansion and the insurance exchanges -- won't be available for four years. Some reforms would kick in earlier, Senate aides explained, but the big pieces would still be a ways off.

And then there is, of course, the abortion question. With both sides still debating the ramifications of the Stupak amendment, the Senate bill seems to incorporate a variety of ideas. While TalkingPointsMemo reports key Democrats are onboard with the abortion language in the Senate bill, others aren't so happy. Shakesville writes,

Of course, Azzy's earlier post outlines why "allowing a woman to use her own private funds" for an abortion is a pretty pathetic solution in a healthcare bill ostensibly designed to serve people who don't have the funds to pay for their healthcare out of pocket. Again I will note that this fuckery only flies in a culture that treats women's healthcare and abortion as mutually exclusive concepts.

So now the real work begins. Debate over the bill is expected to last through December with every nook and cranny of these over 2-thousand pages discussed. OpenCongress has the bill for your tea-drinking, snuggle in bed, reading needs. Join me, won't you? Contributing Editor Erin Kotecki Vest also blogs at Queen of Spain Blog.

The final vote tally was 220-215, with one Republican voting for the bill and 39 Democrats voting against.

Jackie Kucinich from Roll Call explains the lone Republican vote:

(Rep. Anh “Joseph”) Cao was originally expected to vote “no” on the bill along with the rest of his colleagues because it didn’t explicitly ban funding for abortion. But since Democrats agreed to allow a vote on the Stupak amendment, and the U.S. Conference of Catholic Bishops gave their blessing on the Democratic health care bill provided the amendment is accepted — the vote became even tougher for the freshman Republican.

NPR reports the legislation's path was indeed cleared by the Stupak Amendment:

...the Stupak Amendment, introduced by conservative Democrats and intended to bar abortion services from any insurance plan paid for with a federal subsidy, passed in the House of Representatives late Saturday night. The vote was 240-194 in favor, with one vote of "present." Sixty-four Democrats voted "yes" on the amendment, along with all but one Republican, John Shaddeg (R-Ariz.), who voted "present."

A modest and less expensive Republican alternative was voted down, 176-258, with the vote nearly all along party lines. One lone Republican voted against his party's plan, Tim Johnson (R-Ill.)

Rayne at Firedoglake writes,

It’s a fundamental part of our belief system in the Democratic Party, that women have a right to privacy in their reproductive health care decisions. We’ve fought long and hard to protect this right.

And now we’ve seen decades of work to protect this fundamental human right dashed by our own Democratic representatives

While Backyard Conservative writes,

64 Dems vote in favor. But of course no guarantee it will survive conference. Three times Rep. Boehner, Republican Leader asked Democrat committee chairman to guarantee to support it in conference and they would not.

One of the other more talked about moments during of the day of debate came as the Democratic Women's Caucus took to the floor:

The Mahablog called the incident "...nothing but bullying." While Little Green Footballs says "...we get treated to the lovely spectacle of Republicans openly opposed to letting women have a voice in an important debate, and acting like boorish sexist pigs."

President Obama released a statement praising the passage of the bill,

The Affordable Health Care for America Act is a piece of legislation that will provide stability and security for Americans who have insurance; quality affordable options for those who don’t; and bring down the cost of health care for families, businesses, and the government while strengthening the financial health of Medicare. And it is legislation that is fully paid for and will reduce our long-term federal deficit.

But clearly not all were impressed. PolicyGal tweets, "Yes America, this is how liberty dies...with thunderous applause. And the Evil Emperor is wearing a hideous red dress."

While Karoli writes, "imperfect, it is. likely to become even more imperfect in coming days. but it *is* progress. and it does expose the bugs, so to speak."

The Washington Post reports the Senate will now take up the matter,

Democrats have sought for decades to provide universal health care, but not since the 1965 passage of Medicare and Medicaid has a chamber of Congress approved such a vast expansion of coverage. Action now shifts to the Senate, which could spend the rest of the year debating its version of the health-care overhaul. Majority Leader Harry M. Reid (D-Nev.) hopes to bring a measure to the floor before Thanksgiving, but legislation may not reach Obama's desk before the new year.

You can listen to audio of the call here on BlogHer:

You can also read the transcript of the call here on BlogHer:

**start transcript**

Nancy Watzman: Hi, welcome, everyone. I’m Nancy Watzman of the Sunlight Foundation representing BlogHer today and their community generalism initiative on healthcare policy.

The Sunlight Foundation is a non-partisan, non-profit dedicated to using the power of the Internet to catalyze greater government openness and transparency.

As CEO Lisa Stone announced, BlogHer has been sponsoring a bipartisan series of telephone conference calls to connect women bloggers directly with their legislators.

Today on the call we have Representative Cynthia Lummis from Wyoming and I’m going to turn it over to her to give a brief introduction and then we’ll do questions.

Cynthia Lummis: Thank you, Nancy. I appreciate the time you’re spending with me today and looking forward to your questions and your feedback about healthcare reform. I’m a Republican and I want you to know from the outset, Republicans are in favor of healthcare reform but we would do it differently than the Speaker of the House and the Democratic majority.

Among the things that we would like to do is take some of our 53-plus bills and borrow the best of the best ideas from them and individually debate them over time so we can come up with responses to some of the really targeted problems we have with healthcare including addressing pre-existing conditions, addressing how to protect the doctor-patient relationship, and how to deal with people who that truly are in need - people who are not well-served by our current healthcare system - while preserving the rights of people who like their insurance, like their hospitals, like their doctors and want to keep the programs they have.

Just a few minutes ago, the Speaker of the House Nancy Pelosi rolled-out the latest bill on healthcare reform that she will be advocating in the next week. It is almost 2000 pages long. The word “shall” nearly 3500 times, that we know from just a quick word search of the bill.

What’s called the “Doc Fix” which is about $200 billion to adequately compensate doctors is not in this bill so that’s how they got it under a trillion dollars. If you add “Doc Fix” it is over a trillion dollars and it shifts many costs to states in the form of unfunded mandates meaning states will be required to provide services and come up with the money to do so.

An example of that is expanding Medicare to include more low-income people so it’s essentially shifting costs onto states who don’t have the ability to print money like the federal government does so I’m terribly concerned about the proposal and I’m an advocate of a number of Republicans alternatives.

Among the things that I like better are a bill that would fund high-risk pools in states and that would be to serve people who have pre-existing conditions now. Also I favor the ability of employers to receive a tax deduction to contribute to an individual’s health savings account.

That way the individual can go out and shop for the insurance they want and then when they leave that employer and go to another employer, it is portable so that addresses another significant problem with our current healthcare system that we can address without throwing out the baby with the bath water so to speak and producing a brand new system that is government run.

I am very concerned about the financial stability long-term of our Medicare program which of course serves people over the age of 65 so to have another government-run system that in the long run is financially unsustainable to me is very problematic.

One of the Democratic Governors in the United States - the Governor of Tennessee where they have something called “Ten Care” which is a state-run healthcare program - has called this bill the mother unfunded mandates.

So Governors, state legislators and people in states should be I believe very concerned about some of the shifts in obligations to fund healthcare that are in the Speaker’s bill.

And I’ll tell you that we just got the bill so we’re just beginning to analyze the Speaker’s bill. We will be given 72 hours then a big amendment will be added to the bill and we will be given another 72 hours to look at it.

And then we could be voting on the Speaker’s bill next Thursday, Friday or Saturday so this is a very short timeframe to digest a 2000-page bill. I’m not sure what the rush is to reform a healthcare system that serves about 85% of Americans very well.

I wish instead we were targeting on the 15% that is not well-served and addressing their specific issues. Now with that introduction, I would like to open it up for questions.

Nancy Watzman: Yes, let’s go to the first caller.

Operator: Thank you. Ladies and gentlemen, if you would like to register for a question, please press the 1 followed by the 4. If your question has been answered and you would like to withdraw your registration, please press 1-3.

If you are using a speakerphone, we ask you to please pick-up the handset before placing your request. One moment, please, for the first question. And the first question is coming from line 492-L. Please proceed.

(Loralee): Hi. I actually would like you to expound a little bit more on your ideas for - you touched briefly on high-risk pools and pre-existing insurance conditions with the states.

I’m currently enrolled in a high-risk pool and it costs us a huge amount of money every month and they - it’s kind of a well-publicized fact that my pregnancy even though I had just come from a group insurance policy was considered a high-risk condition by the state.

I’m just curious as to what your - I’d like you to go into that a little more in detail as to what you were referring to as to things you would like to see.

Cynthia Lummis: High-risk pools we authorized by Congress a number of years ago to the states. What one of the bills that I’m co-sponsoring does and it is HR 3400 is provide more funding to states for those high-risk pools.

So the obligation on you to come up with a lot of money to pay for your own pre-existing condition will be somewhat relieved and the source of the money to fund those high-risk pools in the states comes from taking monies that no longer will be spent on stimulus and converting them to monies for the high-risk pools.

In other words, we found a way to do it without increasing the deficit and without increasing the debt by taking unspent stimulus monies and sending them to states for the high-risk pools. Did that adequately answer your question?

(Loralee): Pretty much. I just kind of - my husband is - I’m more - I’m a moderate Republican. My husband is very conservative and we have been going at it like cats and dogs about healthcare reform. I’m very for healthcare reform and I tend to be much, much more liberal about it.

And he keeps telling over and over again that it won’t help our particular situation so I just wanted some clarification and thank you.

Nancy Watzman: And (Lora Lea), could you just quickly say who you are and where you’re from since I don’t think we got that when you...

(Lorlee): Oh, sure. They said it was anonymous and that I was not to say that. Yes, (Loralee) and I am actually from Utah.

Nancy Watzman: Okay, great. Thanks.

Cynthia Lummis: And thank you for your question.

(LoraLee): Thank you.

Nancy Watzman: Okay, next caller?

Operator: Thank you, and...

Nancy Watzman: Oh, and I just wanted to clarify, you can definitely identify yourself and please do if you’re willing to.

Operator: Thank you. Ladies and gentlemen as a reminder, if you have a question, please press the 1 followed by the 4, and the next question coming from Line 462-L. Please proceed.

(Jaelithe Judy) Hi, Representative Lummis. Thank you for participating in this call today with BlogHer. We really appreciate it. My name is (Jaelithe Judy). I live in Saint Louis, Missouri and I’m a blogger at (momocrats.com) and I actually also have a slightly more specific question regarding pre-existing conditions.

I am the parent of a child with special needs. I have several family members with pre-existing conditions including both my mother and stepfather and actually I heard you say you’re not sure what the rush is. Well, my stepfather has diabetes and is a small business owner.

He owns a rural farm in rural Washington State and he actually because of his pre-existing condition of diabetes has not been able to afford private health insurance and is not getting the insulin treatment that he currently needs so he could actually die from this current situation with the healthcare system so for me, there is a bit of a rush.

What I wanted to ask you about specifically was I read on your Website that you support Senator Mike Enzi’s bill that was introduced in the Senate in July 2007, Senator Enzi’s 10 steps to transform healthcare.

And I read his bill and in the entire bill there is one mention of patients with pre-existing conditions and it basically says that healthcare plans would be eligible - consumers - would be eligible for tax breaks, you know, tax credits for purchasing specific healthcare plans.

And the only healthcare plans that would be qualified for those tax cuts would be ones that impose no pre-existing condition limitations, but what I’m wondering is, you know, I didn’t see anything in that bill and frankly I’ve also read HR 3400 and I did not see anything in that bill that explicitly prohibits insurance companies in general from discriminating against people with pre-existing conditions.

And I’m just wondering, you know, I mean, right now people with pre-existing conditions can buy into high-risk pools in their states but the cost is very, very high and I heard what you said to (Lora Lea) about trying to control costs by redirecting some stimulus funding to states.

But I’m just wondering, you know, in terms of controlling costs in the private market, what’s the Republican position on that? How do you intend to stop the insurance companies from charging people with pre-existing conditions exorbitant rates that they can’t afford?

Cynthia Lummis: Well, thank you for your question. People with current pre-existing conditions such as the stepfather with diabetes who is in a position right now to find insulin unaffordable could go to their state high-risk insurance pool and find adequate funding there if the Republican bill HR 3400 passed because the monies would be taken out of unspent stimulus monies and transferred over to state high-risk pools to provide more money to help essentially buy-down the stepfather’s insulin cost.

So for people in that kind of dire and immediate need, that bill does address the specific instances of people who are currently finding themselves in an untenable situation so that would address the immediate need that you specified.

Nancy Watzman: Okay. Well, I would like to ask a question. I’m from the Sunlight Foundation as I said and we work very hard to bring transparency to government and I noticed you mentioned, you were talking - when you were talking about the process for the bill, that it would be available for 72 hours and then 72 hours again - I’m wondering what your position is on transparency in this debate but also generally for other debates.

There’s legislation - H Resolution 554 - that would require all legislation be made available for 72 hours before debate begins and I’m wondering if you have a position on that and on transparency in general.

Cynthia Lummis: I’m a big advocate for transparency. I do support the bill that would require that bills be available for 72 hours before voting on them. I also support Representative Reichert’s bill which would require bills being reported out of committee to be available online and those types of votes to be available to the public.

Right now only 12 of Congress’ 21 standing committees requires that bills coming out of committee have votes recorded available to the public and those bills to be posted online so those are some of the transparency provisions that I support.

