Wednesday Is the Day for Release of Senate Panel’s Health Reform Proposal
On Monday, Senate Finance Committee Chair Max Baucus (D-Mont.) said that the bipartisan "Gang of Six" negotiating group needed more time to discuss several outstanding details of its health reform bill and that the measure would be released on Wednesday, a day later than he originally anticipated, The Hill reports.
Still, Baucus assured, "We're on track to release the mark this week and have the markup next week" (Young , The Hill, 9/14).
According to the AP/Atlanta Journal-Constitution, members of the negotiating group emerged from a Monday meeting having "narrowed their differences on a host of difficult issues" -- such as prohibiting federal subsidies for undocumented immigrants to obtain health coverage and ensuring that federal dollars are not spent to provide abortion services -- in their bid to reach a bipartisan agreement on the bill (Alonso-Zaldivar, AP/Atlanta Journal-Constitution, 9/15).
Senate Budget Committee Chair Kent Conrad (D-N.D.), a member of the Gang of Six, said that the group's six members have between 12 and 15 concerns that still need to be addressed (Edney/Hunt, CongressDaily, 9/15). However, Conrad said the group was close to reaching consensus on:
A verification system to prevent undocumented immigrants from receiving federal assistance to purchase insurance;
Ways to lower the cost of a proposal to extend Medicaid eligibility to 133% of the federal poverty level; and
The federal government's providing states with funds to test various initiatives as part of broad reforms to current medical malpractice laws.
Abortion Coverage Still an Issue
On the issue of abortion, the negotiating group currently is working to develop more specific language on existing rules that ban federal funding for abortions, except in cases of rape, incest or when a woman's life is in danger (AP/Atlanta Journal-Constitution, 9/15).
Baucus noted that he is seeking "neutral" language that "maintains the status quo," adding, "I think it's important to remember here that this is a health care bill and not an abortion bill" (Pierce, Roll Call, 9/14).
According to the New York Times, committee documents reveal that negotiating group member Sen. Jeff Bingaman (D-N.M.) has told colleagues that the committee's bill should "remain silent" on the issue of abortion (Pear/Herszenhorn, New York Times, 9/15).
Gang of Six To Meet With Governors To Address Medicaid Expansion Concerns
On Tuesday, the Gang of Six is expected to hold meetings with governors of several states about the Medicaid expansion plan. Many governors have expressed concern that the expansion would create unsustainable financial burdens for their states.
Baucus said Monday, "States are going to be pleasantly surprised that they will have some additional costs but much less than they originally thought" (Whitesides/Smith, Reuters, 9/14).
CBO Says Bill Would Cost $880B Over 10 Years
The Congressional Budget Office has estimated that Baucus' framework for the bill, which he circulated earlier this month, would cost less than $880 billion over 10 years (Herszenhorn, "Prescriptions," New York Times, 9/14).
According to the Washington Post, the bipartisan negotiators were able to lower the cost of the proposal "to a more politically palatable" figure by reducing the size and breadth of subsidies intended to help U.S. residents purchase health coverage (Montgomery/Murray, Washington Post, 9/15).
Subsidies Could Be a Sticking Point in Negotiations
According to CongressDaily, those subsidies could still be a sticking point because some Democrats on the negotiating committee still are concerned with the benchmarks set to invoke the help.
Under Baucus' framework, the tax credits would be enacted on a sliding scale for U.S. residents whose incomes are up to 300% of the federal poverty level. For those with incomes at 300% of FPL, they would receive the tax credit only if they spent more than 13% of their income on health insurance, while people whose incomes were at FPL would have to spend only 3% of their income on coverage to trigger the credit (CongressDaily, 9/15).
CBO Will Score Bill Over 20-Year Period
On Monday, Conrad also announced that CBO likely would provide an additional cost score of the Finance Committee's bill over a 20-year time frame, as opposed to the usual 10-year period, CQ Today reports.
According to CQ Today, proponents say that a 20-year score would provide a broader perspective on the bill's long-term fiscal impact, and in turn alleviate the concerns of lawmakers and the public (Clarke, CQ Today, 9/14).
Republican Concerns Persist
The Times on Tuesday also examined some of the significant changes that Senate Finance Committee ranking member Chuck Grassley (R-Iowa) and Sen. Mike Enzi (R-Wyo.) have requested in Baucus' framework and how those changes could reduce "the chances that [Baucus] can win their support."
According to the Times, Grassley and Enzi explained their concerns with some of the bill's current provisions in documents that were recently delivered to Baucus (New York Times, 9/15).
Baucus has pledged to issue a reform plan that addresses the concerns of Republicans on the negotiating group and in general as part of his effort to reach a bipartisan consensus on the bill, the Post reports (Washington Post, 9/15).
According to The Hill, Baucus in the past few months has been courting Republican support to ensure the bill gets the 60 votes it needs to avoid a filibuster (Young , The Hill, 9/14).
During the Monday meeting, Baucus requested that staff members leave the room so that he could more accurately gauge Republican support for the bill, CongressDaily reports.
Baucus reiterated that he expects to begin markup of the bill on Sept. 21 (CongressDaily, 9/15).
Democrats Suggest 'Tug of War' Over Bill
On Monday night, several Senate Democrats after a private meeting with Baucus said that the Gang of Six's reform bill could meet resistance, particularly from Finance Committee Democrats who have not been involved in its development, the AP/Boston Globe reports (Werner, AP/Boston Globe, 9/14).
After the meeting, Sen. John Kerry (D-Mass.) said, "There will undoubtedly be amendments in the committee process -- and probably a lot of them," adding, "There'll be some big fights over different components of [the bill]" (Young , The Hill, 9/14).
Kerry also said, "We are going to have a tug of war," adding that the bill would be a "starting point" for a new round of negotiations on details with Democrats (Hitt/Weisman, Wall Street Journal, 9/15).Baucus conceded that the markup of the bill, expected to commence next week, would be a busy one but he said he believed Democrats would largely support the package without significant changes (Young , The Hill, 9/14). 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.