(Sen. Evan Bayh, D-Ind., joins the Morning Joe gang to discuss Health Care Reform just hours before the release of Max Baucus' committee's bill.)
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(Pres. Obama administration has exposed the greed of Health Care Insurance companies. No wonder they're angry.)
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(Is it safe to say that the G.O.P.'s agenda involves stopping Health Care Reform because it benefits them personally? Yeah!)
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Max Baucus releases Health Care Bill
Senate Finance Committee chairman Max Baucus (D-Mont.) proposed an $856 billion plan Wednesday to overhaul the health care system, releasing a bill after months of bipartisan negotiations without any immediate Republican support.
The bill forces insurance companies to change the way they do business, such as prohibiting them from dropping or denying coverage based on preexisting conditions. To force competition with private insurers, Baucus chose creating nonprofit consumer-owned cooperatives over the public insurance option, which most Democrats prefer.
“This is a unique moment in history where we can finally reach an objective so many of us have sought for so long,” Baucus said in a statement this morning. “We worked to build a balanced, common-sense package that ensures quality, affordable coverage and doesn’t add a dime to the deficit.”
The long-awaited bill sets off a battle over what could be the shape of a health reform deal that wins at least one or two Republicans votes in the Senate. By trying to add measures to appeal to some
Democrats and some Republicans, Baucus has managed to upset all sides. But what he came up with could be viewed as the kind of balanced approach that threads the needle to achieve a final compromise.
None of the three Republicans involved in the bipartisan negotiations have signed onto the bill, saying there are outstanding issues that need to be resolved. But they said they would continue talking with Baucus and the other two Democrats in the so-called Gang of Six.
The lack of Republican support — at the outset, at least — suggests Democrats will need to make more concessions if they hope to produce a bipartisan bill. Otherwise, the Senate leadership may have to use a last-ditch procedural maneuver known as reconciliation to move the bill through the chamber with 51 votes.
The absence of Republicans could also damage President Barack Obama's efforts to convince Americans that his reform plan has broad support.
The Finance Committee markup is expected to begin Tuesday. Baucus will meet Thursday with the full committee, and amendments will be due Friday at 5 p.m.
The Baucus plan is a more conservative approach than those produced by three committees in the House and by the Senate's Health, Education, Labor and Pensions Committee, but it tracks closely with the concepts that Obama promoted in his speech to Congress last week. The bill is deficit neutral and fully paid for, and less costly than bills approved by other committees.
Baucus chose an alternative to the public insurance option – nongovernmental consumer cooperatives – to provide competition with private insurers.
The bill requires individuals to buy insurance, or else face penalties as high as $3,800 for a family. It would not mandate businesses to provide coverage for their employees – as the House bills do – but it would require them to defray the cost of any government subsidies for which their employees would qualify.
To pay for the overhaul, the legislation calls for imposing a 35 percent excise tax on high-end insurance plans, assessing fees on industry players, including device manufacturers, insurers and clinical laboratories, and making a series of tax code changes.
The bill expands Medicaid coverage to include adults whose incomes are 133 percent above the poverty line, and requires states to pick up more of the tab for the federal-state cost-sharing program.
Government subsidies would be available to families between 100 percent and 300 percent of the poverty line to purchase insurance plans through a new marketplace known as an exchange.
For families with incomes 300 percent and 400 percent of poverty, their annual premiums would be capped at 13 percent of their income. It’s a level that Sen. Ron Wyden (D-Ore.) says is too high, but it would be less than the current average cost of a family insurance plan, which is $13,375, according to the Kaiser Family Foundation.
Sen. Olympia Snowe (R-Maine), the likeliest Republicans to support the bill, said she is waiting for cost estimates from the Congressional Budget Office, which she has not yet seen.
"Hopefully at some point through the committee process we can reach an agreement," Snowe said Tuesday.
Sen. Chuck Grassley (R-Iowa) released a statement Tuesday that was silent on his ultimate decision, but the tone of his message does not bode well for Baucus’s hopes of bringing him on board.
He ticked off a long list of concerns, saying the bill “does not meet the shared goals for affordable, accessible health coverage,” and it does not resolve outstanding issues dealing with abortion and illegal immigration. He suggested the bill does not include his alternative proposal to the individual mandate, nor does it include stronger medical liability reform measures he had pushed.
