By LES BLUMENTHAL
WASHINGTON – With a historic vote looming this weekend, U.S. Rep. Brian Baird said Friday he can’t support the Democratic health care reform bill. Rep. Adam Smith, said he hasn’t made up his mind.
Baird said he isn’t prepared to vote for a bill until the Congressional Budget Office estimates its impact on health insurance premiums. He also wants to wait until Medicare and Medicaid actuaries estimate the impact on those programs for seniors and the poor.
“I can’t in good conscience vote for this without those estimates,” Baird said.
Smith said he is weighing whether the need to overhaul a “big, bloated, wasteful system” and provide insurance to millions currently without it outweighs the bill’s $1 trillion price tag and failure to aggressively rein in rising medical costs.
“I’m legitimately 50-50, right down the middle,” said Smith, a leader among centerist Democrats in the House.
Baird and Smith are Democrats, and their votes could be critical as party leaders scramble to round up the votes needed to pass the legislation.
The Democratic bill requires nearly everyone to obtain health insurance beginning in 2013. It also creates a federal exchange where individuals and small businesses can buy health care. And it provides for a government-run – or public option – health care plan.
The legislation also bars insurance companies from denying coverage based on pre-existing conditions, limits annual out-of-pocket costs for consumers and repeals the current anti-trust exemption for health insurers.
The bill ends the current federal subsidy that has allowed Medicare Advantage to offer low rates to seniors. And it increases the number of people eligible for Medicaid.
Smith said he understands his support for the measure could be critical for its passage.
“Reaching 218 is tough even without me,” Smith said. It takes 218 votes to pass a bill in the House.
Smith said he has had little contact from Democratic leadership, except for a phone call from House Speaker Nancy Pelosi last weekend.
“If in fact they need my vote, they haven’t acted like they do,” Smith said in an interview.
He said he was also surprised he hadn’t heard from the White House. Smith chaired President Obama’s campaign in Washington state during the presidential election.
Smith said he knows if the House doesn’t act it would be a “significant setback.” But he also said the bill costs too much and “shies away from what needs to be done to control (medical) costs.”
The bill provides for a study of overhauling a Medicare reimbursement formula for doctors and hospitals that has penalized Washington and other states with efficient health care systems. But Smith said that was not enough.
“We dance around the edges, but don’t take aggressive steps to contain costs,” he said.
Baird said he has asked House leadership and the White House to delay the vote.
“With the Senate now saying it may be January, what’s the rush?” Baird said.
Baird said no one would buy a house without knowing what the monthly mortgage payment would be. He said it was just as important to know the effects of the health care bill. He also said it was like chasing a train as it leaves the station.
“You need to know where it is going before you jump on,” Baird said. “I understand the need for health care reform and I know people have worked hard. But why not wait?”