Nancy Pelosi: Health-Care Reform Endgame

In the past year, Speaker Nancy Pelosi has pushed a $787 billion stimulus package, a $154 billion jobs program, and funding for the wars in Iraq and Afghanistan through the House. Now her ability to marshal Democratic votes makes her the central player in the most important drama in Washington: the possible passage of health-care reform legislation. What follows are edited excerpts from a conversation aired on Mar. 10.


Many say health reform is on your shoulders; it depends on your ability to convince Democrats. You've got the President campaigning like crazy, but you have to deliver the votes.


Well, I take responsibility for whatever the outcome is, but we're at a place now where I think reform is definitely within reach.

Do you have the votes at this moment?
We don't have the bill yet.

Would you be in a better place if the President started doing what he is doing now—out there speaking with the passion he had during the campaign—a year ago
One year ago on Mar. 5, President Obama called Democrats and Republicans from the House and Senate to the East Room of the White House. In that room he had all of the stakeholders—children's health, public hospitals, private caregivers, insurance companies, the pharmaceutical industry, you name it, every stakeholder in health insurance reform was represented. On that very day—only about five to six weeks after his inauguration—the President began to reach out to the Republicans. It was important to him to strive for bipartisanship, and in fact the health-care bill we will pass has over 150 Republican amendments. It may not have a bipartisan vote, but it has bipartisan amendments.

The rise in health-care premiums in California seems to have set him off.
It certainly did. That [Anthem Blue Cross] increase in California—39%—lit the flame, and that's only one example of the outrageous increases and irresponsibility of insurance companies. What emerged from the recent health-care summit is that Democrats want to regulate the insurance companies; Republicans do not. Left to their own devices, the insurance companies have done harm to the economic well-being of the American people.

Didn't all the talk about a public option hurt the possibility of health-care reform?
Well, I myself was a very strong supporter, but yes. If you are an insurance company, you want to take down the public option, right? You want to get rid of that. But as you do it, you want to confuse the issue of health-care reform. As long as people are talking about the public option, they are not talking about what is in the bill for the American people. But you know what? In some ways it's water under the bridge. It's unfortunate because I think if we had a bill much sooner, all of its merits would be better known, and it would not have been a piñata for six months.

When history is written about health-care reform in the first year of the Obama Administration, it is said by many people that we will find out the Speaker was telling the President he was wasting his time trying to get Republican participation.
Hmm, really? Who said that?

Two Nobel laureate economists—Paul Krugman and Joe Stiglitz—are saying the stimulus wasn't big enough and it didn't create enough jobs quickly.
Obviously the package was bigger in the House, but the President wanted bipartisanship so we got a smaller package coming out of the Senate. But having said that, it was an excellent initiative. And I think it's important to note the following: The health-care bill is a job creator. It will create 4 million jobs over the life of the bill, and several hundred thousand very soon.

How long will it take you to create enough jobs to get back to an unemployment rate that's at 6%?
Well, it will take some time.

Four or five years, right?
Do I have to remind you of the mess President Obama inherited from President Bush, who refused to make these investments in America's infrastructure and job creation?

What do you think unemployment will look like by the end of this year?
Well, it will look a lot better than it would have if we hadn't passed the recovery package.

O.K., but that doesn't answer the question. What will it look like? Will it be at 8%, 9%?
I can't predict that. But everybody is telling us the unemployment rate would be two points higher now if we had not passed the recovery bill.

Obama Chief of Staff Rahm Emanuel is at the center of a controversy over the effectiveness of the Administration. People pointing the finger at him; columns being written. What happened? You know this town.
I know this town, and it's an archery range. Rahm is effective. When you're effective, you become the target.

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