Finance Panel OKs Reform Bill; Leaders Meet To Merge Proposals

On Tuesday, the Senate Finance Committee voted 14-9 to approve its health reform bill, garnering the support of all 13 Democrats on the panel and Sen. Olympia Snowe (R-Maine), the only Republican committee member to back the $829 billion measure, The Hill reports.

The Finance Committee was the last of five congressional committees to approve its version of a health reform bill.

The House reform bill (HR 3200) and the Senate Health, Education, Labor and Pensions Committee's reform bill (S 1679) were approved earlier this summer (Young, The Hill, 10/13).

Snowe

According to the New York Times, it was unclear how Snowe would vote heading into Tuesday's hearing.

Finance Committee Chair Max Baucus (D-Mont.), President Obama and other top Democrats spent months trying to solidify her support as she had been the only Republican in the Senate to show any signs of aligning with Democrats on their reform plans. With her vote, she became the lone Republican in either chamber to publicly endorse any of the current health reform proposals (Pear/Herszenhorn, New York Times, 10/14).

Snowe -- who worked with Baucus as part of the "Gang of Six" bipartisan negotiators who developed the Finance Committee's bill -- said that the bill was not ideal but that she voted for it to continue the committee's progress on reform.

Snowe cautioned that her "vote today is my vote today" and that "it doesn't forecast my vote tomorrow." She said she shared many of the same concerns of other Republicans that the legislation potentially might lead to "vast governmental bureaucracies and governmental intrusions" (Edney, CongressDaily, 10/13).

Rockefeller

Sen. Jay Rockefeller (D-W.Va.), one of two committee Democrats who declined to endorse the bill prior to Tuesday's vote, also voted for the bill. Rockefeller increasingly expressed concern that the bill -- considered to be the most conservative of all five bills in Congress -- would fall short of providing adequate access to all U.S. residents through a government-administered public insurance plan.

The bill omits a public plan in favor of creating a network of not-for-profit health cooperatives, which Rockefeller and several other panel Democrats had rejected (The Hill, 10/13).

Obama and Reid Praise Vote, Snowe

Speaking in the White House Rose Garden after the vote, President Obama also acknowledged that although the Finance Committee's bill is "not perfect," it marks "a critical milestone" in the push for health reform.

"We are now closer than ever before to passing health reform. But we're not there yet. ... Now's the time to dig in and work even harder to get this done," he added (Montgomery/Murray, Washington Post, 10/14).

Obama praised the Finance Committee "for plowing forward" and said Snowe has been "extraordinarily diligent."

Senate Majority Leader Harry Reid (D-Nev.) also praised Snowe for supporting the bill "in the face of immense pressure from opponents of reform," adding that her "courage to stick with her principles ... is heartening and should serve as a reminder that health care is an issue that should defy party labels" (The Hill, 10/13).

Is Budget Reconciliation Off the Table?

In an interview with Politico's "Live Pulse" after Tuesday's vote, Baucus said that he was "satisfied the bill passed by a good margin," adding that Snowe's vote for the bill made it "clear we are not going to have reconciliation on the floor, which is a big relief" (Budoff Brown, "Live Pulse," Politico, 10/13).

Over the summer, Reid suggested that if bipartisan talks failed, Democrats would use the budget reconciliation process, requiring only a 51-vote majority instead of the usual 60, to push through legislation in the Senate (California Healthline, 9/8).

Beginning the Merger

Senate Majority Leader Harry Reid (D-Nev.) will begin merging the chamber's two health reform bills today, a process that is expected to take at least one week, CQ Today reports.

The merged bill is expected to come to the Senate floor the week of Oct. 26, after it is scored by the Congressional Budget Office, according to a senior aide to Democratic leadership (Armstrong, CQ Today, 10/13).

When combining the bills, Reid will be joined by Finance Committee Chair Max Baucus (D-Mont.) and Sen. Christopher Dodd (D-Conn.), who helped shepherd the HELP panel's bill through committee. White House Chief of Staff Rahm Emanuel and Director of the White House Office of Health Reform Nancy-Ann DeParle also are slated to attend meetings (Wayne, CQ Today, 10/13).

According to Time, White House Legislative Director Phil Schiliro, Deputy White House Chief of Staff Jim Messina and White House Office of Management and Budget Director Peter Orszag also are expected to give input during the process (Newton-Small, Time, 10/14).

No members of the GOP have been invited to contribute to the merging of the bills (Wayne, CQ Today, 10/13).

Emanuel Pledges Swift Progress

On Tuesday in an appearance on PBS' "NewsHour with Jim Lehrer," White House Chief of Staff Rahm Emanuel said he and other White House officials are ready to "be up on [Capitol] Hill immediately" to start merging the House committee bills and the two Senate bills, Roll Call reports (Koffler, Roll Call, 10/13).

Key Issues

Reid and the Democratic leadership will face several difficult issues when merging the two bills, including whether to include:

• A government-run public plan option;
• An employer mandate to provide insurance to their workers; and
• A provision giving FDA authority to approve generic competitors to advanced protein-based drugs known as biologics.

There is also disagreement over how much insurers should be permitted to charge older customers (Wayne, CQ Today, 10/13).

According to CQ Today, floor action could last several weeks.

Democrats and Republicans are expected to debate numerous issues, and some believe the GOP will mount several filibusters -- possibly delaying final passage of the bill into November (Armstrong, CQ Today, 10/13).