By Tom Curry National affairs writer
updated 10/30/2009 10:42:36 AM ET 2009-10-30T14:42:36

Claim: The House health bill doesn’t satisfy liberals or conservatives, so its passage is in doubt.

The bill unveiled by House Speaker Nancy Pelosi Thursday would do many things — create a requirement for most Americans to obtain health insurance; set up insurance "exchanges" through which people could get subsidies to reduce the cost of coverage; expand eligibility for the Medicaid program for low-income people; cut the growth rate of spending on the Medicare program for older people. But to the chagrin of some liberals, it wouldn't create a "robust" public insurance plan with provider payments linked to Medicare’s relatively low rates. Can Pelosi find the 218 votes to pass it?

Fact or fiction?
Fiction. There are 256 Democrats in the House, with perhaps two more on the way after next Tuesday's special elections in New York and California. Pelosi only needs 218 votes to win. Also, the bill released Thursday isn't the last word. If OK'd by the House, it would then have to be blended with a Senate bill. New provisions can be added until the last moment. And for liberals disappointed in Pelosi’s version of a public plan, history should teach them that once such federal entitlements become law, they inevitably expand over time. Both Social Security and Medicare grew over the years to cover new categories of people and to add new benefits. For example, in 1937 Social Security provided only retirement benefits; gradually it added disability and survivor benefits.

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