“We’ve been clear from the start that we’re willing to stay at the table,” Grassley said. “There’s no reason not to keep working until we get it right. In the end, legislation that impacts every American should have strong bipartisan support.”
Senate Health Bill Draws Fire on Both Sides
The top Republican on the Senate Finance Committee said Tuesday that he could not support sweeping health care legislation drafted in more than three months of bipartisan negotiations by the chairman of the panel, and several liberal Democrats criticized the bill from the other side of the political spectrum.
The statement by the Republican, Senator Charles E. Grassley of Iowa, came just as the chairman, Senator Max Baucus, Democrat of Montana, put the final touches on his bill to provide health benefits to millions of the uninsured.
“Unfortunately,” Mr. Grassley said, “we’re operating under an artificial deadline set by the Democratic leadership and the White House. I’m disappointed because it looks like we’re being pushed aside by the Democratic leadership so the Senate can move forward on a bill that, up to this point, does not meet the shared goals for affordable, accessible health coverage.”
Mr. Grassley, who participated in the bipartisan negotiations, said he wanted to lower the overall cost of the bill. In addition, he said he wanted stronger guarantees that federal money would not be used to pay for abortions or to subsidize health insurance for illegal immigrants, and he is seeking unspecified “medical malpractice reforms.”
At the same time, Mr. Grassley said he hoped to “stay at the table” working with Democrats. “Legislation that impacts every American should have strong bipartisan support,” he said.
For their part, liberal Democrats said Mr. Baucus’s bill did not go far enough to make insurance affordable to people with low and moderate incomes.
One of the Democrats, Senator John D. Rockefeller IV of West Virginia, said he could not vote for the bill in its current form, in part because it did not include a new government insurance plan to compete with private insurers.
“The way it is now, there’s no way I can vote for the Senate package,” Mr. Rockefeller said.
His comment came just minutes after President Obama’s senior adviser, David Axelrod, met separately with House and Senate Democrats in the Capitol. Mr. Axelrod said it was urgent for Congress to overhaul the health care system, Mr. Obama’s top domestic priority, and he cited public opinion polls to support his contention that Americans shared the president’s view.
Congressional Democrats voiced their concerns as Mr. Baucus prepared to unveil a detailed proposal, on which he wants the panel to vote next week.
Four other Congressional committees have approved health care bills drafted by Democrats and passed without any Republican support.
Democrats expressed a variety of concerns. Representative Charles B. Rangel of New York, the chairman of the Ways and Means Committee, said Mr. Baucus, by paring the cost of the bill, had also cut the subsidies that would help people buy insurance.
“This is reducing coverage for poor and working people,” Mr. Rangel said, adding that such cuts “could destroy the bill.”
The House bill, in its current form, is expected to cost more than $1 trillion over 10 years, while Senate Democrats said the price tag for the Baucus proposal would be $880 billion or less.
Senator Ron Wyden, Democrat of Oregon, said he doubted that subsidies in the Baucus bill would be enough to enable middle-income people to buy insurance without straining family budgets, and he vowed to seek changes.
Senator John Kerry, Democrat of Massachusetts, challenged Mr. Baucus’s plan to help finance coverage of the uninsured by imposing $4 billion a year in fees on manufacturers of medical devices and diagnostic products.
Mr. Baucus’s plan, like the other major bills in Congress, would expand Medicaid to cover childless adults and other people with incomes less than 133 percent of the poverty level ($29,327 for a family of four).
In a telephone conference call with governors on Tuesday, Mr. Baucus said states would have to help pay the cost of covering people newly eligible for Medicaid. But he tried to allay the concerns of governors, who oppose any type of “unfunded mandate.”
Under Mr. Baucus’s proposal, the federal government would pay most of the new Medicaid costs — at least 80 percent in high-income states like Connecticut and 95 percent in poor states like Mississippi.
This represents a significant increase in the federal share. Medicaid is jointly financed by the federal government and the states, and the federal share — not counting extra money provided under the economic stimulus program — ranges from 50 percent to nearly 80 percent.
Mr. Baucus promised aid to states that have already expanded their Medicaid programs along the lines of his proposal. But officials in two such states, Massachusetts and Vermont, said they needed more details about the proposal to know how they would be affected.
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Sources: Politico, NY Times, Washington Post, AP, Google Maps
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