I also support transparency with regard to earmarks so that if someone requests an earmark, they would have to post it with the Clerk of the House in which they serve and that would be available to the public so people know what members of Congress are asking for.

I support legislation being available online. I support one subject per bill so we don’t have these nearly 2000-page-long bills and that we can break things down and have legitimate debates about them.

I oppose the what’s called “air dropping” amendments into bills which means bills that have already passed committee should come to the floor in the form in which the committee passed them and not allow the leadership of the party in charge of Congress to drop massive game-changing amendments into a bill just hours before it is brought to the floor of the House.

And I believe these kind of transparency measures would involve the American people more in our representative democracy at a time when communications and electronic media allows us to have a more participatory democracy.

Nancy Watzman: Okay, thanks. Let’s go on to the next question.

Operator: Thank you. And the next question coming from the line of 455-L. Please proceed.

(Danine): My name is (Danine) and I am calling from (assumption). I have a complicated medical history and I currently on - I’m so sorry - on Medicaid and I want to get off of those programs, be kind of quite frankly, Medicaid and disability are demonized and treated, you know, every time you talk about an entitlement program, you know, well, they’re demonized.

But I absolutely have to have health insurance. I have a condition called (hydrocephalus) and I have a shunt in my head that relieves the pressure from my brain and every single day of my life, I have to be able to afford health insurance and healthcare.

And I - in order to get off of SSI and Medicaid, I need to be able to - I’m working towards self-employment - and I need to be able to afford health insurance.

And with all due respect and I mean this incredibly, the reality is is that our greatest chance for - I don’t - I can’t - the reality is is that I probably won’t be able to afford private insurance in the current environment and my best option is probably - I’m sorry - but it’s probably in with this healthcare reform as the Democrats are proposing it.

Is there any possible way that you can support their policies or get on-board with healthcare reform in 2009? I need healthcare reform. I need something because the day that I don’t have health insurance, that could be the day that my shunt breaks and I need emergency brain surgery.

It’s a life - I think it was literally started - no, I’m sorry. I don’t remember which person said it. That’s the day that I could - that’s the day that - it’s a life and death thing and I’m sorry, but it’s very, very personal for me.

And I need my legislative Congress people to help. I’m not trying to put you on the spot, but...

Cynthia Lummis: No, you’re not putting me on the spot and I appreciate your dilemma. I want you to know how proud I am of America that Medicaid is there for you and you should not feel the least bit apologetic about the fact that Medicaid is serving you to help you with a condition that is highly debilitating and that really affects your quality of life.

That’s why it’s there so please take advantage of it. You are exactly the person that it was meant for. In the case that your condition were to improve to the extent that you could leave the availability of Medicaid, there would be tax credits in Republican plans for low-income people.

Of course the high-risk pools if you still can’t get coverage would be available to you. There is in Republican bills the opportunity for insurance to be purchased across state lines so in states like my state of Wyoming which has a very small population and health insurance cannot be pooled across state lines, bills would allow for Wyoming to participate in much bigger pools.

And the people of Wyoming could band together either through their church or their trade associations or states themselves to provide larger pools of people who can share the burden and lower the cost of health insurance, especially for those of us as I said that are in areas of very small populations.

So by all means, keep your Medicaid, keep healthy to the extent that those medications are helping you have a higher quality of life and don’t be the least apologetic about participating in Medicaid. That’ what it’s there for.

Now the problem I have with the bill that the Speaker rolled-out today is that it forces on states unfunded mandates to expand Medicaid. Where are the states going to get the money to do that?

In California, there would estimates that it could cost California $8 billion a year to expand Medicaid according to the Speaker’s bill. California is already awash in debt. They can’t add $8 billion to the state’s debts in order to cover programs that Congress mandates on them that they can’t afford to pay for.

So the problem I have with the Speaker’s bill and with these government-run programs that Democrats are advocating is that they are not paid for so it will just create a situation just like we’re going to face with Medicare down the road and that is that Medicare will eventually go broke because it is going to be paying out more in benefits than people are paying in.

And with those kinds of unsustainable government programs that promise a lot but are unpaid for, we are burdening our children and grandchildren with paying for us and for our needs without regard to what our children and grandchildren will face in the future.

And I’m opposed to saddling my child and her children with debts that I incur. I need to make sure that while I’m here in Congress, I am being responsible to the next generation and doing the best job I can for us in this generation.

That’s why I encourage you to stay on Medicaid to the extent that you are able to and when your situation improves to the extent that you are able to afford insurance, take advantage of the tax credits. Take advantage of state high-risk pools and thank you and, you know, I hope your condition improves and thank you for your question.

(Danine): I have one quick question. How is Medicare and Medicaid more - how is Medicaid more financially solvent and this is - I’m not being just (cold), I actually want to know?

Cynthia Lummis: What was your question again?

(Danine): Is Medicaid more financially solvent than Medicare?

Cynthia Lummis: Well, Medicaid is - they’re both in trouble. They’re both in trouble in the long run because they’re paying out more in benefits than they take in and every year more of the federal budget is going to pay for entitlement programs, Social Security, Medicare, Medicaid and the states are responsible for of course picking-up a share of Medicaid so it’s also having a big impact on state budgets.

(Danine ): Okay. Thank you.

Nancy Watzman: Let’s - I think we have time for one more quick question so let’s go to it.

Operator: Thank you, and our last question comes from line 396-L. Please proceed.

Erin Kotecki Vest: Good morning, Congresswoman. My name is Erin Kotecki Vest. I am actually the political director over at BlogHer and since you were just so positive about Medicaid and Medicare which kind of astounds me coming from a Republican.

I’d love to talk a little bit more about that and if you would be strengthening something like Medicare and Medicaid over the public option that we’re seeing or something along that lines to get all of these millions without insurance because I am taking a look at a House bill in April that called for replacing the traditional Medicare program with subsidies to help retirees enroll in private healthcare plans.

Essentially abolishing or killing Medicare that came out of the House Budget Committee, Representative Paul Ryan that had 137 Republicans voting for it, so I’d love to hear you talk about the differences there between how you support Medicaid and Medicare and you feel it needs to continue, but also some of these votes that clearly seem to not support it.

Cynthia Lummis: Well, I support the ability of people who need that safety net like the last caller to be able to access that safety net and Medicaid is that safety net for low-income Americans.

So to say I support the program unchanged would be completely inaccurate. Those programs need revision too to be more sustainable but I’m glad that Medicaid is there right now as a safety net for the last caller. I do support reforms in entitlement programs including Medicare and I am anxious to learn more about your proposals to reform Medicare.

Among the things I think that my generation - I’m a baby boomer who has not yet retired - but I know that 10 years from now when I’m eligible for Medicare that I come in with an enormous bubble of Americans who are going to be on that program unless we change it in a way that makes it more sustainable.

So I am advocating reform of Medicare. Furthermore, right now rural hospitals and rural doctors are reimbursed for providing Medicare services at lower rates than urban doctors and urban hospitals.

In fact it’s so bad in my home state of Wyoming that Wyoming Medical Center in Casper, Wyoming is reimbursed for providing hospitalization services to Medicare patients at roughly one-third of the cost to provide them care.

And that is in my view the federal government shirking its responsibility to adequately fund a program that it has set in place, so we have to make sure that doctors and hospitals are reimbursed for the actual cost of providing care to Medicare patients.

At the same time, we must ferret out the waste, fraud and abuse from Medicare and Medicaid. Now I’ve met with federal agencies whose responsibility it is to do that and there have been reductions of over the years from about 17% waste, fraud and abuse to about 10% waste, fraud and abuse so we’re heading in the right direction but we need to continue to ramp-up efforts to ferret out waste, fraud and abuse.

At the same time, I would be delighted to hear your ideas about reforming Medicare so it is more sustainable so as I said my child and her children and the other participants in this call will not be shirking our responsibilities and loading on our children and grandchildren debts and deficits that they cannot...

Nancy Watzman: Excuse me, Congresswoman. We were told by your staff that you have to go, so I would love to urge people who are on the call to leave their comments in the comment section on the blog post at BlogHer and we will be posting the audio and transcript from this event and so people can follow-up that way.

Cynthia Lummis: And I also have a healthcare blog I encourage all the callers to visit. It is www.cynthialummis.tumbler.com and thank you all for participating today.

Nancy Watzman: And thank you Congresswoman. That wraps-up today’s call with Congresswoman Lummis and BlogHer. Thank you for participating and thank you bloggers for joining us. Please keep an eye on blogher.com for the audio and transcript and for the announcement of any new calls where we’ll give you another opportunity to talk with legislators. Thanks.

Operator intro and outro have been deleted

**end transcript**

CNN reports,

The nearly 2,000 page bill -- a combination of three different versions passed by House committees -- would cost $894 billion over 10 years and extend insurance coverage to 36 million uncovered Americans, according to House Speaker Nancy Pelosi.
It guarantees that 96 percent of Americans have coverage, Pelosi said. The figure is based on an analysis by the nonpartisan Congressional Budget Office.
Among other things, the bill would subsidize insurance for poorer Americans and create health insurance exchanges to make it easier for small groups and individuals to purchase coverage. It would also cap annual out-of-pocket expenses and prevent insurance companies from denying coverage for pre-existing conditions.

Reaction across the blogosphere was immediate and much of it centered around the public option included in the legislation.

Pandagon writes the inclusion of the public option was no surprise,

When Nancy Pelosi says something is non-negotiable, you’d better believe her. In general, the bill is exactly what most of us thought it would be. The big thing is the Health Insurance Exchange that would allow people who aren’t covered for whatever reason to buy insurance through the exchange, which would increase competition and drive down prices. There’s also a mandate, which is uncomfortable but should help drive down costs.

Firedoglake writes,

The Blue Dogs fought hard and they won a big victory for the for-profit health insurance companies. If I were an insurance company CEO, I would be writing each of them a very large thank you note (i.e. a campaign contribution). Of course, today was a huge defeat for the American taxpayer, serious health care reform, and working class Americans who are going to be denied a robust public option which could have saved them thousands of dollars.

While Amanda Terkel focused on the bill's treatment of domestic violence,

A less-noticed — but still significant — part of the bill would ensure that insurers in the individual market would no longer treat domestic violence as a pre-existing condition...
...This provision is part of the bill’s larger ban on pre-existing conditions, which stipulates that insurers cannot discriminate based on 'health status, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, disability, or source of injury (including conditions arising out of acts of domestic violence) or any similar factors.

Meanwhile Jillian Bandes at Townhall.com questioned the procedure for allowing the public or the media to cover the announcement,

Apparently, Pelosi wouldn't let those without "proper identification" -- not sure what that meant -- into the West Front area of the Capitol where the release was being staged.

You can read the complete text of the bill here (pdf) and get a summary on the Committee for Education and Labor's blog.

Let me repeat that. Gang raped AT SCHOOL.

CNN has the details:

A California high school student who police said was gang raped in a two-and-a-half-hour assault outside a homecoming dance remained hospitalized in stable condition Monday, two days after she was flown from the attack scene in critical condition. As of late Monday, two suspects had been arrested in the case and a third was being questioned.

The suspects are teenagers too. And allegedly a group of perhaps a dozen stood by and watched. STOOD BY AND WATCHED for more than two hours.

As a woman, as the mother of a daughter, as a human I am in utter disbelief at this mob mentality.

It gets worse. CNN reports she was raped by at least four people. Lt. Mark Gagan of the police department in Richmond says,

"As people announced over time that this was going on, more people came to see, and some actually participated."

Despite this taking place on school grounds, as school district spokesman told ABC News it was ultimately the parent's responsibility to get their child safely home from a dance.

What do you think of that? Do you believe schools are inherently a safe place to leave your child for a dance? Or do you agree with the district that it's your job? Does Richmond need a "Take Back the Night" walk? Do we all need a reminder?

I'm shocked, appalled, and have been teary eyed since I read this. I can't be the only one.

QueenMotherBlog on twitter writes, "That's just awful. Extra disturbing are the people who stood around and watched...no one could slip away and call police? :("

Feather14 says, "...I heard this and was just shocked and sickened."

Daily_Pinch writes, "Heard that on NPR this morning and still have no idea what to say to it...stunned might be understatement."

Tell me what you think.

Contributing Editor Erin Kotecki Vest also blogs at Queen of Spain blog

You can listen to audio of Senator Merkley's call here:

Or you can read the transcript here:

**start transcript**

Nancy Watzman: Hi. Welcome everyone. I’m Nancy Watsman of the Sunlight Foundation, representing BlogHer today in their community journalism initiative on healthcare policy.

The Sunlight Foundation is a nonpartisan, non-profit dedicated to using the power of the internet to catalyze greater government openness and transparency.

As CEO, Lisa Stone, announced BlogHer has been sponsoring a bipartisan series of telephone conference call to connect women bloggers directly with their legislators.

Today on the call we’re lucky to have Jeff Merkley from Oregon and I’d like to turn it over to him for a brief introduction and then we’ll start taking questions.

Jeff Merkley: Thank you very much Nancy and thank you to the entire community of BlogHer for allowing me to participate. I’m pleased to be here to discuss current efforts of - our current efforts to reform our healthcare system.

I’m a member of the Health Education Labor and Pensions committee or better known by the acronym HELP committee. And that committee put out a healthcare reform bill in July. Just last week we received a bill out of the finance committee as well and those two bills are being merged.

