Baucus Makes Last Health-care Bid After Obamas Game Changer
While Baucus said President Barack Obamas Sept. 9 speech to Congress “breathed new life” into negotiations for a bipartisan compromise, the Montana Democrat vowed to present draft legislation with or without Republican votes, after struggling for months to reach a deal.
Failure to achieve a bipartisan bill may undermine public support for the measure, some Republicans have warned. It would also raise the question of whether Obama and congressional leaders can keep enough Democrats unified to pass legislation.
“Theres not very many moderates,” said James Thurber, director of the Center for Congressional and Presidential Studies at American University in Washington. “You move to the middle and you start losing people, significant people.”
The finance committee is the last of five congressional panels to deal with legislation intended to cover more of the 46 million uninsured Americans and tame rising health-care costs, which account for a sixth of the U.S. economy. They are grappling with whether to create a government-run program to compete with private insurers, whether to require employers to cover workers and how to pay for the $900-billion plan.
Democratic Divisions
Congressional Republicans say the proposal is too costly and will add to the federal deficit, which is forecast to be $1.5 trillion next year.
Besides failing to win over any Republicans, Democrats have faced divisions within their own party, particularly over the idea of the new government program, or “public option,” which some party members say would threaten private insurers.
Obama may have helped get Democrats in line during his Sept. 9 speech. He exhorted a joint session of Congress to stop bickering and start cooperating. House Speaker Nancy Pelosi, who had said she couldnt pass a plan without a public option, said on Sept. 10 that she had no “non-negotiable” demands.
Nebraska Senator Ben Nelson, one of the most vocal skeptics of the public option among Democrats, called Obamas speech a “game changer.” Steve Hildebrand, Obamas former deputy campaign manager who had criticized the president for not pushing liberal policies hard enough, echoed those remarks.
Both Parties
“This is going to reach the public, and thats going to reach senators of both parties,” said Senator Charles Schumer, a New York Democrat.
In the speech, Obama focused on proposed changes such as barring insurers from refusing to accept new clients with preexisting conditions and limiting out-of-pocket expenses. He also embraced the idea of a tax on companies offering the most expensive insurance policies and left the door open to nonprofit member-run cooperatives instead of a public option.
“Its cannily similar to what were working on,” Baucus said.
The Baucus plan would also require most Americans to get insurance or pay a fine, and allow states to form compacts to sell health insurance across state lines, a Republican priority.
Sticking Points
One sticking point for Baucuss group is how an expansion of the Medicaid program for the poor affects state governments, which would pick up a portion of the costs. Baucus wants to extend Medicaid coverage to those with incomes 133 percent above the poverty level. Thats worried governors, some of whom will speak to committee members today, said Senator Kent Conrad, a North Dakota Democrat whos in the negotiating group.
Meanwhile, the group may go further than Obama in making changes to medical malpractice law — an effort designed to make an overhaul appeal more to Republicans. There is consensus to include “safe harbor” legal protection for doctors who can show they comply with “best practices,” and expanded use of arbitration to end disputes between patients and practitioners, Conrad said on Sept. 10.
Without Republicans, the options for Democrats may be limited. They control 59 of the 99 current votes in the Senate, short of the 60 usually need to pass legislation. While they can use a budget process known as reconciliation that requires only a simple majority vote, it comes with limits that might require Democrats to significantly scale back their plans.