Senate, House Move Closer on Health Bills as Battle Goes Public
Nov. 2 (Bloomberg) -- After months of private wrangling,the fight over legislation to revamp the U.S. health-care systemwill soon spill onto the House and Senate floors.
House Speaker Nancy Pelosi will seek a vote as early asthis week while trying to pacify fellow Democrats who say herbill isn’t strong enough and others who fret that federaldollars might be used for abortions. Senate Majority LeaderHarry Reid is waiting for cost estimates on his proposals whiletrying to win enough votes just to start debate.
Both top Democrats are moving legislation closer to thepolitical center of their party, cutting the overall cost andchoosing a watered-down version of a government-run healthinsurance program. They may have to bend even further to getenough votes for passage, especially in the Senate.
“Obviously, they play a key role -- the centristDemocrats,” Maine Senator Olympia Snowe, the only Republican ineither chamber who has voted for a congressional health-carebill, told reporters. “I am working with them any way I can.”
Lawmakers are trying to craft a bill that would cover tensof millions of uninsured Americans while curbing medical costs.Their proposals for purchasing exchanges, government subsidiesand a requirement that all Americans have insurance representthe biggest changes to U.S. health care in four decades.
Lacking Votes
Reid already lacks the votes for a government insuranceprogram, or public option. He’s struggling to keep all 60 votescontrolled by Democrats together on a motion to begin debate andwould need 60 again to bring the measure to a final vote.
Reid lost Snowe’s backing when he chose to support a publicoption. Connecticut Senator Joe Lieberman, an independent who isaligned with the Democrats, also said he would oppose the plan,and four other Senate Democrats -- Kent Conrad of North Dakota,Ben Nelson of Nebraska, Blanche Lincoln of Arkansas and MaryLandrieu of Louisiana -- have been critical of the idea.
Snowe would vote for a plan that set up a public optiononly if health-insurance premiums weren’t deemed affordableenough after a certain period of time. That so-called triggerhas support among holdouts including Nelson and Landrieu, andPresident Barack Obama’s administration has signaled an opennessto it.
“Senator Snowe has talked a lot about a trigger, and Ithink she should be listened to,” Landrieu told reporters.
House Fights
In the House, Michigan Democrat Bart Stupak has contendedthat 40 members would remain united to block legislation unlessthe abortion issue is resolved or they are given a chance tointroduce an amendment during floor debate. Leaders of the 82-member Congressional Progressive Caucus are pushing for astronger version of the public option.
The progressives support Pelosi’s original plan for apublic option with reimbursement rates tied to the lower levelspaid by the Medicare program for the elderly. Pelosi had tocompromise, faced with opposition from other members, includingthose in the fiscally conservative Blue Dog Coalition.
Reid’s version of the program is similar to Pelosi’s,though it would allow states to opt out. Besides Snowe’s triggeridea, lawmakers are also considering compromises such asallowing individual states to decide whether to set up a publicoption.
Nelson told reporters he’s undecided about whether to votefor debate to start and said he would have a hard time backing abid to call a final vote on Reid’s proposal.
“It would be very difficult for me to vote for thatprovision,” Nelson said.
Reid has been melding legislation passed by the Senatehealth committee in July with an $829 billion plan approved bythe finance panel on Oct. 13. The health panel included a publicoption; the finance committee rejected it.
Bill Costs
House lawmakers are considering legislation that would cost$1.055 trillion over 10 years, according to a CongressionalBudget Office estimate. Pelosi’s office says the price tag is$894 billion, a net figure that takes into account new revenuesuch as penalties for not buying insurance.
The House bill now contains fees on medical-device makers,similar to those under consideration in the Senate. Proposals inboth the Senate and House would study ways to fix the Medicarepayment system and both have long included provisions toencourage greater use of preventive care.
For the most part, the House and Senate have different waysto pay for their legislation. The House depends mostly on asurtax for couples who make more than $1 million a year. TheSenate would tax insurers on high-end plans.
And while the House requires that employers with payrollsabove $500,000 provide coverage to workers, the Senate wouldpenalize only companies whose employees don’t get coveragethrough work and then qualify for a subsidy to buy a policy.
If both the House and Senate pass legislation, they willwork together on a compromise. And once again leaders willprobably turn to a small group of influential lawmakers, saidMark McClellan, a Bloomberg Television contributor and theformer head of the Centers for Medicare and Medicaid Services.
“The key factor here is the moderates,” he said.
To contact the reporters on this story:Kristin Jensen in Washington at kjensen@bloomberg.net;Laura Litvan in Washington at llitvan@bloomberg.net
Last Updated: November 2, 2009 00:01 ESTSource: Bloomberg
« Back to Health News
Related News
-
Health overhaul raises stakes for Medicare job Nov 1, 2009 @ 10:41 PM
WASHINGTON (Reuters) - The healthcare overhaul moving through Congress elevates the job of running the government's $700-billion Medicare agency to new heights and all but guarantees a political battle over filling the post.
-
Senate healthcare bill unscathed after first week Nov 1, 2009 @ 10:41 PM
WASHINGTON (Reuters) - A broad healthcare overhaul emerged unscathed on Friday from the first week of Senate committee debate, with Chairman Max Baucus keeping fellow Democrats in line and shielding key elements from Republican attacks.
-
Baucus Bill May End Up Being a Mere Rough Draft Nov 1, 2009 @ 10:41 PM
At precisely 11:53 a.m. Friday, after a full week of debate on his bill to refashion the nation's health-care system, Senate Finance Committee Chairman Max Baucus (D-Mont.) rose from his chair and silently slipped out the back door.
-
House Bill Would Assure Workers Paid Sick Days Nov 1, 2009 @ 10:41 PM
In an effort to rein in the spread of the H1N1 flu, Representative George Miller, the chairman of the House Education and Labor Committee, introduced legislation on Tuesday that would guarantee five paid sick days for workers sent home by their employers with a contagious illness.
-
Health Care Debate Focuses on Legal Immigrants Nov 1, 2009 @ 10:41 PM
The debate over health care for illegal immigrants continues to percolate in Congress despite the Obama administration’s efforts to put it to rest, with lawmakers in both houses also wrangling over how much coverage to provide for immigrants who have settled in the country legally.