They are different in some significant ways. One is that the bill from the HELP committee had a strong, robust public option. The bill from the finance committee does not.

There are a host of issues that are really at the heart of this reform but perhaps the very heart is the idea of creating a market sometimes called a gateway or exchange where every individual and business can go and select from a range of healthcare insurance choices.

This enables our individuals and small businesses that have had to buy insurance on their own, to buy now by being a part of a very large pool. And by so doing, getting a much better price and much better range of choices.

So that’s at the heart of this. Also key pieces are investment in prevention, investment in disease management, a series of insurance reforms such as the insurance company would have to accept anyone who applied - guaranteed acceptance.

They would have to cover existing conditions or preexisting conditions. And they could not dump folks out of health insurance once they were members of the plan. Currently you can pay your premiums for 15 years, get seriously ill and then have the insurance not renew your insurance.

And that’s really outrageous and unfair and it needs to stop. So we have insurance reforms. We have an extension of insurance so those who don’t have it. And we have serious efforts such as the public option to bend the cost curve.

So that’s - those are kind of the three big components. And with that, I’ll just thank you again for inviting me to be a part of this conversation.

Nancy Watzman: Okay. Let’s move to questions. Can we get the first caller?

Operator: Yes, thank you. Ladies and gentlemen, if you would like to register a question please press the 1 followed by the 4 on your telephone. You’ll hear a three toned prompt to acknowledge your request.

If your question has been answered and you would like to withdraw that registration please press the 1 followed by the 3. If you’re using a speakerphone we do ask that you please lift your handset before entering that request.

One brief moment for our first question. Our first question comes from line number 678W. Please proceed with your question.

(Danine): Hi. My name is (Danine) and I’m calling from Wisconsin. I had a spinal cord injury in 2005 and I was paralyzed from the neck down. I have recovered my mobility for the most part but I have a lot of health problems.

And I’ve been on disability and Medicaid since then. I’m hoping to work my way toward self employment but in order to do that I need affordable health insurance. And I need - my guess is that the best way to do that is through a public option.

We’ve heard Senator, recently that they’re talking about talking about a public option in combining the two bills. What is the status of the public option in the Senate?

Jeff Merkley: (Danine) thank you for your call and I’m sorry to hear about your injury. Your situation is not unlike that of many Americans who would be helped dramatically by this healthcare reform.

Because you would be able to go as an individual to the healthcare exchange or gateway and you would not have - there would be no ability of an insurance company to deny you, the ability to join and get a policy or to not cover a preexisting condition.

You would have a full range of choices at the exchange including hopefully, from my point of view, a public option. So there might be Blue Cross/Blue Shield, there would be a Kaiser plan, there would be AETNA and so on and so forth through the list of companies but also hopefully, a public option.

I am fighting very hard for this. And to give you a sense, we have a public option in Oregon in our workers’ compensation market which is a different part of the health insurance market. It covers injuries sustained while at work.

We have found that the public option has resulted in the cost today per hour being one half of what they were 20 years ago in workers’ compensation. Senator Whitehouse promoted the public option workers’ compensation in Rhode Island and similarly, their rates dropped by 50%.

So having a competitor, a competitor that is not dedicated to treating healthcare as a source of profit but healthcare as a source of healing, makes an enormous difference.

And so I think the odds are very good that there will be a public option come out of the negotiations taking place currently in the Majority Leader’s office. We’re hoping to have that bill on the floor next week. So the rubber is really hitting the road now.

(Danine): Okay, thank you.

Jeff Merkley: Thank you very much.

Nancy Watzman: Okay, yeah. Let’s take our next question.

Operator: And our next question comes from line 692W. Please proceed with your question.

(Audrey): Good morning Senator Merkley. My name is (Audrey) and I’m joining the call from Maine. My question is brief but it’s twofold. I have a chronic illness which has depleted our family’s financial cushion despite the presence of health insurance through my husband’s employer.

And one of the things that has slowed our inevitable descent into foreclosure has been our health savings account. Why are HSAs still not a viable part of the any of the current proposals for healthcare reform? Because if anything, an HSA would help people keep the insurance they like.

Secondly, it’s in regards to tort reform. I was reading the CBOs on estimates. Tort reform, meaningful tort reform would reduce the federal deficit by at least $54 billion over ten years.

I’m having a hard time understanding why this isn’t an integral part of the reform process. Can you help shed some light on both of these questions?

Jeff Merkley: Certainly I can sure try. Let me start with tort reform. Tort reform has been experimented with in various states so we have a good sense of the results out of those laboratories. We have found that it has reduced the cost of liability insurance to doctors by some modest amount.

It has not however, had any impact on reducing the cost of healthcare to the citizen. So the insurance companies have done better and in some cases the providers of healthcare have done better but citizens have not.

The amount of the change is estimated to be about half of a percent in terms of the impact of potential tort reform up on healthcare. So it’s a very tiny part of the puzzle. Place that in perspective, we currently have rates that are doubling every six to eight years.

And so that’s 100% increase over the course of six to eight years. Tort reform would be a 1% impact on the cost so it’s very small impact. Furthermore, tort reform - you can call it tort reform but from the point of the citizen, is taking away the fundamental right to compensation for gross negligence.

That is a huge decision of the government to take away a common law right that has existed since we were first a nation and to say that indeed you do not have the ability to seek compensation for gross negligence.

And so that’s basically outlines of the tort reform debate. Second, you raised the question of health savings accounts. Certainly health savings accounts for those who are in a position to be able to save tax free an account, it’s a wonderful thing just like IRAs are a wonderful thing.

But for most working Americans they’re not in a position to be able to set funds aside in a health savings account. They’re not in a position to be able to set much aside in the way of retirement accounts. That’s why we have social security because it’s not feasible for every family to save on their own.

And it’s why affordable, accessible healthcare necessitates providing a structure that every American can take advantage of, not those just in a financial place, a beneficial place where they’re able to set aside extra funds.

So while health savings accounts may be a nice addition to whatever reform is involved it doesn’t go to the heart of the challenge for most working families.

Nancy Watzman: Now (Audrey) did you have any follow up to that?

(Audrey): Well kind of because it kind of goes back to the conversation I had with Speaker Pelosi last week. Like I said, we’re headed into foreclosure because of our copays and our - I mean we’ve got an insane deductible. We have a $10,000 yearly deductible on our insurance.

And then she mentioned this 400% federal poverty level. Well we’re right above that. That this healthcare reform is mostly going to help - I mean everything that I’ve read and listened to and have heard there’s this magic number of 400% of the poverty level.

And these reforms that are - that you guys are proposing are going to help people who sit in that bracket. Well we’re slightly above that so we’re kind of still going to be in the same place.

And without the ability to save for these deductibles and whatnot - because if we’re excluded from the most beneficial portion of this reform that’s being proposed we’re going to be in the same boat. And it’s a horrible to thing...

Jeff Merkley: Hey (Audrey)?

(Audrey): ...to be in.

Jeff Merkley: (Audrey) let me ask you this question. Do you buy health insurance through a small business or on your own or...

(Audrey): No.

Jeff Merkley: ...through a large business?

(Audrey): It’s provided through my husband’s employer.

Jeff Merkley: Well there - let me give you a couple of examples of how this might affect you. Your husband’s employer would be able to go to a Healthcare exchange and be part of a much larger pool and therefore enable you to - the company to buy that insurance at a lower price because they’re now part of a larger negotiating group.

And in addition, the way the bill is structured in the health committee, when the company goes to that exchange they could choose to provide a gold plan or a silver plan or a bronze plan.

But you would have the choice as a family, of which gold plan, which silver plan, which bronze plan so you could pick the plan that best fits the circumstances of your particular family, greatly increasing competition and creating a better fit between individual plans and where individual families are.

In addition, a lot of what’s driving the increase in healthcare is the uninsured going to the emergency room and those costs getting transferred onto insurance.

But if we create a circumstance where virtually everybody is in the pool, then we break this (desk) cycle insurance where there’re more uninsured, more and more cost transfer, more and more upward pressure on rates so you would also benefit from that aspect.

And then finally, I would note that should you have - your husband happen to leave his job you would now have a transferable, portable insurance policy. And leaving a job doesn’t result in a double whammy of both losing your job and losing your healthcare all at the same time.

Nancy Watzman: Okay. Let’s go onto the next...

(Audrey): Thank you.

Jeff Merkley: You’re welcome.

Operator: Great. Our next question comes from the line 702W. Please proceed with your question.

(Susan): Hello Senator. My name is (Susan) and I am from the Madison, Wisconsin area. As you can imagine, me saying that I’m going to be talking to a senator has kind of elicited people’s thoughts and ideas of healthcare.

And one of the things that a lot of people have been asking about for me to ask and what seems to be a bipartisan effort, is to lose the antitrust exemption that health insurers have.

That is a - seems to be a bipartisan effort. What else seems to be something that both sides can agree on and what sort of efforts are democrats having a hard time battling republicans with?

Jeff Merkley: Well there’s a great deal that is in the healthcare reform - and thank you (Susan) for calling in today. There’s a great deal that democrats and republicans have agreed on.

They’ve agreed that we need to have much more investment in prevention, much more investment in disease management. There are about four diseases that constitute about 70% of our healthcare dollar expenses.

There is agreement to invest in healthy choice incentives which are - the approach is taken by self insured companies like Safeway and Pitney Bowes where they provide incentives in terms of vacation days or bonuses to individuals who do a better job of either quitting smoking or managing their diabetes or hypertension.

And the result is, is not only is the individual employee assisted but the cost of the entire pool of healthcare goes down because those costs are so significant within the system.

Another area that there is a lot of agreement on is the investment in the workforce. We have the challenge of so many doctors and nurses and nurse practitioners retiring because they are a part of the Baby Boom generation.

At the same time all the rest of us who are part of the Baby Boom generation, need more healthcare. So you have demand for healthcare going up when the number of providers is going down so we need to invest in the workforce. So those are all areas of substantial agreement and cooperation.

I think probably the area that most highlights the different in philosophy has been this issue of the public option. Virtually all of my republican colleagues have said we believe in a for-profit system.

We do not want there to be a choice that is a non-profit choice because that might undermine the success of the for-profit companies. I couldn’t disagree more. You have a very successful system of for-profits in Germany. You have a system of for-profits in France.

But what they can charge is highly regulated so it’s regulated like a utility is here in the United States. But what we have are for-profit companies with no price regulation and therefore, what we’re paying for healthcare is 2-1/2 times roughly what Germany or France is paying even though all three have for-profit systems.

So one way we can approach this within our own system is to have a non-profit competitor, a competitor that is dedicated to healing, not dedicated to revenues for its stockholders. And so I think that’s an effective way within our system.

But there is a fundamental, philosophical divide in - on that particular issue.

(Susan): It - what do you think it would take for the republicans or those who don’t believe in the public option for it to happen?

Jeff Merkley: Well one of the ideas we’ve been talking about is providing a state opt out so that if a particular state said we don’t want to have a public option in our state a governor or an act of the legislature in that state could say okay, this particular state be it - choose a state, Kansas, Oklahoma, Texas says we don’t want to be part.

That would allow us to have those states that do want to pursue this who do feel that you need to have a healthcare plan dedicated to healing as part of the mix. Then those states would be able to proceed as well and it allows everyone to come together around kind of a federalist view of the power of states.

So that may be a bridge that can help connect both progressive democrats with moderate democrats and progressive/moderate democrats with their colleagues across the aisle.

Nancy Watzman: Thanks. I know our time is short so let’s go onto the - we have a few more callers so let’s go onto the next one. The senator only has a couple more minutes.

Operator: Our next question comes from line 714W. Please proceed with your question.

(Karoli): Hi there. My name is (Karoli) and I’m from California. We’re currently uninsured and our 20 year old son has just been diagnosed with two chronic diseases, one of which is diabetes.

What do you see as the bridge that will be made available for people like us between now and the year 2013 when all of these reforms are supposed to take effect?

Jeff Merkley: (Karoli) that’s an excellent question and I don’t have an excellent answer for you. The - as you correctly point out the plan to establish state level exchanges under the healthcare reform is anticipated to take three to four years to set up.

I have been asking the question of whether it has to take that long. If you have a willing state why can’t they go ahead and set up the exchange in a year? Now if it’s a state that really desires to do it they might be able to do it in six months.

States like my home state of Oregon, have been very involved in healthcare. They have a healthcare commission. They have a legislature that’s deeply in tune with the need for reform.

And I just would like to see a pathway that states could move a lot more quickly. But as you rightly point out, under the current - certainly the way the bills are structured, it would take a while to set up these commissions and a while to set up a public option as well.

But we can move individual pieces faster. That’s certainly something I’m encouraging. A lot of other senators are making the same point. So I don’t think we’ve seen the end of this conversation of what can we immediately start investing in prevention and in disease management.

Can we immediately provide a policy - the term that’s being used is a policy for our young invincible - young folks who generally have good health but need catastrophic coverage in case something goes dramatically wrong.

But in this case I feel like you put your finger on an excellent question and (data) is still underway on how we can move key components of healthcare reform up sooner.

Nancy Watzman: Okay. Well I’m getting word that Senator, you have to go. I really appreciate your time here today. And...

Jeff Merkley: Well it is a pleasure joining you all. Thank you very much Nancy for the invitation.

