(Against the backdrop of Montana’s belief that the best government is the least government, Sen. Max Baucus is pushing a health plan that relies on federal support. NBC’s Kerry Sanders reports.)
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Let's start out with who the Gang of Six are:
DEMOCRATS:
Sen. Max Baucus (Mont.), chairman
Sen. Jeff Bingaman (N.M.)
Sen. Kent Conrad (N.D.)
Baucus and Conrad are moderates and have not been as adamant about pursuing the public option as liberals in their party. Conrad has floated the alternative of co-ops -- privately owned entities that could help bring costs down -- but the concept has not caught on with many.
REPUBLICANS:
Sen. Mike Enzi (Wyo.)
Sen. Charles Grassley (Iowa)
Sen. Olympia Snowe (Maine)
Enzi and Grassley are conservatives who have stressed they will not vote for a bill that includes universal coverage and either tax increases or Medicare cuts. Snowe, a moderate, has recently emerged with a compromise that does not include the public option at the start, but would have a trigger that would create a public option if particular conditions are not met over a period of time.
THE ISSUES:
While the health care debate raged across the country over the summer, the Gang of Six continued to work on a solution. However their cooperative nature showed cracks at the end of last month. Perhaps the worst was when Democrats called out Grassley, who is up for re-election next year, for his fundraising letter asking people for "support in helping me defeat Obama-care." White House senior adviser David Axelrod replied that Grassley's statements "were not exactly consistent with good-faith negotiations."
Baucus set a deadline of Sept. 15 to draft the committee's bill. With the differences among the Gang of Six and the political land mines their decisions face, the bill might look more like a patchwork for some votes than a consensus for many. Should the plan include Snowe's "trigger" compromise, it might appeal to moderates -- including Maine's other Republican senator, Susan Collins -- as well as liberal Democrats, helping garner at least 60 votes in the full Senate.
Should the bill exclude the public option, a pivotal vote on the Finance Committee might come from New Jersey Democrat Robert Menendez, who has been vocal in supporting the public option. His stance might be a bellwether to see how other liberals will vote.
Fines proposed for going without insurance
Americans would be fined up to $3,800 for failing to buy health insurance under a plan that circulated in Congress on Tuesday as divisions among Democrats undercut President Barack Obama's effort to regain traction on his health care overhaul.
As Obama talked strategy with Democratic leaders at the White House, the one idea that most appeals to his party's liberal base lost ground in Congress. Prospects for a government-run plan to compete with private insurers sank as a leading moderate Democrat said he could no longer support the idea.
The fast-moving developments put Obama in a box. As a candidate, he opposed fines to force individuals to buy health insurance, and he supported setting up a public insurance plan. On Tuesday, fellow Democrats publicly begged to differ on both ideas.
Democratic congressional leaders put on a bold front as they left the White House after their meeting with the president.
"We're re-energized; we're ready to do health care reform," said Senate Majority Leader Harry Reid of Nevada.
House Speaker Nancy Pelosi, D-Calif., insisted the public plan is still politically viable. "I believe that a public option will be essential to our passing a bill in the House of Representatives," she said.
After a month of contentious forums, Americans were seeking specifics from the president in his speech to a joint session of Congress on Wednesday night. So were his fellow Democrats, divided on how best to solve the problem of the nation's nearly 50 million uninsured.
The latest proposal: a 10-year, $900-billion bipartisan compromise that Sen. Max Baucus, D-Mont., a moderate who heads the influential Finance Committee, was trying to broker. It would guarantee coverage for nearly all Americans, regardless of medical problems.
But the Baucus plan also includes the fines that Obama has rejected. In what appeared to be a sign of tension, White House spokesman Robert Gibbs pointedly noted that the administration had not received a copy of the plan before it leaked to lobbyists and news media Tuesday.
Time is running out....
The Baucus plan would require insurers to take all applicants, regardless of age or health. But smokers could be charged higher premiums. And 60-year-olds could be charged five times as much for a policy as 20-year-olds.
Baucus said Tuesday he's trying to get agreement from a small group of bipartisan negotiators in advance of Obama's speech. "Time is running out very quickly," he said. "I made that very clear to the group."
Some experts consider the $900-billion price tag a relative bargain because the country now spends about $2.5 trillion a year on health care. But it would require hefty fees on insurers, drug companies and others in the health care industry to help pay for it.
Just as auto coverage is now mandatory in nearly all states, Baucus would require that all Americans get health insurance once the system is overhauled. Penalties for failing to do so would start at $750 a year for individuals and $1,500 for families. Households making more than three times the federal poverty level — about $66,000 for a family of four — would face the maximum fines. For families, it would be $3,800, and for individuals, $950.
