As a registered nurse, Rep. Lois Capps, D-Calif., has worked hard on health legislation throughout her 10 years in Congress. For example, she's introduced legislation to expand health screening, and improve public information on cancer and stroke.
The 71-year old Capps, the vice chairwoman of the Energy and Commerce Health Subcommittee, has been outspoken in her support for a health overhaul. While she is a member of the moderate New Democrat Coalition, she supports the more liberal parts of the House health bill.
She spoke with KHN's Eric Pianin during a break in the committee's markup of the bill. Here's an edited version of the conversation.
Q: What was your reaction to the agreement with the Blue Dogs yesterday, especially the proposals that would take away some of the subsidies for lower income people to buy insurance and require states to pick up some of the cost of expanded Medicaid under the bill?
A: It presents one more challenge to getting the bill passed in the best possible way we can. First of all, I'm glad [the Blue Dogs] are at the table, now. They had been negotiating, but now we were able to go ahead with the markup, which is a good thing.
Q: What do you think about the current proposal, with 70 percent of the ($120 billion of cost savings coming) from subsidies?
A: That was working under the context that it had to all come out from that portion of the bill. But if we're able to get it from a larger framework, using more of the bill, rather than just the public option part of it, if that's possible, then we should be able to meet the obligation.
Q: What has been the atmosphere around the negotiations? Long nights?
A: I have to hand it to the leadership, who met with different groups for many, many days for hours and hours and hours on end. Also the staff. We have some very professional staff that drafted this legislation. There's no such thing as a perfect bill. Frankly, with getting the Blue Dogs back in the mix, (we've been) giving up some other things. It's a matter of how much we can preserve that's excellent for the American people. [The bill] increases coverage, it lowers the cost, it provides better health care. As a public health nurse, I'm really looking forward to increased emphasis on prevention.
Q: With so many differences between the House version and the version being negotiated in the Senate by Sen. Baucus and others, do you feel you're worlds apart or do you think there's a lot of room for a compromise?
A: Well, I work in the House. At some point we're going to have to vote on a bill that comes from a conference committee. Right now I'm glad and thankful that the leadership was wise enough to have the three major House committees [Ways and Means, Education and Labor and Energy and Commerce] work from a fairly common denominator, a bill. That doesn't mean we come out in identical places, but as it's reconciled on the House side, it's going to be not impossible to bring something to the floor -- bringing the best of all of the three in a way that we can support in a vote on the floor.
Q: From your perspective, what are the must-haves in the bill?
A: It's always best to hold the insurance companies accountable. We have to provide competition. We want to keep the American aspect of this, the private aspects of it, so we have to provide competition. And that's what a robust public option does. That's a major part of it for me: if we can make sure we include everybody, and provide prevention and have that be part of the legislation. I'm disappointed that the Congressional Budget Office can't score it, or won't score it, but I know in my heart, from my long years of experience as a public health nurse, that that will help to lower the cost.
Q: What's your biggest problem with the House version right now?
A: To make it possible for the public option to be viable and to make it be paid for without putting it on the backs of poor people. That's our goal.
Q: Henry Waxman, the new chairman of the committee, how would you describe his management style in dealing with members?
A: Infinitely patient, a good listener and very determined to see this through.
Q: And yet he blew up last Friday for a while [during negotiations with the Blue Dogs].
A: He's a human being, isn't he?