Nancy Watzman: Yeah. Thank you so much. And, you know, hopefully we’ll have the chance to talk more.

Jeff Merkley: And I appreciate everybody tuning in and the fact that you all have an enormous ability to reach out and connect with so many Americans through your blogging.

And this greatly expands the conversation and it expands it in ways that are so much more intelligent than the conversation that often takes place in many of our media (outlets). So I just appreciate so much that - your all dedication to conversing about the issues that challenge us as a nation.

Nancy Watzman: Well thanks so much. That wraps up today’s call with Senator Merkley and BlogHer. Thanks for participating and thanks bloggers for joining us.

Keep an eye on BlogHer.com for the audio and transcript of this call and the announcement of the next call where we’ll give you another opportunity to talk about healthcare reform with legislators. Thanks.

Operator intro and outro have been deleted

**end transcript**

The Speaker spent 30 minutes answering questions from maternity care to middle class tax implications from a variety of women bloggers.

You can listen to the call with Speaker Pelosi -

Or you can read the transcript of the call -

**start transcript**

Nancy Watzmen: Hi. Welcome everyone. I’m Nancy Watsmen of the Sunlight Foundation representing Blogher today in their community journalism initiative on healthcare policy.

The Sunlight Foundation is a non-partisan, non-profit dedicated to using the power of the Internet to catalyze greater government openness and transparencies.

As CEO (Lisa Stone) announced, Blogher is sponsoring the bi-partisan series of telephone conference calls to connect women bloggers directly with legislators.

Today on the call we have House Speaker, Nancy Pelosi, who as you all know is right in the thick of the healthcare debate and we’ll turn the call over to her for an introduction and then I know lots of people have question so we’ll get right to them. Speaker Pelosi.

Nancy Pelosi: Thank you very much Nancy and thanks for the opportunity to share some thoughts about healthcare reform especially how the impact - how it impacts women on this call today.

We are very enthusiastic about where we are on this legislation this week. The Senate and Finance Committee passed its bill out, now five committees have. We are closer to having health insurance reform as we ever have been in our history.

And it is from the standpoint of the House of Representatives which I speak for in terms of our initiative, our principals our that we will have affordability for the middle class and we will have security for America’s seniors and we will have responsibility to our children to make this bill very fiscally sound. And it doesn’t add a dime to the deficit.

When it comes to women in particular, women have the most to gain in health insurance reform in my view. Women often face higher health care costs in men and face multiple other barriers to obtaining health insurance, for example, women are charged up to 48% more then men in the individual market.

In our bill it would make it illegal for insurance companies to use gender ratings, charging women more then men for the same coverage. In addition, women are denied coverage or charged more for preexisting conditions like pregnancy, C-Sections or domestic violence.

If you’ve ever been in any of those situation and of course we - our bill makes it against the law for (unintelligible) who are denied coverage or charged higher premiums on the basis or preexisting conditions.

Just a couple more things - 79% of women with individual market policies do not have any maternity coverage. Imagine that. In our legislation exchange would be required to cover maternity services and over time plans outside the exchange would be required to do so as well.

Again, many women do not have access to employer-provided coverage. This will be changed in the bill because premium assistance would be provided to all those with an income up to 400% of poverty which is about for a couple about 80-some thousand dollars or 40-some for an individual.

Even employer-provided coverage is in decline and so we’re trying to change that dynamic as well. And women’s (health) face more unaffordable out-of-pocket costs and preventative services are also often unaffordable to women and their children. And the legislation changes that. And it just would - putting on this opening, just relate to the economy.

Over one million women have lost health insurance coverage due to their spouse’s job loss and they also then because of their own job loss when the women are in the market - are working - are some of the first people to be let go and therefore lose their health insurance.

So it is important for us to have health insurance that expands coverage for all. It does - do it in a way that improves the quality, lowers the cost and enables people to keep what they have if they like it but also to recognize the disparities that exist for women and health care.

Pleased to take any questions and again I thank you Nancy for the opportunity to share some thoughts on our legislation.

Nancy Watzmen: Well thank you. Yes, let’s go straight to the first caller.

Operator: Ladies and gentlemen if you would like to register a question, please press the 1 followed by the 4 on your telephone. You will hear a three-toned prompt to acknowledge your request. If your question has been answered and you’d like to withdraw, please press the 1 followed by the 3.

If you’re using a speakerphone, please lift your handset before entering your request. Our first question comes from the line of R726. Please go ahead.

Woman: Good morning Madame Speaker. Thank you so much.

Nancy Pelosi: Good morning.

(Audrey): Thank you so much for taking time to speak with us today and listen to our concerns. My name is (Audrey) and I’m joining in from Maine. Briefly, my chronic illness is such that my family is in financial ruin now and facing foreclosure due to the result of medical bills. We do have health insurance but are faced with an insane deductible and outrageous co pays that have led us to choose between our family’s one piece of security, our home, or our mental and physical health.

I’ve been fortunate enough to sit down on two recent conference calls with the elected representatives of both parties and neither have been able to answer my question in a way that is meaningful to me or my family. Right now especially we’re all hearing very different and sometimes alarming things from people on both side of the health care reform challenge.

And most recently it’s been claimed that the proposal that passed the senate finance committee would indeed sharply raise our family’s premiums. Very simply, Madame Speaker, can you tell me why I should lend my voice and support to the proposed health care reform when I cannot clearly find out what it means for me and hundreds of thousands of families like mine, whether it means more of the same or genuine relief from being pimped out to the insurance companies for profit?

Nancy Pelosi: Thank you (Audrey) for your question. Let me just - I don’t want to speak to what’s in the senate bill because we think our bill is much better then the senate bill but let me give you some hope as to what is on our side and what we will go to the conference table to fight for and I believe we’ll prevail on.

It - I want to just put it in the conte- a little bigger context for a moment. But this - these insurance reforms, and they will include those that address your situation, are essential to how we go forward. No discrimination for preexisting conditions like diabetes, a heart condition or cancer. These are - all that I named are long term illnesses or chronic conditions.

No dropping your coverage because you become sick. No refusal to renew your coverage if you’ve paid in full and become ill. No more job loss or life decisions made based on loss of coverage. No need to change doctors or plans if you like the coverage you have.

Now here are the ones that - no co pays for preventive and wellness care. Now in your case, no excessive out-of-pocket expenses, deductibles or co pays. Yearly caps on what you pay. Yearly caps on what you pay. No yearly or lifetime cost caps on what insurance companies cover.

Now from what you have said it sounds to me like you have high deductible and out of pocket and that would be excluded. No excessive out-of-pocket expenses, deductibles or co pays because that makes it unaffordable therefore unaccessible (sic) - inaccessible to people.

And again, if - say - I know this is probably not your situation, but for someone who has - a person with a disability which is - would be similar to having a chronic disease ill- condition. I won’t say disease. You would have a cap on what you pay in but no yearly or lifetime cap on what your insurance companies cover.

So you would be protected in that way. And your case is one of the main reasons why we - the current system is totally unsustainable for America’s working families. The economic security that is undermined by high medical costs, you know, is related to your physical condition.

I like when you’ve been diagnosed with cancer now you’re going to - you have a high deductible and by the way, lessen the stress in your life. Well, that’s impossible, right? So the high co pay and the high deductible is what we are trying to get at in this bill.

And that’s why I said is our first principle - affordability for the middle class. That doesn’t just mean affordability for standard fare and while everyone’s well, your insurance doesn’t cost that much. It means affordability when you are well and affordability when you are sick.

Sixty percent of the bankruptcies last year in our country were due to medical bills. So the relationship between health care costs and economic security are directly related as you have spelled out so clearly. But stay tuned to what you see because this is going to be a fight that we intend to win as we go forward.

And one of the - if I just may go from (Audrey)’s question to another reason why we believe we will be able to keep this promise, is first of all it - everything has to fit together. The insurance companies must - that reform must take place.

And it must take place within the - what we call the exchange. Now there will be an exchange in which people can go buy insurance or if they’re under 400% of poverty would be sub - get some subsidy relative to their income level to help them afford the insurance.

And if - what we’re saying though is you must do this. You are mandated to do this and in our health bill, businesses are mandated to provide the insurance. So I am saying as Speaker, how can we mandate people to go buy and charge from the very same people who have in some respects ripped them off up until now.

So what we’re saying is we will help with subsidies. We’re making it affordable by having within the exchange a public option. So that says to (Audrey), if you - if we can help you with your health - to afford your health insurance, and we mandate that you buy it, but we can’t - we do not want you to be forced to buy it from the same people who didn’t give you a fair shake to begin with, you can do that if you wish. If it works for you - or it didn’t work for you but it worked for somebody, but we all - rather then force people to buy from the insurance industry, we want to give them the freedom to buy in the public option or in the insurance industry - whichever they please, but they would have the freedom to make that choice.

It would give them leverage. It would increase competition and we believe, lower costs and keep the insurance companies on it.

Nancy Watzmen: Thanks so much Speaker. I know we have a lot of questions so let’s go to the next...

Nancy Pelosi: Thank you (Audrey). Good luck to you.

(Audrey): Thank you.

Nancy Pelosi: Pay attention to what we’re doing. Hold us accountable.

Operator: And our next question is from the line of R738. Please proceed with your question.

(Emily): Hi Madame Speaker. It’s really an honor to talk to you today. My name is...

Nancy Pelosi: My pleasure. Thank you.

(Emily): My name is (Emily) and I’m a blogger from Chicago, Illinois. Right now I’m actually sitting in the DMV so this is very convenient that I have the opportunity to ask you this question.

As a (unintelligible) it kind of strikes fear in my heart to think that the government might be overseeing health care. It’s scary enough when I have to go to the post office and the DMV and see the level or bureaucracy that I have to deal with just to get something simple like renew my driver’s license.

I know that you said there will be a public option and there will be government oversight, so my question for you is why lend my voice to support of the house bill knowing that the government may be responsible for doling out healthcare and overseeing something that is very important and vital to me.

Nancy Pelosi: Well make - let me make it a different - a distinction here. We are not doling out healthcare. What we are doing is helping people pay for the healthcare having a level playing field for the public so they can do it. Now an example, which you may not like but has been successful and works for millions - tens of millions of people in our country is Medicare.

And frequently when people come to the meetings and say, “I don’t want any government initiative, and by the way, keep your hands off my Medicare,” is one of the contradictions that we run into. But your questioning of the efficiency of government is one that I respect.

In fact, in our legislation how we’re able to cover the costs is by injecting - just injecting very harsh scrutiny to the system and injecting efficiencies into it so that we can extract some of the resources out of it without impacting the benefits but addressing waste, fraud, abuse, duplication, obsolescence and the like.

And that should’ve been done a while ago and we’ve tried to do that over time and this gives us the opportunity to do it. But the public option is perhaps ill named because it sounds like it’s a public option.

What it is is an option that must compete with a level playing field with a private sector that any - it must be administratively sustainable on its own. It has to pay for itself and it has to be actuarially sound so it can’t have any advantage over the private sector.

The advantage it does have is that its profit motive may be different in terms of - and I’ll go into that in a second and it would probably not be advertising to the extent the health insurance companies do.

But did you know that right now health insurance companies can spend what it - they take in the premiums and they can spend whatever they want on benefits? Well in our bill we insist that the health insurance companies spend 85% of what they take in in premiums in - to spend on benefits.

That’s what insurance is about. You pool resources for when you need them rather then you pool them so they can be excessive profits and compensation and advertising budgets and the rest. But the money really does - largely 85% of it to them.

So it is not to be confused with any delivery of service - of health care services and that’s how sometimes people like to paint it. That’s not what it’s about. It’s to create a level playing field for private sector competition for market oriented solutions so that the middle income families in America have a chance.

And I might say that in addition to what I just said about the affordability of insurance, in the bill you would be pleased to note that there are many initiatives through public private partnerships for innovation, for incentives to the private sector on its own in terms of health IT and the - using the technologies to go forward to again recognize where the market solutions can work better.

So it is - again everything that we try to do now is in the tradition of our founders which were very entrepreneurial, very market oriented and we’re public private partnerships we the preferred way rather then a public solution.

Nancy Wazsmen: Okay next question.

Operator: Our next question is from the line of R772. Please go ahead with your question.

(Heather): Good morning Madame Speaker. Thank you so much for the opportunity to talk with you.

Nancy Pelosi: Good morning. Thank you.

(Heather): My name is (Heather) and I’m from Los Angeles, California.

Nancy Pelosi: Good morning.

(Heather): And my question for you is - good morning - my question for you is there’s a lot of talk about the preexisting condition exclusions but I’m worried that things are going to get a little nitpicky. For example, I have a blood clotting condition that makes my pregnancies extremely high risk and runs the risk of premature birth for my children.

Everyone involved in my medical care, from my doctors all the way up to my insurance companies know that my pregnancies are going to cost more. And so I’m worried that this preexisting condition clause is not going to be across the board, if it’s going to end up being gray area because my preexisting condition is an active one. It’s not for a lack of a better example, cancer that could be in remission. And is this going to be something that might end up happening?

Nancy Pelosi: No, no (Heather). Actually quite to the contrary because what we are saying very clearly is there can be no discrimination in cost, that is to say, what is charged to an individual for - because of a preexisting condition.

