Included within the recently passed health care law is a provision that allows states to propose their own pilot health care programs and seek a waiver from the federal health care law so that they can pursue their own approaches to health care reform. The current law allows states to pursue these waivers in 2017. Yesterday, Rep. Peter Welch (D-VT) introduced an amendment to the law that would move this waiver date up to 2014, and he instantly received support from his fellow Vermont public officials Sens. Bernie Sanders (I-VT), Patrick Leahy (D-VT), and Gov. Peter Shumlin (D-VT). There is also support in the Senate for moving the waiver date forward, in the form of an amendment introduced by Sens. Scott Brown (R-MA) and Ron Wyden (D-OR).

Earlier today, ThinkProgress attended a meeting with Democratic House members and asked them about their plans to respond to the Republican push to repeal health care and about their thoughts on Welch’s legislation. Two members of Congress, Reps. Jan Schakowsky (D-IL) and Jim McDermott (D-WA), explictly endorsed Welch’s proposal. Schakowsky told ThinkProgress that she “absolutely” supports the Welch proposal and that Republicans “ought to be for” it because they claim to believe in “states’ rights”:

THINKPROGRESS: [Welch] had mentioned along with the rest of the delegation of Vermont that they’re actually looking at moving the waiver of letting state’s pursue their own health systems from 2017 to 2014 to allow Vermont to pursue sort of a single payer style approach. Would you support moving that waiver?

SCHAKOWSKY: Absolutely. I think that all of the leadership now in Vermont, here in the House, Senate, the Governor had a press conference together in order to do that. Let Vermont show us the way to a single payer system. The former governor was on television last night, Howard Dean, talking about that as well. I think we should be able to experiment. We should give states the option. Republicans ought to be for that. States’ rights, experiment with their own plans, and do a single payer.

McDermott told ThinkProgress that he “of course” supports the Welch proposal. He explained that he had tried to get a single payer system enacted in 1985 in Washington state, but that federal insurance laws prevented him from doing so. He said that “state by state implementation is probably the best way to go”:

THINKPROGRESS: You mentioned earlier that you were a single payer advocate, states like Vermont or maybe California, may move ahead and implement state based programs like that, but they need a waiver from the federal government; the current waiver kicks in at 2017, some members are trying to push that waiver forward and implement those systems in 2014, would you support that?

MCDERMOTT: Of course. I basically tried to do that in the state of Washington in 1985. But the problem at that point was you couldn’t get everybody in the state into it because of ERISA. [...] The big companies use ERISA as their protection, they were not willing to allow the state of Washington to develop their own plans. I watch what happened in Canada in ’67 when Tommy Douglas put the program together in Saskatchewan. My view is that state by state implementation is probably the best way to go.

Watch it:

Meanwhile, at least two members of the Democratic leadership — House Democratic Steering and Policy Committee Co-Chair Rep. Rosa DeLauro (D-CT) and Assistant Minority Leader Rep. James Clyburn (D-SC) — expressed positive support for Welch’s idea without explicitly endorsing his amendment. DeLauro told ThinkProgress that we should “talk about” Welch’s amendment and that she’s never said that states shouldn’t be able to go forward with their own plans if they have “a better plan.” When asked if that meant she thought Welch’s idea was a good idea, she replied that it “does” sound like a good idea:

THINKPROGRESS: Let’s say a state like Vermont, Congressman Welch’s state, have a plan that is more progressive, that meets all the requirements of the Affordable Care Act, but is maybe more efficient, covers more people, is more comprehensive, right now a state like that can request a waiver to do their own health care system but they have to wait until 2017. Congressman Welch is proposing we move that to 2014, so that maybe they can move forward.

DELAURO: Let’s talk about it. Where you have more progressive plans. I have said I’ve never been one to say we ought to we shouldn’t if a state has a better plan, whether that’s on food safety, or health care, that we shouldn’t do is to lower the standards. The standards should always be raised in these arenas.

THINKPROGRESS: So it sounds like you’re saying it’s a good idea.

