Senate’s Reform Bill Likely Won’t Include Medicare Buy-In Option
On Monday night, Senate Democrats appeared ready to jettison a Medicare buy-in proposal for people ages 55 to 64 in order to garner the 60 votes needed to overcome a threatened filibuster of the chamber's health reform bill (HR 3590), Politico reports (Budoff Brown/Raju, Politico, 12/14).
The Medicare expansion proposal was part of a compromise on the bill's public health insurance plan that was reached last week by five moderate and five liberal Senate Democrats.
After dropping a public plan from the chamber's health care reform bill, negotiators added the Medicare buy-in proposal as a means to appease liberals who adamantly support including a public option (Levey/Hook, Los Angeles Times, 12/15).
On Sunday, Sen. Joseph Lieberman (I-Conn.) -- a critical vote in the health reform effort -- said on CBS' "Face the Nation" that he would not support a bill that included the Medicare buy-in, a point he reiterated privately to Majority Leader Harry Reid (D-Nev.).
After White House Chief of Staff Rahm Emanuel reportedly urged Reid to cut a deal with Lieberman, the senator held a caucus meeting on Monday night largely to address concerns about the proposal and stress the importance of passing health reform legislation this year (Politico, 12/14).
Following the meeting, Reid said, "Democrats are not going to let the American people down," adding, "I am confident that by next week, we will be on our way to final passage" (Murray/Montgomery, Washington Post, 12/15).
Reid would not confirm or deny whether the Medicare buy-in proposal was being dropped from the bill, saying that he is waiting on the final score from the Congressional Budget Office (Politico, 12/14).
According to the Washington Post, the CBO score is expected to come out today at the earliest (Washington Post, 12/15).
After the caucus meeting, Senate Finance Committee Chair Max Baucus (D-Mont.) was asked whether it seems likely that the Medicare buy-in proposal will be stricken from the legislation. He responded, "It's looking like that's the case" (Hulse/Pear, New York Times, 12/15). "It's just a matter of getting support from 60 senators, and that seems to be a condition that's necessary to get to 60," Baucus added (Pierce/Drucker, Roll Call, 12/14).
Most Democratic senators left the caucus meeting agreeing that the Medicare plan should not impede the overall goal of passing health reform.
Senate Health, Education, Labor and Pensions Committee Chair Tom Harkin (D-Iowa) said, "This bill, in and of itself -- without the public option, without Medicare buy-in -- is a giant step forward for transforming America's health care system," adding, "There's enough good stuff in this bill that we should move ahead with it" (Wayne/Armstrong, CQ Today, 12/14).
Sen. Jay Rockefeller (D-W.Va.), one of the leading liberal negotiators who strongly supports a public plan, said, "We're not going to get all that we want. But we're going to get so much more than we have" (Washington Post, 12/15).
According to the Los Angeles Times, the only remnant of a public option likely to remain in the Senate bill is a "trigger" proposal that would institute a public plan only if new not-for-profit insurance exchanges fail to control costs and provide adequate competition to private insurers (Los Angeles Times, 12/15).
Removing the public plan and the Medicare buy-in proposal leaves Reid with limited choices as to how to move the bill forward.According to CQ Today, with the Christmas recess quickly approaching, Reid likely will not have enough time to gather a new group of Senate negotiators to find yet another compromise and will instead be forced to choose an already-proposed option (CQ Today, 12/14). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.