It doesn’t same some, not others, and the rest. And the insurance industry will say, “Well then it’s going to cost us so much more money to insure all these people.”

(Heather): Right.

Nancy Pelosi: And that’s why we are saying that the more - if we have this big pool of people and we can do it. Let me just say in terms of maternity services in particular, as a benefit category in an essential ben- in other words, we have an essential benefit package that we’re insisting upon and in the bill it includes coverage of maternity services as a benefit category in the essential benefit package that is outlined.

As a result all health insurance plans in the health insurance exchange would be required to cover all maternity services and over time even the plans that are not in the exchange. If a plan said, “I’m not going to go into the exchange,” they would even be required to do so.

So when the plan comes into effect, you would choose a plan and many of which would exist within the exchange, to cover all medical benefits right from the start. And the insurance companies want to operate within the exchange. They want to because that’s where a good deal - you know, they’re going to get tens of millions more customers and most of those will be within the exchange.

So they want to operate within the exchange. There’s no disincentive. There’s no incentive, shall I say, for them to operate outside and your situation is exactly - we’re not just talking - they’re - whether it’s C section or, you know, other extenuating circumstances occurring associated with pregnancy, pregnancy and all of its - and all that that implies cannot be considered a preexisting condition. It is now as is can you believe, domestic violence?

(Heather): Yes.

Nancy Pelosi: C section. They’re called preexisting conditions. I’ve had children and they told me I was a poor risk. I mean, this is many years ago when I was having babies. They said, “You’re a poor risk.” I said, “I thought I proved my strength by having five babies.” And they said, “Now we don’t want to give you any insurance because you’ve had five children.”

Nancy Watzmen: Well as a pregnant person myself I appreciate the discussion about all that. Let’s go on to the next call.

Nancy Pelosi: Okay.

Operator: Our next question is from the line of R768. Please go ahead. The line of R768, please ask your question. Your line is open.

Nancy Watzmen: Do we have the next caller? Let’s move on.

Nancy Pelosi: As you get the next caller, I want to thank - wish Heather (lock later) family and so (Audrey) with her situation and (Emily). Keep watching what we’re doing. Hold us accountable as I said to (Audrey) earlier.

Nancy Wazsmen: That’s what we’re here for. Okay, do we have the next caller?

Operator: Yes.

Nancy Watzmen: I know we don’t have much time, so.

Operator: It is from the line of R764. Please so ahead.

(Dana Loesch): Hi Madam Speaker. My name is (Dana Loesch). I’m calling from St. Louis. And I guess the question that I have for you - and I do appreciate the time that you’re taking this morning to speak with all of us.

Nancy Pelosi: My pleasure.

(Dana Loesch): My question for you is you were talking about how to protect seniors, talking about how to protect middle class families and I’m kind of concerned twofold. I’m concerned, one, about this insurance exchange but I’m also wondering how there can be any claims made to protect the middle class when our President himself said in past June and then ABC news, he said he wants to cut $200 billion from Medicare and Medicaid spending over the next decade to help pay for this healthcare system.

And I know that a lot of things have been said to the contrary of this but I’m just wondering how you reconcile what he has said about cutting Medicare and Medicaid, how you can reconcile the latest report that came out that said that this plan is actually going to cost middle class families and additional $1700 per year. And how that can also be reconciled with - when we talk about the insurance exchange.

The (Pace) and Choice Act was actually going to take employer subsidies and - for health care - give those to the employees so they could go out and buy their own insurance and have that power themselves instead of having to rely on the government to do it for them in the exchange.

And I know it’s kind of a three-parter but those three things are all concerning me equally.

Nancy Pelosi: Well let’s start with Medicare because I believe that’s where you started.

(Dana Loesch): Yes.

Nancy Pelosi: And that is that yes, the President said $200 billion. It’ll probably be more then that over ten years because we do see that there is opportunity to wring out waste, fraud, abuse, obsolescence and duplication. We’ve tried to do this before. Now we’re in the position of power. All that we can do so without any diminution of benefit in the initiative.

And that is why we - Medicare solvency will be extended by another five years under the house bill because we make Medicare sustainable. That is why AARP has said that in opposition to a ad campaign that the health insurance industry has put out there to say it’s going to hurt seniors.

Their charge is the industry has said that it would hurt America’s seniors yet the AARP has said the change is actually aimed to strengthen Medicare and improve beneficiary’s care and access to physicians. They’re not the only ones saying it but since their brand name is so big I quote them. But other - fact check and others have confirmed that statement as well because that is what the intention is.

Look, we passed Medicare to begin with 44 years ago this summer. It was a Democratic initiative, had some bipartisan support. We hope this legislation will. We always strive for that but this is an initiative that we have a commitment to from its birth and that it keeps its promise to our seniors. So do not interpret that there will be efficiencies thrust upon it to mean that it would weaken instead it strengthens Medicare.

In terms of the exchange, exchange is really quite a brilliant initiative to say that in the exchange were the insurance companies want to participate that they will be - people will be able to go into an exchange if they’re below 44 - 400% of poverty they would get some assistance depending on how far below they are to - for purchasing an exchange.

The businesses would have tax credits, small businesses, so that their employees can go into the exchange. And also others can be in the exchange. And that’s why we say the (unintelligible) arena, the insurance industry, it has to be an arena that also gives the freedom of individuals to have another option which is a not-for-profit option there.

So it is - it’s brilliant but again, when we finish our bill, which should be within a week and people see it on the Internet and how one part of it relates to another I think they will see the brilliance of the exchange.

What was your third point (Dana)?

(Dana Loesch): I asked about the - I wanted to do a quick - can I do a quick follow up? Will anybody object if I...

((Crosstalk))

Nancy Pelosi: ...what the third one is so I can incorporate into the answer.

(Dana Loesch): Okay. No, I had asked about the Medicare and then the insurance exchange and then I mentioned how the Patient’s Choice Act was actually taking - their idea was to take federal subsidies that employer - for employers for health care, and have the employees use that to go out and buy their own health care instead of having sort of the - instead of having a government involved in with the exchange. And I was wondering what you had you had thought of that.

Nancy Pelosi: Okay and so you wanted to have a call back on the Medicare, did you? You said you wanted to...

(Dana Loesch): No that was the third part of my - that was kind of like the third end of the question was that.

Nancy Pelosi: Oh okay but I thought you said may I say something about what you already...

(Dana Loesch): Oh no. I know we’re running out of time and there’re other people waiting so go ahead.

Nancy Pelosi: No, I think this is probably going to be the last question on that. But again, the way this has been put together it has an integrity to it and this would have - it would have the benefit of having employers or individuals in a market so that it would be a situation where the cost would be lower for all.

And let me just say that - because I think it’s important to note in relationship to your question and just the whole insurance reform - if we do nothing, small businesses will have an increased cost of $2.5 trillion over the next ten years - $2.5 trillion.

It’s just totally unsustainable. The insurance industry as I mentioned has said they’re going to increase the premiums to small businesses, to businesses by 10% next year - 10%. And for individual families it will go up by thousands of dollars and over ten years be something like nearly $20,000 in increase premiums.

So the status quo is totally unacceptable. But when you put together an initiative that is real reform that says the insurance companies must have their reforms, there must be an exchange in which people can have leverage, whether they’re a small business, people will take credits from small businesses that are excluded from requiring that they have health insurance because they are so small, or whether you are below 400% of poverty or if you’re above it - that there is a place that is a level playing field for the middle class.

So when I send my conferees to the table from the house to the senate, I want them to have the most muscle for the middle class. I want a bill that goes right down the middle, that does not add a dime to the deficit, goes down the middle philosophically so that it really does the job. It’s not some philosophical idea that somebody had.

It’s a very pragmatic system to provide the health insurance so that our economy - our - it helps individuals in terms of their costs, it helps businesses in terms of their cost, it helps the economy in terms of the dynamism that our businesses would not be - have a stranglehold on them, increases their competitiveness especially internationally, and it also helps reduce the deficit.

Health insurance reform is entitlement reform and that’s what we have to have to take down the deficit. So this is - again, the status quo is totally unsustainable and unacceptable. The course the we are going on saves the most for the individual for the business and for the government and the taxpayer and is something that will make America healthier.

It’s not just about health care. It’s about health - that prevention. It’s about wellness. It’s about early intervention. It’s about biomedical research and the issue of customized private - personalized care that is specific to an individual. It is about health IT so that the health care is onsite. Wherever somebody is their records are there and so it makes it...

Nancy Watzmen: Excuse me Speaker - we’re being told by your staff that you have to get on a plane.

Nancy Pelosi: Yes, unfortunately I do so...

Nancy Watzmen: With the President.

Nancy Pelosi: I’m going to have to say goodbye for now and hopefully we can get together again especially when our bill is finally - is up on the Internet which should be in about a week or two depending on how we dissolve some of the outstanding issues. But whenever it is, before we take it up on the floor, the public will have a num- 72 hours at a minimum to see what is up there.

But in the meantime we want to give people an idea of what is there so it - when they see the final bill it’s just in some of the clarifications but not a complete introduction to a whole new idea.

So thank you Nancy very much. Good luck to all of you and I look forward to having another conversation sometime soon.

Nancy Watzmen: That’s great. Thanks so much.

Nancy Pelosi: Thank you.

Nancy Watzmen: And that wraps up today’s call with House Speaker Nancy Pelosi and blog her. Thanks for participating and thanks bloggers for joining us.

Please keep on eye on blogher.com for the audio and transcript of this call and for the announcement of the next call where we’ll give you another opportunity to talk about health care reform with legislators.

Operator intro and outro has been removed

**end transcript**

Join us for our next call in our bi-partisan series on Wednesday October 21st, with Senator Jeff Merkley from Oregon.

In winning the Nobel Peace Prize, President Obama joins an elite group of U.S. presidents. He is the fourth to win the prize, the third to win it while in office and the first to receive it during his first year in office.

Unlike his predecessors, Obama was selected not for substantive accomplishments, but for his "vision" and inspiring "hope" at the beginning of his presidency.

BlogHer Contributing Editor Nordette writes, "Feels like an honor, possibly premature, and a lot of pressure to me. Look for more fundamentalist religious conservatives to say this is more evidence that Obama is the anti-Christ, a figure who is supposed to bring about a false peace."

The President also expressed surprise at his win:

Feministe writes,

"We absolutely should push Obama to do better — and he has a lot to improve — but the attacks on him for being awarded such a prestigious prize are disturbing. We have a sitting president who won a Nobel Peace Prize. That was unthinkable a year ago. I realize that a lot of people on the right are sore losers, but this is getting ridiculous. The Nobel conversations are already sounding like the flipside of the conservative reaction when Chicago didn’t get the Olympics — there, conservatives were giddy that America had lost something just because Obama wanted it; here, conservatives are devastated that an American leader won something, just because Obama is that leader."

While Jack & Jill Politics contends Obama should have turned it down-

"The Nobel selection committee appears to have so internalized that message that they’ve given the world’s most prestigious honor to a 9-month president whose promises are yet unfulfilled. I’m sure the Nobel committee is very, very smart, but it all made me wonder if they’re so eager to reward the first black president of the U.S. that they wanted to get it done now, just in case he turns out to be a warmonger robbing them of their chance to meet the coolest kid on the block.

The people who elected him hoping for change need to think critically and seriously about what this means for holding him accountable to the vision he put out during the campaign. Maybe Obama will make peace, maybe he won’t. There’s no way to know at this early stage, though the Administration’s flirtations with escalation in Afghanistan and Pakistan raise real questions. If, as the President said in his acceptance speech, this is a 'spurring' prize to encourage him to follow through on climate change and other agendas, we should make sure that it doesn’t provide more cover than motivation."

Althouse thinks this isn't about the Nobel at all-

"The question is why didn't he get the Olympics.

The story of Barack Obama is the story of winning things when he hasn't yet done enough to deserve them. He is, quite simply, Barack Obama. We understand that. Why didn't the IOC understand? You could see it in that smile on his face, when he concluded his little speech in Copenhagen, that he bore the sublime knowledge he would acquire the Olympics for Chicago. Because he is Barack Obama, the man to whom grand prizes are given."

While Firedoglake muses, "I can almost hear the screaming from Dick Cheney and the neocons as they get the news."

The White House announced the President will be giving the $1.4 million dollars that comes with the prize to charity.

You can listen to the call with Rep. Miller -

You can also read the transcript below:

**start transcript**

Nancy Watzman: Welcome everyone. I’m Nancy Watzman of the Sunlight Foundation representing Blogher today and their community journalism initiative on healthcare policy.

The Sunlight Foundation is a non-partisan, non-profit dedicated to using the power of the Internet to catalyze greater government openness and transparency.

As CEO Lisa Stone announced Blogher has been sponsoring a bipartisan series of telephone conference calls to connect women bloggers directly with legislators.

Today on the call we have Representative George Miller. He’s been Congress for 35 years and is Chairman of the Influential House Education and Labor Committee.

He’s a key champion of HR3200, America’s Affordable Health Choices Act. So let’s begin the call and take some questions. Well actually the Chairman would speak for - introduce himself.

George Miller: All right, thank you very much. I appreciate the opportunity to talk to the Bloghers and I’ll just take a couple of minutes here to kind of outline where we are and then open it up for your questions.

I appreciate the invitation to speak with you. There has been no issue that I have been involved in in my public career in the Congress of the United States that has had more intensity and debated more extensively than the issue of healthcare and healthcare reform.

