During this afternoon’s Rules Committee hearing to determine which amendments would be introduced during floor debate of the House health care bill, Rep. Virginia Foxx (R-NC) suggested that it’s better to be uninsured than enrolled in the government’s Medicaid program. “I want to ask you if you know that Medicaid patients visit the emergency room at twice the rate of uninsured patients in this country,” she said. “More government paid insurance is going to increase the number of people going to the emergency rooms.”

Rep. Jim McGovern (D-MA) responded, “I thank the gentlelady for making the case for keeping more people in this country uninsured. And I guess if that’s the Republican position, then fine”:

MCGOVERN: If you don’t have insurance then you have no choice but to go to the emergency room. But what we’re also trying to do is to put in place kind of a system, as Mr. Rangel said, that encourage prevention, and preventative care, so that people can actually not get sick and not end up in emergency rooms. So if you want to make the case that more and more people in this country should be uninsured, fine. I just disagree with you.

Watch the exchange:

“I’m making the case that your bill doesn’t insure anywhere near what our bill does, and I think that is unacceptable and is wrong in this country,” McGovern said, hinting that under the Republican alternative, the number of uninsured Americans would increase to 52 million by 2019.

Rep. Frank Pallone (D-NJ) explained that “one of the things that this bill does is make major increase in the reimbursement rate so that it gets up to the Medicare level, and even beyond, and that means that doctors will now take these Medicaid patients, they’ll get primary care, they’ll get to see a doctor on a regular basis and they won’t go to the emergency room.”

This morning, on a conference call with reporters, House Majority Leader Steny Hoyer (D-MD) warned that “action on a health care overhaul could slip past a planned Saturday evening vote into Sunday — or even Monday or Tuesday — if House Republicans employ delaying tactics.” House Speaker Nancy Pelosi (D-CA) assured reporters yesterday that “we will” have enough votes to pass the House, but press reports indicate Democrats have yet to reach agreement over coverage for undocumented immigrants and abortion.

Yesterday, 20 members of the Hispanic Caucus threatened to vote against a bill that prevented undocumented immigrants from purchasing coverage in the exchange with their own money and it’s unclear if ongoing negotiations have satisfied enough of the 40 pro-life Democrats unhappy with the bill’s restrictions on abortion funding. Reps. Bart Stupak (D-MI) and Brad Ellsworth (D-IN) have offered stronger abortion language that the caucus is currently considering.

Assuming that every Republican votes against the measure, Democrats have to peel away approximately 22 unsatisfied caucus members to pass the bill in the House. President Obama is expected to officially endorse the legislation later today and personally rally support for the measure during a visit to the Capitol on Saturday. Still, major policy disagreements could delay a House vote. Below is a table laying out the areas of disagreement:

Abortion:

Immigration:

Democrats would also have to defray likely Republican efforts to use the the motion to recommit “as an opportunity to insert a social issue poison pill, likely on abortion or immigration, that would peel off enough moderate Democrats to pass.” Republicans “could craft an abortion measure that gives pro-life Democrats little choice but to vote with the minority to change the bill. That change could make the final bill unpalatable enough for most Dems that its passage would be put in jeopardy,” Politico speculates.

Under the Republican health care alternative filed in the House, young and healthy individuals can purchase policies from insurers that don’t abide by local benefit or rate standards. The Republican bill allows the health insurer to choose a “primary state” “whose covered laws shall govern the health insurance issuer” and market policies to other states without adhering “to all of the consumer protection laws or restrictions on rate changes of the state.”

Over at MYDD, Bruce Webb, calls the provision, “Sweatshop Insurance.” “This bill goes far beyond that in stripping states of power over insurance rates and conditions,” he notes. It “explicitly expands the definition of ‘State’ to include not just D.C. and Puerto Rico, which makes some sense in context, but adds BY NAME the Virgin Islands, Guam, American Samoa and Jack Abramoff’s favorite client-the Northern Marianas home of the ‘Made in the USA’ Chinese-owned close to slave labor sweatshops.” From pages 121-122 of the bill:

As Webb goes on to explain, “companies can simply designate the Northern Marianas as the ‘primary State’ for their plan, or since it is closer the Virgin Islands and then have those governments be the sole regulator. And given the record of corruption in the N. Marianas and the willingness of various Caribbean and Atlantic Island nations to let themselves be used as off-shore banking and tax shelter entities you can bet Aetna and WellPoint are slavering at the prospect of ‘basing’ their plans out of a PO Box on some tropical nation.”

The Wonk Room tried to identify if any of the islands regulated individual insurance policies. We contacted several lobbying firm representing the N. Marianas but only reached Donna Christensen, the non-voting Delegate from the United States Virgin Islands to the United States House of Representatives. Her office did not know if the Virgin Islands had any consumer protections for policies sold in the individual market.