Baucus would offer tax credits to help pay premiums for households making up to three times the poverty level, and for small employers paying about average middle-class wages. People working for companies that offer coverage could avoid the fines by signing up.
The fines pose a dilemma for Obama. As a candidate, the president campaigned hard against making health insurance a requirement, and fining people for not getting it.
"Punishing families who can't afford health care to begin with just doesn't make sense," he said during his party's primaries. At the time, he proposed mandatory insurance only for children.
Public Option in doubt
White House officials have since backed away somewhat from Obama's opposition to mandated coverage for all, but there's no indication that Obama would support fines.
One idea that Obama championed during and since the campaign — a government insurance option — appeared to be sinking fast.
House Majority Leader Steny Hoyer, D-Md., told reporters a Medicare-like plan for middle-class Americans and their families isn't an essential part of legislation for him. Hoyer's comments came shortly after a key Democratic moderate said he could no longer back a bill that includes a new government plan.
The fast-moving developments left liberals in a quandary. They've drawn a line, saying they won't vote for legislation if it doesn't include a public plan to compete with private insurance companies and force them to lower costs.
Rep. Mike Ross, D-Ark., who once supported a public option, said Tuesday that after hearing from constituents during the August recess, he's changed his mind.
"If House leadership presents a final bill that contains a government-run public option, I will oppose it," Ross said.
House Democrats are considering a fallback: using the public plan as a last resort if after a few years the insurance industry has failed to curb costs.
Non-profit Co-ops
Obama's commitment to a public plan has been in question and lawmakers hoped his speech to Congress would make his position on that clear.
Baucus is calling for nonprofit co-ops to compete in the marketplace instead of a public plan.
An 18-page summary of the Baucus proposal was obtained by The Associated Press. The complex plan would make dozens of changes in the health care system, many of them contentious. For example, it includes new fees on insurers, drug companies, medical device manufacturers and clinical labs.
People working for major employers would probably not see big changes. The plan is geared to helping those who now have the hardest time getting and keeping coverage: the self-employed and small business owners.
Max Baucus to Gang of Six: "Time is running out"
As Congress waits on the president’s health care speech Wednesday, Barack Obama is in the unusual position of waiting on six senators most of the public couldn't pick out in a crowd.
They’ll decide whether Obama has any hope of getting significant Republican votes for health reform — or whether he will have to go it alone with only Democrats, a politically risky path.
Senate Finance Committee Chairman Max Baucus (D-Mont.) gave the bipartisan Gang of Six until 10 a.m. Wednesday to submit ideas on his compromise health reform bill. At that point, he will decide whether to continue the talks or possibly abandon hopes of a broadly bipartisan bill.
The goal is to have a decision ahead of Obama’s speech to a joint session of Congress — and whatever Baucus decides could chart the course of health care reform in the Congress.
Baucus’s compromise bill is, in effect, the last hope to achieve Obama’s goal of getting significant Republican support for an overhaul of the U.S. health care system. But two of the last Republican negotiators, Sens. Chuck Grassley of Iowa and Mike Enzi of Wyoming, have signaled in recent weeks that they might not be able to sign on to a compromise. If not, Baucus said Tuesday he would go ahead with his bill anyway.
“Time is running out very quickly, and I suspect I will be making some decisions very quickly,” Baucus said. “On the one hand, I want to work to get a solution, but I want to make clear that we aren’t going to dally.”
Baucus has proposed legislation that does not include the public insurance option favored by liberals but does include health care cooperatives. He also supports a new tax on health insurers who provide high-cost plans and a new fee on insurance companies to pay for reform, designed to raise $6 billion per year starting in 2010.
Sen. Kent Conrad (D-N.D.), a member of the Gang of Six, said he supports Baucus’s framework. But he cautioned that since the group is waiting on cost estimates from the Congressional Budget Office, it will be hard to reach a final agreement before Obama’s speech.
“It’s very good,” Conrad said. “Very credible, very responsible. Paid for. Bends the cost curve in the right way. Will expand coverage to about 94 percent of the American people. That’s pretty darn good.”
Baucus’s announcement capped a day that was strangely quiet on the health care front, with all sides seeming to sense that anything said before Obama’s speech Wednesday might well be obsolete by the time he finishes his address to Congress.