And I think that overall has been very good for the country. I think it’s been good for the members of Congress to hear from the constituents. I was disappointed at some of the activities that took place this summer with the incredible misrepresentations and the efforts to try to scare Americans away from this bill and keeping members of Congress from, you know, talking with their constituents about what was in the bill.

But I think we’ve passed that stage for the most part and since the August break the leadership and the Chairman of the Committees and Democratic leadership have been meeting on a daily, ongoing, regular basis every day that we’ve been back in Washington with the members of the Democratic caucus, with the members of our Committee, with the members of the various caucuses within our Democratic caucus, with the progressive caucus, the Blue Dogs, the new Democrats, people who are concerned about regional disparities, people who are concerned about public option, no public option.

And those meetings continue today. But I think we’re really coming toward the end of that process for - at this stage which would be to finalize the last remaining decisions on the cost of the bill, some options to pay for it or not.

But - and then to send it off to the Congressional Budget Office where they can give us a score as they’re now doing for - or they will be doing shortly for the Senate bill.

We think that may take as many as ten days for them to do that and then we would - when we have that score if it requires additional changes to be made because of some finding by the Congressional Budget Office we will take time to do that.

Those will have to be scored and then I think we will be ready to introduce a bill that is the product of the three - the work of the three Committees, the Ways and Means Committee, the Energy and Commerce Committee and my Committee, Education and Labor.

We started out with probably about 75 to 80% of the bills being in common from the three Committees and then there were amendments that were offered in the various Committees and we’ve been walking through some of those, and also listening to the members after the August break.

I think the product that we’re going to end up with will reflect the work of those Committees and it will also be consistent with the goals of - that President Obama has laid out.

And some of you are familiar with those. First and foremost of course is in the long history of insurance company discrimination based upon pre-existing conditions to deny either families coverage because of one individual in that family may have a pre-existing condition or to deny an individual coverage because they have a pre-existing condition.

We also are working very hard to introduce competition into that insurance market with the introduction of the public option. If you have a robust public option and this is the discussions going on now - we have two different versions of the public option we reported from the Committees. A robust public option saves you about $110 billion.

That savings comes from the lowered premiums that people would have to pay for their insurance plans in the national insurance exchange. We believe that and CBO tells us that that public option would drive competition. Those lower premiums that people would have to save would save families money and individuals money.

It would also save the government money in the subsidies that it has to pay to help families and individuals pay for that coverage in the national exchange. We expect that we will be able to cover about 97% of the people in the current program.

There will always be some people who just, you know, won’t sign up, won’t do this and over time we also - we expect that we’ll find them but they don’t necessarily show up the day you open up the new plan or even in the first year.

And again the choice and the competition we think is important. The other one is that never again will people lose their insurance because they’ve lost their job, because they switched jobs or because they’ve decided they wanted to go out on their own and start a small business.

They will be able to stay in the exchange. Their premiums may change. Their subsidies may change but they will always have coverage. Their family will always have coverage if they have a family.

Many, many people, you know, Congress looking at the business rule, you know, really think we pay huge prices in the nation for that job lock; people who can’t leave a job for another opportunity because of the need for insurance or the absence of insurance in the next job or people who don’t start businesses because they don’t - they would not be able to have insurance for themselves or for their family.

We believe that we’re going to provide the incentives to shift to a - instead of reimbursing everybody for activity in the medical field for outcomes in the medical field and we have a number of studies to - for the Institute of Medicine on how that can be done.

We require bundling so that hospitals and providers can look at the overall medical care that they provide to an individual and figure out how to get the best outcomes at the lowest cost.

So we’re really taking medicine I think into an area where many of us had believed that it should go for a long time. The simple fee for service creates huge expenditures that really don’t reflect in the better health status of Americans.

And that’s really what we’re after. We’re really after improving the health status, not just health insurance coverage but the health status of Americans. We believe that we strengthened Medicare and I think that’s important.

There’s been a lot of rumbling back and forth for that. The changes that we make in this system we believe and CBO tells us will extend the solvency of Medicare by an additional five years.

And yet we think we’ll provide better care for seniors. We will be closing the doughnut hole that - after seniors exhaust part of their benefits for prescription drugs in Part D they’re then on their own for quite a while and then they get help again.

We’re hoping to be able to close that very rapidly with this legislation. There’s still some discussion about how rapidly we’ll be able to do that. A lot of that pertains to the cost of doing that.

The President said that on the coverage part of this legislation and the reforms that he wanted a limitation of $900 billion that we believe we’ll be able to meet that.

He said he wanted a deficit neutral over ten years. We believe it’ll be deficit neutral over ten years and that’s why - we’ll see what CBO says but that’s our goal and that’s what we will bring to the floor.

And we also wanted them as they talk and hear Washington bending the curb we want to look out over an additional 10 or 15 year period and know that we’re - we have policies in place that will help us reduce the long-term healthcare costs because that’s what our economy needs.

That’s what businesses needs, that’s what families need is to understand that we cannot continue to absorb these dramatic increases in health costs or insurance premium costs that are crushing businesses and crushing families.

It’s a big list. It’s controversial but I’m very encouraged by the attitude in the caucus and I think the progress that’s being made in the Senate is very helpful. They’re not the same bills but we - I do believe that we will pass them in both the House and the Senate.

We’ll have a Conference Committee and we’ll have a bill to the President’s desk before the end of the year. So I’m really quite encouraged but it’s been a long effort.

You know, we’re changing the system in America that sort of grew up haphazardly over a 50, 60-year period and it’s a very complex process to do it and to try and do it right.

And I think we see many of the people who have been engaged in the study of the medical system, economists and providers and medical experts and others think that we’re really dealing with the right pieces here.

Do they agree with everything we’ve done? Not necessarily so but we’re on the right track and we’re making changes where we can get the best deal hopefully for the taxpayer, for the - for families that have to buy coverage and for the economy. So thank you again and I’d be happy to answer a few questions.

Nancy Watzman: Well thank you. Yeah let’s turn it over to our callers and if you’d like to introduce yourself to the Chairman please do so. So let’s take the first call.

Operator: Ladies and gentlemen, if you’d like to register a question, please press the 1 followed by the 4 on your telephone. You will hear a three tone prompt to acknowledge your request.

If your question has been answered and you would like to withdraw your registration, please press the 1 followed by the 3. If you are using a speakerphone please lift your handset before entering your request.

One moment please for the first question. And our first question comes from the line of 296N as in November. Please proceed with your question.

(Jaelithe Judy): Hello Chairman. Nice to hear from you today. My name is...

George Miller: Thank you.

(Jaelithe Judy): I appreciate you coming to speak with women Bloghers. My name is (Jaelithe Judy). I live in Missouri. I write for monocaps.com and I have a son with a chronic health condition so I’ve been following this debate very closely because I’m an independent contractor.

And if my husband were not currently employed by a big business there would be no way we could get individual insurance that would cover our own family that would - our whole family that would be affordable.

George Miller: Right.

(Jaelithe Judy): My question for you is I understand that you’re a supporter of the public option.

George Miller: Yes.

(Jaelithe Judy): And I know that the House bill included the public option and in the Senate there’s been a lot of debate about the public option. I’m wondering what is the plan in the House if the Senate passes a bill with no public option or with a very weak public option or with a public option trigger?

What is the House going to do during reconciliation to try and preserve a strong public option in the final plan?

George Miller: Thank you. One, correctly we believe we will pass a public option in the House. Whether or not the Senate will or not remains to be seen. A number of my colleagues in the Senate tell me they think that when they get to the floor they may very well pass a version of the public option.

We’re hoping to pass a robust, strong public option. That’s still in debate in our caucus. We’re counting votes and people in support of one proposal versus another are going through the caucus and counting the votes and talking to the members.

And we’ll know that result probably here within the next couple of days. But I do believe that we will take a plan with a public option. The question is whether we have negotiated rates or whether we have rates that are based upon Medicare plus 5%.

There’s a lot of concern that if you have Medicare plus 5% that perhaps providers will not accept patients from the exchange, from the public option. Others believe that that’s not - that’s really not an issue and that that could be fine.

The other plan is to negotiate those rates somewhere between Medicare rates and the average of plans that are offered in the exchange. That would still continue to put downward pressure on those plans.

If we did the pure robust public option that my Committee and another Committee reported out that saves us $110 billion over ten years. That savings as I pointed out go to families and go to the taxpayer.

If we have negotiated rates we save about somewhere between 25 and maybe $35 billion dollars. So the choice is important and the choice is significant.

And when we’re trying to insert competition into the insurance market you can see what the difference will mean. Do taxpayers and ratepayers save $110 billion over ten years or do they save 25 to $35 billion over the next ten years?

In either case I think we will end up with a public option and I think that in either of these cases we will be able to drive a much more competitive insurance market for the government that provides subsidies for people that go to the insurance exchange and for families that have to pay for part of their policies. But I think the public option will go to the President’s desk is my conclusion.

Nancy Watzman: Okay, any follow up on that with this caller or...? Are you still on the line?

(Jaelithe Judy): Yes I’m still here. Well I guess so you’re confident then that the final bill will have a public option in it?

George Miller: Yes I am. I am. I think it’s very important to the House of Representatives. I think it’s fundamental to building the most efficient and cost-effective system for the - for our country and I think it will prevail.

I think it’s more an argument now of what kind of public option we will have and that’s very different than maybe the argument that we were having back in July and August.

Nancy Watzman: Okay, should we go to the next call?

Operator: And the next question comes from the line of 221N as in November. Please proceed.

Wendy Norris: Hi, this is Wendy Norris and I’m with RH Reality Check. I was wondering more of a political question - why the caucus allowed the debate to be diverted on abortion and maternal health care?

It seems as though we’ve gotten ourselves really tied up in knots over, you know, issues that are quite controversial and we’re losing sight of the bigger picture and the opportunity to really make the case to the American public about healthcare reform overall.

And I’d be interested in your thoughts on sort of the sausage making behind healthcare reform in Congress.

George Miller: Well we’re, you know, obviously we would prefer and making every effort to keep the healthcare reform debate and the insurance reform debate front and center with the American public.

But in the - this is a democratic system and we’re on notice that there will be individuals in our caucus and certainly when we come to the floor perhaps Republicans and Republicans with some Democrats that are - have under discussion amendments or challenges on the question of the use of public funds for abortion.

They want to extend the ban on public funds to include subsidies that are provided to people. The question is whether there will be at least one plan in the exchange that does not - that doesn’t provide for abortion or one plan that does and the others don’t.

I mean, this is all a matter of discussion and I don’t know where it’s going to come out but you can’t avoid that discussion because it’s, you know, obviously of great importance to many members of the Congress on both sides of the aisle.

We’ve been through these legislative battles before on this issue and I - this is going to continue. And there’s a lot of discussions going on on this subject among various members of Congress that have been involved in it many years.

Nancy Watzman: Okay, next caller.

Operator: The next question is from line 207N. Please proceed.

(Karoli): Hi Representative Miller. My name is (Carolee) and I have been unemployed for the last almost year now and my husband is self-employed. And through a series of - well it’s not really important other than to say that our COBRA administrator has managed to set things up in a way that causes our whole entire family to be uninsured.

I’m 51; my husband is 56. I have a 20-year-old who was just diagnosed with diabetes a month ago. And my question is if healthcare reform - if the actual provisions aren’t taking hold until the year 2013 what do we do in the meantime?

We can’t get insurance at our age and employers don’t want to hire us at our age.

George Miller: Sure, sure. We are - or the President in his - when he spoke to the nation on this subject several weeks ago asked us to create in this legislation a plan for people who have pre-existing conditions who do not have insurance.

We’re in the process of doing that as a part of this bill. I - I’m sorry, you know, it’s in the - we’re formulating it right now so I don’t - I can’t give you all of the details on it.

But it’s really designed for those individuals that sound very much like you on how do they get from here to 2013. And to create a fund to address those concerns I think at the outset we’re talking about setting aside $5 billion to help those individuals and families in that situation. And so that’s how we’re trying to deal with it.

Nancy Watzman: Okay, next...

(Karoli): Can I just follow that up with one quick question? Is there any consideration being given to allowing us say over 50 or over 55 to buy into Medicare as an option?

George Miller: That’s been discussed but we haven’t - that’s what I would prefer but I haven’t been able to secure the ability to do that. I think that’s - it’s not completely off the table because people recognize because of the economy and what’s taking place and people that are thrown into that position, you know, because of their employment COBRA may not be an option for them.

So that continues - we continue to have some discussion about that. I don’t want to get your hopes up.

(Karoli): Thank you.

George Miller: That’s all right. Thank you.

(Karoli): Me too. Thank you.

Nancy Watzman: Okay I know we don’t have too much more time so let’s go to the next call and maybe try to keep it quick so everyone can get their questions in.

Operator: And the next question is from line 274N. Please proceed.

Maria Niles: Hi Representative Miller. My name is Maria Niles and I blog at both Blogher and my own blog called popconsumer. And my question is about purchase mandates.

And what if anything is coming from the House? I know I’ve heard that there are considerations in the Senate to require people to purchase health coverage.

I’m concerned that someone like myself who is self-employed will be required to purchase private health insurance and that it may not be affordable. And I’m just very concerned about being forced to contribute to the profits of a private company.

