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RALEIGH — Asked about her take on health care reform Monday, U.S. Sen. Kay Hagan started with the pragmatic realities.

“First of all, the president would like to have a bill by October,” Hagan said on her way to the airport. To get that bill, no one party to the health care debate can get everything it wants. “What I’m working on is getting a bill that can get to our president.”

Hagan is one of a few Democrats who have not fully embraced President Barack Obama’s health care plan. Like Obama, Hagan agrees there has to be some public entity that will insure those who either don’t have health coverage or don’t have enough of it.

“There will be some sort of backstop provision,” Hagan said.

The rub may be what that backstop looks like. Many, including Democratic leaders such as Sen. Harry Reid of Nevada and Ted Kennedy of Massachusetts, have put forward what’s known as a “public option” provider, a federally run insurer.

Hagan is a fairly junior senator, with not even a year in Washington under her belt. But her presence on a key health care committee — as well as identification as a potential swing “Democratic moderate” vote — has prompted extra attention, from television ads to blog posts.

Hagan worries that such a federally run insurer may prompt companies to drop their private plans, or prompt individuals to run to a cheaper alternative, and destabilize the insurance market.

And she said Monday that the idea of tying the reimbursements paid by such a public provider to the rates paid by Medicare or Medicaid — as suggested by the House — won’t work.

“If it’s tied to Medicare rates, that’s not going to get enough votes to pass,” Hagan said.

Her reluctance to dive head-first into the public provider pool has angered some commentators on the left, who have written that she’s betraying Kennedy or Obama by not falling in step with the party.

“I want to strike a balance,” Hagan said. “I want to get things done and I want to make sure I’m one of those senators who can bridge the divide and get things done.”

At this point, Hagan said, she is less hung up on the various positions and talking points than she is trying to craft a bill that will both work and pass Congress.

“It’s not so much what you call it, but how it is composed,” Hagan said.

And, she noted, the public provider piece was only one part — albeit an important one — of a larger measure. Her committee, Health, Education, Labor and Pension, is looking at five facets of the bill, Hagan said. They are:

•  Coverage. “On coverage, we’ve come to the conclusion that everybody should be covered,” Hagan said. Health insurance companies and other providers should not be able to block people because of prior illnesses or gender, she said.
•  Quality. This is essentially the question of what is covered and for whom. “It’s going to require the Department of Health and Human Services to develop a national strategy that will focus on health care quality,” Hagan said.
•  Prevention. Hagan’s been big on the “we’ve all got to take better care of ourselves” theme for a long time.
•  Work force. This has to do with ensuring there are enough doctors and nurses to do the job.
•  Fraud and abuse. Lumped into this category you might also find discussion of a national standard for health information technology, which would allow various branches of the health care system to talk to one another — and bill — more efficiently.

Hagan a rural Democrat?

One more piece of Hagan-related business: the Greensboro (population 235,000 give or take) Democrat was cited as one of a number of “rural Democrats” taking issue with Obama administration policies by the Politico Web site.

The Washington-based all-things-political magazine may have been better off saying “moderate Democrats that happen to be from states with significant farm income,” but the point seems to be that Hagan is among those who might not be squarely in Team Obama’s camp.

From the Politico piece:

“(M)embers of Congress are scrambling to save thousands of jobs and warning of severe political consequences that could come from shuttering what are often community pillars. Sen. Kay Hagan (D-N.C.) questioned how independent owned and operated businesses have any financial impact on automakers.

“'None of us can quite understand why they consider dealerships a drag when they are the ones that buy the cars, that take the financial risks. Many of the dealerships that are being closed are profitable.’”

Coble notes

Two items of note from Rep. Howard Coble’s office this week. The Greensboro Republican reports he:

•  Was appointed to the board of visitors at the Coast Guard Academy. Coble is a retired Coast Guard captain.
•  Filed a bill to extend a tax credit for would-be home buyers.

“Under current law,” Rep. Coble says in a release, “only first-time home buyers are eligible for this tax credit. Our legislation would extend the credit to all home buyers. In addition, there would be no income limit on who would be eligible for the tax credit, but we do keep the $8,000 tax credit cap in place.”

Votes

Among the votes of note in the U.S. House last week:

• HR 2847 — Making appropriations for the departments of Commerce and Justice, and Science, and related agencies for the fiscal year ending Sept. 30, 2010.

Democrats Brad Miller and Mel Watt voted yes.

Republicans Howard Coble and Virginia Fox voted no.

• Four separate resolutions impeaching Samuel B. Kent, judge of the United States District Court for the Southern District of Texas, for high crimes and misdemeanors.

Coble, Foxx and Miller voted yes on all four articles, which passed on unanimous votes.

Watt voted yes on the first three but “present” on the fourth. The Washington Post reported:

“Rep. Mel Watt (D-N.C.) did vote 'present’ on the fourth article, which accuses Kent of lying to the FBI. 'He thought the fourth one was borderline — the weakest of the four by far,’ explained a Watt aide, adding that his boss also voted 'present’ on the fourth article when the Judiciary Committee considered the charges.”

Among votes of note in the U.S. Senate last week:

• The conference report for HR 2346 — a bill making supplemental appropriations for the fiscal year ending Sept. 30, 2009, and for other purposes. The measure passed 91-5.

Sen. Richard Burr, a Winston-Salem Republican, and Hagan both voted “yes.”

Contact Mark Binker at (919) 832-5549 or mark.binker@news-record.com