DELAURO: It does. Let’s see what the fish hooks are, let’s see what the benefits are. And let’s have a debate about it. About the principle of it needs to be what we’re dealing with here and how we can make this piece of legislation a stronger piece of legislation. No one has ever said that this is it, it’s cast in concrete and that’s it we’re not moving on. It would be foolish to do that.

Watch it:

Meanwhile, Clyburn told the blogger meeting that there is a precedence for states opting out of federal laws if they can meet the minimum requirements or exceed them, citing the case of South Carolina, which opted out of certain provisions of the Civil Rights Act because it exceeded the requirements. Clyburn appeared to use the analogy to support Welch’s idea, asking rhetorically, “What’s wrong with that?”

– Zaid Jilani and Kevin Donohoe

Moments ago in a vote of 245 to 189, the House passed H.R. 2 ‘Repeal the Job Killing Health Care Law Act after just seven hours of floor debate and without allowing Democrats to offer any substantive amendments to the legislation. The bill will now got to the Senate, where Majority Leader Harry Reid (D-NV) has said he would not schedule it for a vote. Just three Democrats voted in favor of repeal.

Before the final vote, the minority unsuccessfully offered a motion to recommit that would have prevented the law from being repealed unless a majority of members gave up their government-sponsored health coverage. So far, only nine Republicans have said that they would opt out of the tax payer subsidized Federal Employee Health Benefits Plan (FEHBP). Watch the vote:

Republicans will soon vote on another measure instructing the committees of jurisdiction to draft up reform “replacement” legislation, but have not said when or if the measure would be considered by the full chamber. Republicans see their repeal effort as a multi-year campaign and have promised to target or defund different portions of the law — including the 1099 reporting requirement and the abortion provisions — that could attract bipartisan support in Congress.

Democrats, meanwhile, are also planning to keep health reform in the headlines. Yesterday, the Vermont Congressional delegation offered a bill that would allow states greater flexibility to adopt innovative solutions to the health care crisis, including constructing a single-payer health care system. Sens. Ron Wyden (D-OR) and Scott Brown (R-MA) have offered a similar bill in the Senate.

Yesterday, the Department of Health and Human Services released a new report showing that up to 129 million Americans have a pre-existing condition and would likely be denied coverage in the individual health insurance market. According to the analysis, examples of what may be considered a pre-existing condition include, “heart disease, cancer, asthma, high blood pressure, and arthritis.”

Republicans have questioned the results of the report by arguing that many Americans with pre-existing conditions already have insurance coverage, but during this afternoon’s floor debate in the House, Rep. Phil Gingrey (R-GA) took the argument one step further, belittling the ailments:

GINGREY: One hundred and twenty nine million people with pre-existing conditions! They would all have to have hang nails and fever blisters to have pre-existing conditions and if you believe those statistics, I’ve got a beach to sell you in Pennsylvania.

These comments prompted Rep. Frank Pallone (D-NJ) to defend the report by reading off the actual ailments that would be considered a pre-existing condition. Watch it:

As Kathleen Sebelius, Secretary of Health and Human Services, explained yesterday, while many of the 129 million Americans already have insurance, they would have a hard time finding coverage if the law were repealed and they were to lose their job. “A number of people are in jobs with large employers where people can’t be underwritten because of their health condition, that’s good news. But those folks frankly can’t look at leaving that jobs, can’t start their own business, can’t have the freedom to retiring early before they have qualify for Medicare because they are terrified they will lose that insurance coverage,” Sebelius said, pointing out that insurers deny coverage to 1 out of every 7 who apply for it in the individual market.

And while Gingrey’s “hang nail” comments are certainly ridiculous, insurance companies are not above denying coverage for fairly elementary ailments. Insurers will disqualify you for just taking certain medicines because of the possibility of future costs, including common drugs as Lipito and Nexium and often deny coverage to individuals in high risk occupations, such as firefighting, lumber work, telecom installation, and anything more dangerous than office work.