But if the White House was looking for signs of encouragement ahead of the president’s address, there were few to be found. House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) met with Obama at the White House — and Pelosi emerged from the meeting saying that the public insurance option remains “essential” to passing a bill in the House, despite repeated signals from the White House that Obama doesn’t consider it essential at all.
A leading negotiator for the Blue Dog Democrats, Rep. Mike Ross of Arkansas, said he could no longer support a bill in Congress that included the public option, even though he agreed to a compromise in July that included such a plan. Also, Sen. Ben Nelson (D-Neb.), a key moderate, said it would be tough for him to support a bill that had no Republican support.
“To have any credibility, this has to have as broad of bipartisan support as possible – and I think we get better legislation that way, I think that this is a moderate version now of health care reform compared to the two bills – the House bill and the Senate bill that are there,” Nelson said. “And I think it’s more moderate in part because the chairman is seeking bipartisan support. And bipartisan support may have been sought in the other instances but it wasn’t successful.”
And one of Obama’s top campaign advisers, Steve Hildebrand, channeled the liberal frustration with Obama in an interview with POLITICO, saying Obama “needs to be more bold in his leadership” on health care reform and other topics.
White House press secretary Robert Gibbs declined to preview the speech in detail, beyond saying that members of Congress would know clearly what Obama wants in a bill. Gibbs also said Obama continues to believe that a public health insurance option is a “very valuable tool” to provide needed competition to private insurers — even amid signals that Obama will say he is willing to sign a bill without a public option.
If there was a glimmer of positive news for Obama, it came from Baucus, who kept alive the idea that there could be Republican votes for a health reform bill.
The bipartisan group of six senators met Tuesday for the first time since recess, and going into the meeting, Republicans were noncommittal. Grassley and Enzi declined to say where they were headed on Baucus’s bill, which contains elements that both senators have resisted, including the creation of nonprofit insurance cooperatives.
Sen. Olympia Snowe (R-Maine), who is widely believed to be one of the only Republicans willing to sign on to the Baucus bill, struck a more upbeat note than did her fellow Republicans.
“There are number of promising elements, some of which we have had a consensus on; others we continue to discuss,” Snowe said.
But as to whether she could support the Baucus proposal, Snowe said “that is still premature.”
Baucus gave the president a boost by presenting a plan that broadly overlaps the work of four other committees and by making clear that he intends to move ahead with or without Grassley, his trusted ally on the Finance Committee. Capitol Hill observers had questioned whether Baucus would force the Republicans’ hand after relenting several times to Republican requests for more time.
The talk on K Street and Capitol Hill was that Baucus wants to schedule the committee markup for the week of Sept. 21, which would put the Senate much closer to acting on a bill in October. The Finance Committee would need to pass a bill by the end of this month, leaving time to negotiate a merger with a bill passed by the Senate Health, Education, Labor and Pensions Committee.
Baucus said he has not formally proposed a date to begin the markup but would move ahead soon.
“It just really comes down to a matter of political will to get this put together,” Baucus said. “There are clearly some substantive suggestions that some of the members had. But to be honest, my own view is that a lot of this comes down to political will. I am just hopeful that the president gives his statement tomorrow night and that will help move the ball forward very expeditiously.”
On Republican concerns, Baucus said: “There are a couple of points there that may make sense. I asked each of the five to give several ideas back to me so I can decide what next course of action makes the most sense.”
Senate Republican staffers drafted their critique of the Baucus bill, noting that it still leaves out key cost details, such as how much federal funding the insurance cooperatives would get, and contains other issues that are troubling to Republicans, including an “unsustainable” Medicare expansion, the $900 billion price tag, the lack of a permanent fix to the payment system for physicians, and a “broad expansion of government authority over health care.”
One other aspect of the Baucus’s $900 billion plan that’s likely to be controversial: a mandate that would require every American to either purchase coverage or face a penalty.
Baucus set the fines at a maximum of $950 for an individual and $3,800 for a family above 300 percent of the poverty line. For families at 100 percent to 300 percent of the poverty line, the maximum penalty is $750 for an individual and $1,500 for a family.
Republicans found one provision they liked: allowing younger people to buy only lower-cost catastrophic coverage. “It’s a model we should consider for more people – especially people with higher incomes,” according to the Republican critique of the plan.
At the same time, progressive lawmakers kept up their pressure campaign on Obama over the public option.
“Wednesday night will either mark the beginning of the battle or the sad start of a retreat,” Rep. Anthony Weiner (D-N.Y.) said. “Only the president can decide which.”
During a conference call last week with the president, progressives and members of the Congressional Black Caucus told Obama it was too early to offer concessions, particularly any that would trim programs from lower-income communities.
