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April 19, 2014

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Dina Titus vote for reform bill could undercut support

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Justin M. Bowen

Rep. Dina Titus, D-Nev., who won her first term with less than 50 percent of the vote, faces a rocky road to re-election in November.

There is a reason why Democratic Rep. Dina Titus and her House colleagues say Republicans may be the opposition, but the Senate is the enemy.

As the House and Senate work to resolve differences in the health care reform legislation and craft a final bill, Titus and her Democratic colleagues are in a potentially uncomfortable spot.

Titus and Democratic Rep. Shelley Berkley want to support President Barack Obama’s top domestic policy priority of health care reform. With nearly 500,000 uninsured Nevadans, and insured residents who face rising health care costs, they want changes.

But their opposition to key provisions in the Senate bill that were absent from the House bill they supported are leaving them with a difficult decision: Can they live with the Senate version or do they withhold their votes for a better deal?

Erik Herzik, chairman of the political science department at UNR, said Titus, in particular, is “in a tough spot.”

Although Berkley serves in the politically safe Las Vegas district that routinely re-elects her by a robust majority, Titus won her first term with less than 50 percent of the vote, and her 3rd Congressional District is more evenly divided among Democrats, Republicans and independents.

In Titus’ election this fall, Herzik notes, “she’s running against a doctor.”

Former Republican state Sen. Joe Heck, a medical doctor, and Republican businessman Rob Lauer will face off in a primary.

“No matter what she does,” Herzik said, “she’s going to get hammered.”

Click to enlarge photo

Shelley Berkley

The House and Senate bills differ on contentious issues: abortion coverage, the ability for illegal immigrants to buy health care and the public option plan. But for Titus and Berkley, the proposed taxes to pay for subsidies to help households buy insurance might prove to be the thorniest issue.

Both lawmakers strongly opposed a proposed tax on so-called Cadillac health plans — high-end health insurance policies enjoyed by corporate executives and many unions. In the fall, Berkley and Titus signed a letter opposing the tax.

Unions oppose the Cadillac tax after workers fought for better health policies rather than higher wages. The Culinary Union in Las Vegas, which represents maids and other hotel workers, decided to for go wages for better benefits in crucial negotiations several years ago.

“To turn around and tax that now violates the contractual relationship between labor and management,” Berkley said in the fall, “and goes back on a promise President Obama made that he would not increase taxes on the middle class.”

Titus, too, raised a red flag at the time. “Taxing insurance companies for high-cost insurance plans will only serve to place a greater burden on middle-class families,” she said.

The House bill has no Cadillac-plan tax, but the Senate raises nearly $150 billion by taxing plans valued at more than $8,000 for an individual or $23,000 for a family.

Whether Berkley and Titus can live with that tax remains to be seen.

“I’m just going to look and see what comes out in the final version,” Titus said last week.

Titus said the threshold for the Cadillac tax could be raised during negotiations so it spares Las Vegas workers.

“I’m going to remain optimistic there’s some negotiating room,” she said. “I’m hopeful it’s not going to be as drastic as the Senate.”

Another tax provision could prove difficult for Titus.

She withheld her support for the House bill during a committee vote because she opposed its proposed tax on incomes above $280,000 for individuals or $350,000 for couples. At the time, Titus worried that the tax would unfairly snare small-business owners in her district, sympathizing with mom-and-pop owners of restaurants, hair salons and other shops who have been hard hit by the recession.

The House eventually changed the proposal to a millionaire’s tax — a tax on incomes above $1 million for families or $500,000 for individuals — and won Titus’ support.

Now, however, the Senate bill proposes a tax on those earning more than $200,000 a year, or $250,000 for couples filing jointly. The tax would be on Medicare earnings.

When asked last week whether that was a make-or-break issue for her, Titus said, “I want to see what the compromise is. I’m not sure it’s going to come out the same formula as it is in the Senate.”

Neither the House nor Senate has much room for negotiating. The House passed its bill with 220 votes — two more than needed. The Senate had exactly the 60 votes needed. With Democrats facing unified Republican opposition to the legislation, the debate is really among Democrats.

Republicans argue the bill will lead to a government takeover of health care, and will bring more taxes and poorer coverage. They say the process should be slowed to allow more time for debate.

Nevadans remain mixed on the health care issue, opposed to the current legislation in Congress, but wanting changes.

Democrats have devoted precious months to the issue, and most analysts agree that failure to produce a final bill at this point would worsen the party’s standing among voters.

November’s election is poised to be a difficult one for Democrats as the national mood shifts away from the enthusiasm that swept Obama into office. Failure to pass a bill would reaffirm to voters that Washington is dysfunctional, and the party in power would likely pay a steeper price in November, analysts think.

Democrats have a challenging task before them in selling the bill. Some of that is apparent as Titus and Berkley argue that the final legislation may contain too many beneficial elements to vote against it.

Under both versions of the bill, the insurance industry would be banned from denying coverage for pre-existing conditions and Americans would be required to carry insurance — with subsidies given to help low- and moderate-income households afford it. Eventually, 31 million uninsured Americans would be covered.

“It’s really going to look at what that balance is,” Titus spokesman Andrew Stoddard said.

Studies show that health care costs continue to rise and employer coverage is expected to deteriorate if nothing is done.

Berkley spokesman David Cherry said the congresswoman thinks that outlook is unsustainable for Nevada families.

“These are living, breathing people who need health insurance,” Cherry said. “That’s going to overcome some concerns for her. She’s going to weigh it, and in all likelihood at the end of the day is going vote for it.”

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