George Miller: Sure, sure. There is in the House bill an individual mandate. You will be required to have health insurance. At tax time you will be required to provide proof of insurance.

And in that mandate we would expect it again depending upon your situation if you, you know, if your employer provides it that’s one set of circumstances.

If not you would go to the exchange and depending upon your income we would provide subsidies for people of between 133% of the poverty rate and 400% of the poverty rate.

And those subsidies - we continue to work them out but they would obviously be graduated. People at 130% would pay essentially little or, you know, would pay 2% perhaps of the premium and at 400% you would end up paying maybe 97% of the premium.

Four hundred percent is about $88,000 and that’s where people would go to the - there in that exchange they could choose private insurance plan, you know, Kaiser or Blue Cross or they could choose a public plan, whichever fit them better as individuals or as family members.

But there is an individual mandate. One of the things we’re trying to do is to get rid of the uncompensated costs for individuals who don’t have insurance and then encounter a health problem, crises, whatever it is and then the system ends up - the hospital or the providers or others end up paying those costs because that person wasn’t insured.

So there’s an employer mandate on employers to provide insurance. Small employers are exempted along the scale but for individuals there’s a mandate to have insurance.

Nancy Watzman: Okay, next question.

Operator: And the next question is from the line of 958M. Please proceed.

(Erin Koteki vest): Hi Chairman. This is (Erin Kotekivest). I am with Blogher and my own blog, Queen of Spain blog. I wanted to ask you - we’ve got a lot of community members who are very concerned as they hear about pre-existing conditions being applied to victims of domestic violence. Could you speak a bit about that please?

George Miller: Well we will not allow insurance policies to be rated based upon any pre-existing conditions. I - apparently in some states that that’s an allowed pre-existing condition - it’s my understanding. Correct me if I’m wrong.

But in this legislation the insurance policies in the exchange and for employers and else later on but for the insurance policies in the exchange we do not allow any pre-existing conditions. We cannot deny coverage to individuals in the future because of any of those conditions.

Nancy Watzman: Okay.

George Miller: All right?

Nancy Watzman: And I’d like to ask you a very quick question as representative of the Sunlight Foundation which cares very much about transparency in government. I’m wondering what will you see transparency playing in this, you know, in the debate and what role you think it should play?

George Miller: Well, you know, I think it’s a very important part of this debate. As you know when we finally passed the three bills prior to the August break they were up on the Internet.

My Committee site, my personal site got an exceptional number of hits from people who either read it or in fact downloaded it. It was quite amazing the number of - numbers of people who downloaded it.

And I assume the other committees and the speaker site and other sites in the Congress got those same kinds of requests. As we now near the end of this process, when this bill is finalized, I mean, as I said earlier we’re going to go to the Congressional Budget Office, we’ll get new costs and then we’ll have to make changes according to that.

And then when we’re ready to introduce the bill, when the bill’s introduced that bill will be on the Internet for 72 hours. And if there is a manager’s amendment which would be - usually it deals with making relatively small changes but it could be some other issue that pops up.

And if that manager’s amendment - when it is approved by the Rules Committee that will also have to be on there for 72 hours. So in my, you know, ordinarily around here you introduce the bill.

That bill would be on the Internet for 72 hours. During that time you might be putting together a manager’s amendment so - and that manager’s amendment is approved by the Rules Committee.

Another 72 hours would run so you can see here spaces of time, you know, made - whether it’s two 72-hour periods or something - somewhat longer than that. But the final drafts of the bill and the manager’s amendment will both be available on the Internet for that period of time. Speaker Pelosi is committed to that and the rest of the issue is committed to that.

Nancy Watzman: Okay. Well thank you so much.

George Miller: Thank you for the opportunity.

Nancy Watzman: That wraps up today’s call and - with Representative George Miller and Blogher. Thank you for participating and thank you Bloghers for joining us. Please keep an eye on Blogher.com for the audio and transcript of this call and for the announcement of the next call where we give you another opportunity to talk healthcare reform with legislators.

Operator introduction and conclusion has been deleted.

**end transcript**

Rep. Cathy McMorris Rodgers spent time answering questions on everything from pre-existing conditions to her stance on the public option.

You can hear audio of BlogHer's call with McMorris Rodgers here:

Or read the transcript here on BlogHer.com.

-start transcript-

Operator introduction deleted.

Nancy Watzman: Hi. Welcome everyone. I’m Nancy Watzman of the Sunlight Foundation representing Blogher today and their community journalism initiative on healthcare policy.

The Sunlight Foundation is a non-partisan, non-profit dedicated to using the power of the Internet to catalyze greater government openness and transparency.

As CEO Lisa Stone announced, Blogher has been sponsoring a bipartisan series of telephone conference calls to connect women bloggers directly with their legislators.

Today on the call we have Representative Cathy McMorris Rodgers. Rodgers is a Republican and represents Washington State’s 5th Congressional District. I’ll turn it over to the congresswoman now.

Cathy McMorris Rodgers: Hello everyone and thanks. I just want to start by thanking Blogher for hosting today’s session. I look forward to this dialogue. I am Cathy McMorris Rodgers. I’m starting my third term in Congress, so I guess I’m about half way through my third term in Congress.

Just by way of background, I do come from Washington State. I was born and raised on the farm, involved in a family owned business for many years, served the State House for ten years. I’m also a mom. I’ve been married just for three years and we have a two year old son, named Cole, so I know firsthand now the challenges of being a working mom.

I today wanted to talk just briefly about the healthcare issue that is currently before Congress, and especially as it relates to women.

I’m not sure how many realize that women really are the chief healthcare officer in many families, responsible for taking children to appointments, addressing the needs of their spouses, aging parents. In fact, it’s estimated that women make 85% of the healthcare decisions in this country.

Women also wear other hats as it relates to healthcare. It’s interesting to note that women are now - women owned businesses are now the fastest growing segment in our economy. And I think that is very exciting.

And in that role, women understand the challenges of providing health insurance to employees. They see first hand how they premium increases every year impact their ability to actually provide healthcare options to their employees.

Women also are working in the healthcare sector. When you look at nurse, 90% of nurses in this country are women, 98% of women are personal and home care aides. Women are also a growing segment of doctors in this country, which is exciting.

So, as we approach the healthcare debate, I think the prospective from women is very important and it’s one that needs to be recognized and I think it ultimately could have one of - be one of the loudest voices in the debate.

As a wife, as a mother, and as a member of Congress, I can tell you that, I’d like to see this healthcare debate focus on aspects of the system that are in true need of reform. And I approach healthcare reform wanting to answer three questions.

And the first question is, will the proposal improve the health of our country? And in that regard, I’d like to see us challenging America to be healthy. As we approach healthcare reform, our legislation, whatever passed Congress, needs to be creating a system that is actually going to provide incentives for each individual to be more responsible for his or her own healthcare and to make healthy decisions in their everyday lifestyle.

Secondly, does the proposal save money? The big challenge for us in healthcare is the rising cost and is the rising cost of healthcare itself, of the healthcare delivery system in America that then results in health insurance premiums increasing, and ultimately then, causes the number of uninsured in this country to increase.

So we need as we approach healthcare reform, to include provisions that are going to help save cost and put Medicare and Medicaid on paths to sustainability. It is -Medicare right now is scheduled to go bankrupt in 2017. We need to be addressing that.

Thirdly, I ask myself the question, does it protect the vulnerable? And I believe that it is very important, as we approach healthcare reform, that we recognize that there are those in this country who have severe healthcare needs and need extra support and there is a role for the government to be providing a safety net and making sure that we’re taking care of the vulnerable in this country.

Right now there are several bills that are before Congress. I think everyone is aware that four out of the five committees in the House and the Senate have now passed different versions and this debate is on the forefront and we need - I have serious concerns about all of the bills that are currently before Congress.

I would really prefer to see us scrap the current proposals and come together, sit down, Republicans and Democrats in a way that we could actually talk about how we can move forward with a healthcare bill that will meet the needs that I outlined, answering these questions.

The country has, in my opinion, rejected the bills that are currently before Congress. The outcry that we’ve heard at the Town Hall Meetings and across this country is largely people saying, “This is not the kind of healthcare reform that we want in this country.”

Nancy Watzman: On that note, maybe we should turn to the questions?

Cathy McMorris Rodgers: Okay.

Nancy Watzman: It’s again a lot of the folks here have a lot of great things to ask.

Cathy McMorris Rodgers: Sure.

Nancy Watzman: So...

Cathy McMorris Rodgers: Sure. Sounds good.

Operator: We have a first question. Ladies and gentlemen, if you would like to register a question, please press the one, followed by the four on your telephone. You will hear a three tone prompt to acknowledge your request. And if your question has been answered and you would like to withdraw your registration, please press the one, followed b the three.

If you’re using a speaker phone, please lift your handset before entering your requests.

One moment please, for our first question. And our first question comes from the line (I466). Please proceed with your question.

Woman: Hello.

Cathy McMorris Rodgers: Hello.

(Jennifer): Hi. My name’s (Jennifer) and I live in Texas. And I have a question as a small business owner, that one of the things you talked about on your Web site, was that you wanted small businesses -one of your proposals was for small businesses to be able to band together to be able to buy better health insurance. Because that’s a huge concern for me, not only being a woman, but a small business owner, is that the insurance premiums are just absolutely outrageous.

So I was hoping that maybe you could just take a second and tell me just a little bit more about that?

Cathy McMorris Rodgers: Sure. Sure. And that’s a great question and I believe that this is one area where there is broad agreement, that we to be providing more options for our small business owners all across this country.

I have been a long time supporter of the association health plans, for example, that would allow small business owners within a state to band together, or beyond state boundaries, to band together and to access plans outside of state boundaries that would provide you more choices for your employees.

The unions and the corporations in this country have the access to these types of national plans, yet our small business owners don’t. And as - when you see who - when you look at who the uninsured are in this country, about a third to a half of them are your 18 to 35 year olds. But the second largest chunk is your small business owners and their employees that, although they would like to have health insurance and small business owners would like to offer health insurance to their employees, they simply do not have access to affordable plans.

So this is an area where I think that there’s some agreement. This is a step that we should be taking as soon as possible to allow our small business owners more choices.

Nancy Watzman: Do we have the next question lined up?

Operator: Yes absolutely. Our next question comes from the line (I500). Please proceed with your question.

(Audrey Holden): Hi Representative Rodgers. My name is (Audrey Holden) and I’m calling from Maine. Unlike a lot of people in the country, we do have health insurance, however, because of an ongoing chronic illness, our health insurance costs threaten to bankrupt our family and we’re near foreclosure due to the rising cost of our premiums and our deductibles.

This is something I haven’t heard addressed at all any way from the right and I’d like to know how you guys plan on addressing the rising costs of premiums, deductibles and copays, which threaten millions of families just like mine across the nation?

Cathy McMorris Rodgers: Right. And that’s a good question and it’s one that we must answer. And I want to answer it in two parts. First is, just addressing the cost drivers within the system in general and we need to take action that will help reduce the cost drivers that are currently driving up healthcare costs all across this country for everyone and that includes medical liability reforms, it includes incentives for wellness.

One of the biggest cost drivers in our system, is the chronic diseases, the preventable chronic diseases, your heart disease, your diabetes that is driving up costs. We need health IT and we - and there’s other ways to actually control the overall costs.

To your point, and I would as far as the individual that has some ongoing healthcare issues that are expensive and cause your premiums to increase even more than others, I would say that we on the conservative side, we recognize that there needs to be support for those. And there needs to - we’d like to see the high risk pools expanded in this country and more support given to - from the Federal Government to making these high risk pools available and affordable to people like that - like you and your family that find yourself in this situation.

Nancy Watzman: Okay, and the next question?

Operator: And our next question comes from line (I481). Please proceed with your question.

(Melissa): Hi. My name is (Melissa) and I’m calling from West Virginia. I wanted to know how the conservatives plan to address the preexisting condition and the problems that that causes for people that are chronically ill, like myself and the caller before me?

Can you speak to how you feel about having preexisting conditions not, you know, just not be acknowledged, that we need to get rid of that in the insurance industry?

Cathy McMorris Rodgers: Well, and this is - it’s unacceptable what is currently happening in the insurance industry. The fact that someone with a preexisting condition is just flat out not able to get health insurance.

And I - my son has special needs and he - my son has Down’s Syndrome and I hear a lot from the disability community, a lot of these examples of individuals, families that are not able to get health insurance for their children or for their family members because of a preexisting condition.

And so part of the solution needs to be that this is no longer allowed, just a blanket refusal or select - a selection by the health insurance companies. I think one of the solutions is the high risk pool, is allowing, is making a commitment to making these types of plans available and affordable to families then.

Because it - even if they’re available right now, sometimes they’re very expensive and so they need to be- there needs to be a commitment by the Federal Government to help our vulnerable and support these high risk pools.

Nancy Watzman: Okay. And I believe we have another question?

Operator: We do. We have a question from line (I507). Please proceed with your question.

(Julie Pippert): Hi. This is (Julie Piper) and I’m calling from Texas. One of the states that’s been Republican run for a long time and not only allows a lot of preexisting condition exclusions, but also doesn’t force insurance companies to cover basic conditions, such maternity care.

It caused a catastrophic financial collapse for my family personally, but I wanted to back track on my original question, because of something that you said and that is, that the majority of the Americans are not backing healthcare reform.