“A health reform bill without a robust public option will not achieve the health reform this country so desperately needs,” Weiner said. “We cannot vote for anything less.”
Key Senators Discuss Trimming Health Bill
Senate health-care negotiators agreed late Thursday to ignore the increasingly strident rhetoric from Republican and Democratic leaders and to keep working toward a bill that can win broad support from the rank-and-file in both parties, according to sources familiar with the talks.
In a conference call, the three Democratic and three Republican members of the Senate Finance Committee agreed to redouble their efforts to craft a less costly alternative to the trillion-dollar initiatives so far put forward in Congress. They discussed the possibility of also reining in the scope of their package, the sources said.
The senators rejected the idea of imposing a deadline on their negotiations, and they agreed to talk again Sept. 4 -- four days before lawmakers are scheduled to return to Washington from their August break. The consensus, one participant said, was "to take your time to get it right."
In a written statement released after the approximately 90-minute teleconference, Sen. Max Baucus (D-Mont.), chairman of the finance panel, said the group had "a productive conversation" and that they "remain committed to continuing our path toward a bipartisan health-care reform bill."
"Our discussion included an increased emphasis on affordability and reducing costs, and our efforts moving forward will reflect that focus," he said.
Before leaving for the month-long recess, Baucus had pegged the cost of the negotiators' ideas at less than $900 billion over the next decade. Thursday's discussions focused on driving that cost lower, the sources said.
The senators also shared tales from their home states, where some lawmakers have been besieged by protesters angry about a potential government takeover of the nation's health-care system.
Attention has focused for the past week on the prospects of the Finance Committee negotiators' talks, after the senior Republican member, Sen. Charles E. Grassley (Iowa), infuriated some Democrats by refusing to debunk a false rumor that the House's health-care bill would spawn "death panels," empowered to decide whether the sick and the old get to live or die.
Other leading Republicans -- including Senate Minority Whip Jon Kyl (Ariz.) and House Minority Leader John A. Boehner (Ohio) -- seemed to press the attack, asserting that no Republican would ever vote for many of the key features of President Obama's health-care overhaul.
Grassley has since denied trying to undermine the reform effort, and his Democratic colleagues said there was no partisan rancor in Thursday night's conference call. Meanwhile, congressional Democrats said the finance panel will be allowed to keep trying to hash out a deal for at least several more weeks.
In a radio interview broadcast from the White House Thursday afternoon, Obama reasserted his commitment to working with Republicans on health reform, saying: "My attitude has always been, let's see if we can get this done with some consensus. I would love to have more Republicans engaged and involved in this process." But Obama said he believes some Republicans have decided, " 'Let's not give them a victory and maybe we can have a replay of 1993-94.' . . . I think there are some folks who are taking a page out of that playbook."
Before heading out of town on vacation, the president planned to meet Friday with former Senate majority leader Tom Daschle, a consummate legislative strategist who had been the president's first choice to lead the administration's drive for health reform.
"We are willing to make compromises," Obama told his radio audience. But he said he is not willing to give up on "core principles."
Obama tried to clear up what he described as confusion surrounding his health-care proposal. He described the public option -- a government-run provider -- as only a small, and optional, part of his overall initiative.
"What we've said is, we think that's a good idea," Obama said of publicly funded health insurance. "We haven't said that's the only aspect."
Obama repeated his aides' contention that the White House continues to regard a public option as not essential. "The press got a little excited, and some folks on the left got a little excited," he said. "Our position on this hasn't changed."
Lawmakers from both parties have voiced resistance to the public option proposal, but liberal Democrats have been increasingly outspoken in their conviction that it must remain intact for health-care reform to be meaningful.
House Speaker Nancy Pelosi (D-Calif.) declared Thursday that a government-run health insurance program is mandatory in a House bill, and she knocked down speculation that any health-care bill from her chamber might be watered down before it is brought to a vote, presumably in September.
"I don't know how you would scale it down," Pelosi said in San Francisco. "There's no way I can pass a bill in the House of Representatives without a public option." The bill has passed out of three House committees, in each case including a public option.
Pres. Obama was a guest of Philadelphia-based radio talk show host Michael Smerconish, a contrarian, sometimes right-leaning commentator who broke ranks with conservatives last year to support the president in the election. Later in the day, Obama participated in a forum with supporters at the Democratic National Committee headquarters on the same subject.
Sources: MSNBC, Politico, Washington Post, Whitehouse.gov, NBC San Diego, NJ.com, Wikipedia
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