The House Democratic conference call today lasted two hours and featured much criticism of the one policy for which President Obama has cited a preference, the excise tax on high-end insurance plans. As I noted yesterday, 190 Democrats, or well over half the caucus, have signed a letter opposing the tax, so it’s unsurprising that they would make this a major issue in the merging of the House and Senate bills.

There were other issues raised as well.

“The questions were about national exchanges, about the public option, about the Cadillac plans, about consumer protection, about insurance reform,” said Rep. George Miller (D-CA), chairman of the House Education and Labor Committee, and one of the chief authors of the House health care bill. “We told them what things the staff had started to discuss or haven’t discussed yet.”

According to a House leadership aide, members chief concerns on the call regarded a familiar array of issues. “Many members raised concerns about excise tax (in opposition to it),” the aide said. State exchanges came up — many Members want a national exchange. Several spoke up also in favor of anti-trust exemption (repealing it) and keeping in place strong insurance reforms.”

The excise tax is getting so much ink because a) Obama spoke out for it and b) anything with the word “tax” in it gets a disproportionate amount of attention in Washington debates. But in general, it is a pretty poor way to address cost control and over-utilization in health care, and rank and file Democrats recognize the political and policy implications of such a maneuver.

The President now must face the unions in an attempt to sell them on the excise tax, and I don’t think they’ll accept a “promise to move on EFCA” the way leadership has tried to stop other mini-revolts with promises on other issues.

Hopefully, with all the heat on the excise tax, the House will be able to sneak through some other valuable elements of the bill, like a national exchange, or closing the wellness program loophole that could allow you to charge more based on your medical condition, or even something so seemingly small as a billion dollars for states to enforce insurer price gouging, something that doesn’t appear in the Senate bill.

UPDATE: Progressive Caucus Co-Chair Raul Grijalva has released a statement on the conference call:

“Today’s call was productive in terms of allowing members to make their feelings known, and I was glad to hear that leadership wants the entire Democratic Caucus to work through the outstanding issues until we get them right. At this stage, the White House needs to understand what is at stake and must weigh in substantively on the major differences between the House and Senate versions of the bill. Along with many others, I continue to feel that the House language provides better solutions to a wide range of problems with our health care system, especially regarding the public option and the creation of a national insurance exchange. Those and many other unresolved issues, including affordability mechanisms and insurance company oversight, will be discussed thoroughly over the next few weeks. As those conversations take place, I look forward to promoting the same publicly supported, money-saving progressive agenda that I have championed since this process began.”