Health-care Tactic Future Rests On Snowe, Battling Democrats, Cbo
The Senate Finance Committee tomorrow is scheduled to vote on a plan to curb rising medical costs and cover tens of millions of uninsured Americans at a cost of $829 billion over 10 years. The next step for Senate leaders is to try to bring together divided Democrats to craft a compromise for the full chamber, a process also taking place in the House.
Senate leaders are also wooing Republican Olympia Snowe of Maine, whose support may help shore up backing from Democrats in Republican-leaning states. In the House, lawmakers are waiting for the Congressional Budget Office to analyze the costs of various proposals to make sure they dont add to the deficit, meeting a requirement of President Barack Obama.
“Snowes a pivotal vote, and the CBOs the pivotal actor,” said Rogan Kersh, a public policy professor and associate dean at New York University. “Everybodys held hostage to what figure they come up with.”
The nonpartisan agency last week blessed the Senate finance panels plan, which requires that all individuals obtain insurance, imposes restrictions on insurers ability to deny people coverage, and establishes nonprofit cooperatives to compete with private insurers.
The plan, built on a framework by Senator Max Baucus, a Montana Democrat who runs the committee, contains enough new taxes and savings that it would cut the budget deficit by $81 billion over 10 years, the CBO estimated.
Last to Act
The finance committee will be the last of five congressional panels to act on Obamas top domestic priority. Baucus delayed a vote for months while trying to win Republican support, an effort he continues with Snowe and others. None of the other four measures has won any Republican backing.
Snowe has been noncommittal. While saying the CBO analysis of her committees bill was “important,” she told reporters on Oct. 7 she still has “a lot to review.” She is one of 10 Republicans on the panel, which has 13 Democrats.
Michigan Senator Debbie Stabenow, a Democrat on the committee, said she spoke with Snowe last week and is eager to see what she decides about the vote.
“The big question is whether it will be bipartisan,” Stabenow told reporters on Oct. 9.
While Democrats say they are unified in their desire to get legislation passed, they are split on the specifics. Among other issues, the party is grappling with whether to create a government-run insurance option, whether to require that employers cover workers and how to pay for the legislation.
Two of the Democrats on the finance panel, Senators Ron Wyden of Oregon and Jay Rockefeller of West Virginia, wont yet say how they will vote. Both are proponents of the government- run program, or public option, and said they are focused on making health care more affordable.
“The primary focus should be on bringing premiums down,” Wyden said. “You dont have, when you go home, people saying, what I really want is an exemption or a hardship waiver.”
Baucus opted against an employer mandate and the public option. He also included $6 billion in federal seed money for the cooperatives to offer an alternative to insurers such as Hartford, Connecticut-based Aetna Inc.
The Senate finance panel plan calls for new taxes on high- end insurance plans and fees on industries such as drugmakers and medical device manufacturers. The House versions would institute surtaxes on the wealthiest Americans, and leaders are now considering new ideas such as a tax on insurer profits.
Common Ground
There is common ground in all the measures. They require that Americans get insurance, with varying penalties for failing to do so. They also encourage greater use of preventive care, electronic records and research on the effectiveness of treatments. Under all the plans, insurers would have to accept new clients, regardless of preexisting conditions.
Lawmakers will face some pushback from health-care industries in the weeks ahead. Insurers are upset that the finance panel scaled back penalties for not buying insurance. The hospitals, which agreed to contribute $155 billion in savings toward the effort, said not enough new people will be covered by the finance committees version.