Kaiser Family Foundation just yesterday put out that public support for healthcare reform increased in September. Fifty seven percent of families now believe that tackling healthcare reform is more important that ever and that’s an increase.

Additionally, basically right now, another new survey, also from Kaiser found that Medicaid and State spending on Medicaid has climbed sharply. It’s been an enormous increase, an average of 5.4% and it is causing massive state budget problems.

Now, affordable for middle class, small business, and also the poor and working poor, being uninsured is a big problem. So how would your plan solve that?

Cathy McMorris Rodgers: I agree that America wants healthcare reform. America has rejected the current proposal before Congress, HR3200 that is the bill currently before the House and that’s the legislation that does not have the support of the American people.

The numbers that I’ve seen it is in the mid 30’s as far as the number of people that support this plan and an overwhelming majority have rejected the current bill that’s before Congress.

Having said that, I’m not saying that we shouldn’t pass healthcare reform. I have been a longtime proponent of healthcare reform, of taking steps to insure that everyone in this country has access to affordable and quality healthcare.

You mentioned Medicaid and Medicaid spending and how it is bankrupting or causing deficits at the State level. Part of the proposal currently before Congress is just - is to put more people on Medicaid and ask the State to cover that cost. It is a - it’s a huge shift. It’s a cost shift from the Federal Government to the State and Medicaid - if you know anything about Medicaid, it is not the premium healthcare for anyone in this country.

I believe that we need to be taking steps to actually make Medicaid better, improve it, make - you know, we’ve made a commitment to low income, to the developmentally disabled in this country, and it’s largely through Medicaid.

And yet, try to find a doctor, try to find a healthcare provider who will take a Medicaid patient. It is very difficult because the Federal Government doesn’t pay the bills. The Federal Government doesn’t reimburse at cost. The Federal Government reimburses the provider at 50 to 60% of the cost, so as a doctor every time you see with Medicaid, you’re losing money and it’s not sustainable.

I’ve worked on legislation to improve Medicaid reimbursements. I actually was a part of getting legislation through for critical access hospitals, so that their Medicaid would be reimbursed at cost and it’s kept hospitals in the rural areas open.

And it goes to one of my fundamental concerns about the current proposal, it is expanding programs like Medicaid, it is creating a new program called the Public Option, the Government option, that is very similar to Medicaid and Medicare, yet these programs are not sustainable. These programs are on paths to bankruptcy at the Federal level. They are programs - they are causing budget challenges at the State level because they are not - we are not being honest about the cost and the quality of the care within these programs.

And we need to improve these programs as a part of healthcare reform. So there’s a lot that needs to be done with healthcare reform. I just do not believe that the current bill, HR3200, has the support of the American people.

Nancy Watzman: Okay. The next question?

Operator: Our next question comes from line (I509). Please proceed with your question.

(Jaelithe Judy): Hi Congresswoman. My name is (Jalis Judy) and I live in Missouri, but my parents - my mother and stepfather actually live outside of Spokane in your district and they own a small farm and a small business.

And they both have chronic health conditions. My mother has sleep apnea, my stepfather has diabetes. And it’s been very difficult for them to acquire private health insurance at an affordable cost because of these preexisting conditions that they have.

And I know that you’ve already spoken a bit about preexisting conditions and the unwillingness of insurance companies to provide affordable plans to people who do have chronic health conditions. But I’m wondering - I’ve read through your proposal, House Resolution 621 that you introduced on July 9, that was about what you would like to see in a healthcare reform bill.

And there was nothing in that proposal about banning insurance companies from discriminating against people with preexisting conditions. The vast majority of the Republican bills and amendments in Congress right now, do not outlaw rescissions, which is you know, dropping people for having preexisting conditions or a denial of coverage for preexisting conditions.

And I’m just wondering, if you support protecting people with preexisting conditions, why is it that you and the Republicans in general have not proposed any serious regulations on private insurance companies to prevent them from denying coverage to people with preexisting conditions

And if you plan to expand the high risk pools, you know, as an alternative to banning private insurance companies from denying coverage to people with preexisting conditions, isn’t that also a government funded, basically a public option and insurance plan for those people? And how do you plan to you know, keep that a cost effective measure, if you believe that a general public option would be unsustainable?

Cathy McMorris Rodgers: The House Republicans, I would encourage you to look at HR3400, which outlines four pillars that is - that are fundamental to reform and the first pillar addresses the preexisting condition.

This - we’ve outlined many different ways our priorities - and we just came out last week with three priorities and one included addressing the preexisting conditions.

So it is very much a priority for us.

(Jaelithe Judy): I understand that it’s a priority, but how specifically do you intend to address that issue? I have not seen any specific plans to address that issue?

Cathy McMorris Rodgers: Well, I would encourage you to look at HR3400 and look at that first pillar that is dedicated to preexisting conditions and it is - it lays out the expansion of the high risk pools, it lays out language that would prohibit health insurance companies from continuing to discriminate the way that they do.

And I think as you listen to the leadership of the House Republicans, as you listen to others, we very much are talking about preexisting conditions.

Nancy Watzman: Okay, we have another question?

Operator: We do have another question from the line of (I415). Please proceed with your question.

(Erin Kotecki Vest): Hi. This is (Erin Kotecki Vest). I’m with Blogher and I am in California. I know you touched a bit on the public option in the current bill and the reasons you couldn’t support it, being the cost reasons.

Is there any circumstances under which you would support a public option considering that the latest New York Times CBS poll shows that 65% of the people would like to see one?

Cathy McMorris Rodgers: You know, my concern is to just make sure that we being realistic about the cost, also the functionality. When you think about the reality of what the public option will represent, it is - I would encourage you to think about your experience with other government agencies. Think about your experience when you go to the Department of Motor Vehicles and you are trying to get your license renewed and the waiting lists that are - or the lines that you encounter and the lack of choice.

And just think of the way that government delivers services. I have concerns about the reality of a public option creating the waiting list, being the step that will ultimately lead us to a place where you have to call a government bureaucrat to get an appointment, and that is the person that is deciding which doctor that you see.

I had this experience when I signed my son up with Tricare. My husband is retired from the Navy and he is a 26 year veteran. And we had this experience.

I’m, you know, we just last week passed this bill in the house, the Student Loan Bill and I think this is a good example of how I see the public option working within healthcare.

When the Student Loan Bill was passed last week, this is the Federal Government insuring that there are loans - low interest rate loans available to students who want to college all across this country.

In the ‘70’s the Federal Government made a commitment to keep - to keeping those interest rates low, so the loans were actually managed by credit unions and banks all across this country and the Federal Government made a commitment to keeping interest rates low.

So if interest rates went so high, the Federal Government would come in and help with that cost.

In the early ‘90’s, we set up a government run student loan program, called the Direct Lending Program. And it was set up to be an auction, a choice, and now 15 years later, in 2009, when you look at universities and colleges all across this country, 20% of them have opted to offer this government option, the direct loan, student loan.

But just last week, we passed legislation that will eliminate the private sector in student lending and your only choice now, is going to be the government option.

And you might say, well so what? What does that mean for health care? This - it goes to our concern with the public option, that it starts out as the - as providing choice, providing competition within the marketplace. But the way that the government operates, it comes in and it becomes the dominant player and it truly is the - it is the step towards a single payer government run system, where we would all be one single system and it would be a government operated system.

I believe that we want competition in the marketplace. We want private sector and there is a rule for the government to be providing safety nets for populations that we identify need support, but we do not want a one size fits all health care system.

Nancy Watzman: Okay. I would like to ask you a question, Congressman, or actually first I would like to congratulate you, because I know you’ve stood up for openness and transparency in this debate. And are - that you are a sponsor of HR Resolution 554,, which the main priority of the Sunlight Foundation and would require that legislation be made available for 72 hours before Congress begins debating it.

So I just wanted to ask you, what role do you think, transparency, government transparency has in this healthcare debate and beyond that, what role do you think transparency needs to play in any reforms that are passed?

Cathy McMorris Rodgers: Well, I am a big proponent of transparency and I - and the Internet gives us the opportunity to really shine the light of day on what’s happening in Congress. Give the public the opportunity to actually look at legislation before it’s passed on, give members the chance to hear from people all across this country as to what they like, what their concerns are, and I believe that the outcome will be better legislation.

In recent years, we’ve seen these huge comprehensive bills in Congress. We refer to them as bills that become Christmas trees, because so much is added to them.

And members don’t have the chance to read the bill, let alone understand what’s in the bill. We find out weeks, months later what was actually in a bill.

That is not a good way to legislate. That doesn’t have a positive result. So I’m hopeful that the focus on transparency, by both Republicans and Democrats is going to result in more accountability.

I’d like to see us just you know, end the days of the comprehensive bills, these huge bills that no one knows what’s in it. And let’s start taking step by step approaches, where we can actually have debates on issues that are before us and have the chance to have the public give their input and actually understand what’s in the bill and what we’re voting on.

I also think that transparency could play an important role in tracking how Federal dollars are spent. You know, it just blows my mind.

One of the biggest challenges for me as a new member of Congress was just getting my arm around the amount of money that we spend and I’m quite concerned about the lack of transparency, the lack of accountability.

The Stimulus Bill, which authorized almost $800 billion in spending, you know, they’re already estimating that at least 10% of that $80 billion, is going to just be lost.

You know, and it just blows my mind. These are precious dollars that there’s so many needs in this country, we can’t afford to be wasting or losing money like that. We - and transparency I think can play a very important role in providing some accountability and insuring that these taxpayer dollars are spent wisely.

Nancy Watzman: Okay, well thank you so much. That wraps up today’s call with Representative Cathy McMorris Rodgers and Blogher. Thank you for participating and thank you Bloghers for joining us.

Please keep an eye on blogher.com for the audio and transcript of this call and for the announcement of the next call, where we will give you another opportunity to talk healthcare reform with legislators.

-end transcript-

We want YOU to participate in our next call - stay tuned and be part of the conversation.

Five Democrats joined with all the Republicans on the committee to reject an amendment by Sen. Jay Rockefeller (D-W.Va.) in a 15-8 vote.
Three Democrats then joined the Republicans to defeat a second public-option proposal. By a vote of 13-10, the committee rejected an amendment by Sen. Charles Schumer (D-N.Y.).
Schumer, however, said the debate is far from over. He acknowledged during the debate that the public option doesn't yet have the 60 votes on the Senate floor it needs to overcome a filibuster, but he emphasized to Huffington Post outside the hearing room: "Yet. I said 'yet.'"

So if the public option doesn't have the 60 votes why not 51? Jane Hamsher at Firedoglake explores the idea-

Chuck Schumer and Max Baucus just said that there were not 60 votes for the public option in the Senate.

The Public Option doesn't need 60 votes. It needs 51. That is, unless the GOP filibusters it. What Baucus and Schumer are saying -- explicitly -- is that there are Democrats who would support a GOP filibuster to keep the public option from having an up-or-down vote on the floor of the Senate. They are saying that there are Democrats who would vote with the GOP to block a vote on something that the President says he supports -- a public option.

My physician, Dr. Daniel Cole of UCLA Medical Center, wasn't happy with the news of the amendments failing. "They are just postponing the inevitable" he told me, shaking his head. He then explained to me how he voted for Obama but really wants him to be stronger on the public option.

My own doctor, MY OWN DOCTOR then sat there telling me how patients he sees can't take these insurance hikes any longer. How people can't pay their bills. How a public option NEEDS TO HAPPEN and WILL HAPPEN EVENTUALLY because there is just no other way.

As it turns out, public support for health care reform is up to 57%, and support for a public option at 65%.

So where does that leave us?

CNN reports:

In efforts to bridge differences, the Finance Committee proposal dropped the public insurance option and a mandate for all employers to provide health coverage. It would require individuals to have coverage or face a fine of up to $1,900 for a family of four but includes subsidies to help low- and middle-income Americans obtain health care plans.

The committee began debating the compromise measure last week, with arguments erupting over Democratic proposals to reduce subsidies for some Medicare coverage while eliminating fraud and waste in the government health care plan for senior citizens.

Republicans argued that the changes would reduce benefits for senior citizens, but Democrats say the overall effect would be minor. Some advocacy groups cite reports that the amount of money involved is no more than 5 percent of overall Medicare spending and therefore won't adversely affect benefits for the elderly.

Another compromise being discussed? One by Republican Sen. Olympia Snowe. Snowe has brought up a "trigger" mechanism that would create a public option in the future if specific thresholds and costs are not me. But the "trigger" has yet to be included in any proposal.

However the last, best gasp for any public option seems to be that magic 51 number. Will it or won't it ever get to that? Who knows. Wonkette takes a stab-

Well, it can: if the Dems can come together as 60 in a cloture vote, then the final floor vote on a public option would only need 50. Would you like to be one of the few Democrats standing on the floor, with the entire Republican caucus, to filibuster a health care bill from reaching an up-or-down vote on the Senate?

But of course the Democratic majority would never actually make the opposition go through with a real-life filibuster. Tacky!

Tacky, maybe. But my doctor and I will take tacky over NOTHING any day.

Contributing Editor Erin Kotecki Vest also blogs at Queen of Spain blog, where she's really tired of sitting in doctor's offices.

BlogHer is non-partisan, but our bloggers (like me!) aren't! Read more of our coverage at News & Politics