As the House prepares to repeal health care reform, Education and Workforce Ranking Member Rep. George Miller (D-CA) offered the most impassioned defense of the Affordable Care Act, warning lawmakers that the vote was a matter of “life and death” for Americans who are fighting against the bureaucracy of the existing health care system:

MILLER: The other side of the aisle said this is a bureaucratic system. Has anybody, any family in America, any single mother, any spouse, any child, any grandparent, met a more bureaucratic system than the American health care system? There is no more bureaucratic system! [...]

Everyone has been run around the block by their insurance company, it’s something they all share. It’s almost the problems they share with their cable company. Not quite, it’s not as dramatic here. Because this is life and death, this is the security of your family, this is whether or not you can change jobs, this is whether or not your children will be protected, this is whether or not your parents will be able to afford the prescription drugs. Because that is what this legislation enables and gives the freedoms to American families to have. Repeal, we’d go back into the clutches of these bureaucrats spread across the world. [...]

Nobody wants to go back there, ladies and gentlemen. They’ve been there for 50 years and health care costs have gone up faster than any other segment in our economy. Faster than anything you can imagine. Faster than a speeding rocket, faster than a speeding airplane, faster than Superman. Health care costs have gone up because of the insurance bureaucracies.

Watch it:

Miller’s tone was surprising, given the more controlled rhetoric of this weeks’ health care debate, but is a welcome change following the Democrats’ failed strategy of selling the law in very academic terms.

While Republicans have relied on the same old arguments against reform, they’ve avoided describing the repeal measure as “job killing” and have generally stopped accusing Democrats of rationing health care. Some have even gone out of their way to mention that Democrats didn’t harbor any sinister motivations in passing the law. For their part, Democrats are using debate as a review of the laws most popular provisions, arguing that Republicans are wasting time on legislation that will never pass in the Senate and taking away benefits from their constituents.

Miller has been particularly punchy, tweeting out how many people would lose their health benefits from Republican districts if the law were repealed.

Last week, the Kaiser Family Foundation reported that Arizona was the only state to cut health insurance for children and one of two (along with New Jersey) to reduce services for low-income families in 2010. Now, Gov. Jan Brewer (R-AZ) — who has been criticized for cutting mental health programs and transplant coverage — has proposed to balance the state budget by dropping 280,000 residents from Medicaid. Later today, the Arizona legislature will meet in a special session to allow Brewer to seek a two-year waiver “from a requirement under federal health-care reform that states maintain current eligibility levels”:

The governor’s spokesman did not respond to a request seeking an interview with Brewer about her budget, which starkly painted her response to the federal constraints: Seek a way out from under federal rules so she can reduce the Arizona Health Care Cost Containment System, the state’s Medicaid alternative, and save the state $1.5 billion over the next two years. She wants a waiver that would allow Arizona to drop coverage of childless adults and curb funding to some low-income parents, and blind and disabled people.

If approved, the coverage reductions would last two years. After that, federal Medicaid dollars would help cover Arizona patients under the terms of federal health-care reform. [...]

Brewer’s plan is silent on emergency funding for certain medical transplants that Democrats and others have pushed, and it does not address the anticipated impact of any of the tax cuts and incentives Brewer and lawmakers have promised as a way to energize the economy.

Several conservative governors have asked the feds for a waiver to cut back on their existing Medicaid program without losing federal funding, and Arizona has previously jumped through some fairly small legislative hoops to avoid giving up this revenue stream. In March, the Arizona legislature eliminated funding for KidsCare, the state’s CHIP program, only to reestablish it months later in order to avoid losing billions of dollars in federal matching funds. The health law requires states that want to continue receiving federal health care funds to maintain eligibility in Medicaid and CHIP.

Arizona is cutting back its health care programs while challenging the constitutionality of federal health care reform — the Arizona Attorney General has now joined the Florida-led multi-state challenge against the law — and asking the federal government to leave health policy to the states. It’s one heck of a deal for the 280,000 residents who could be eliminated from the state’s program — Arizona is going to eliminate their state coverage and then argue that the federal government should be allowed to step in and help.