Sen. Max Baucus spent the past few months trying to negotiate a compromise health care overhaul package that would have bipartisan support. But when Baucus, the Senate Finance Committee chairman, finally released the details of his massive bill on Wednesday, there was no sign of Republican backing.
Many Democrats are worried that Baucus offered far too many concessions to Republicans — most notably dropping the idea of a government-run health care plan to compete with private insurers — without securing any firm support from across the aisle.
The top selling point of the Baucus bill was supposed to be its bipartisan appeal. Without some Republican support, Baucus' version could end up adding to the cacophony of competing proposals passed by several committees in the House and Senate.
Baucus (D-MT) did manage to hold the cost down below that of the other bills. The nonpartisan Congressional Budget Office estimated the cost at $774 billion over 10 years, while the Finance Committee put it at $856 billion. Either way, the price tag likely remains too high for most Republicans.
Wyoming Republican Sen. Mike Enzi had been involved in the negotiations with Baucus as part of the "Gang of Six" trying to reach a consensus, but he rejected the current version. "The proposal released today still spends too much, and it does too little to cut health care costs for those with health insurance," Enzi said in a statement.
Baucus is still hoping to attract at least one Republican vote when the committee votes on the measure, which could happen as early as next week.
"By the time the Finance Committee votes on final passage for health care reform, I think you will find Republican support," Baucus said at a press conference. "This is a very balanced bill."
There are some signals that Republican Sen. Olympia Snowe of Maine is still considering whether to support the compromise. But other Republicans sound unalterably opposed to it. Senate Minority Leader Mitch McConnell has already blasted the bill as a "partisan proposal."
The Bill's Implications
The new bill is notably more moderate, and less expensive, than the proposals passed by other committees in the House and Senate. Instead of the so-called public option, Baucus wants to create a network of private, nonprofit health care cooperatives that could compete with private insurance. The bill would provide $6 billion in seed money to assist with start-up costs.
Baucus did meet President Obama's cost target of $900 billion or less over a decade. But many Democrats have said that the cuts made to reach the target could end up hurting the ability of lower-income Americans to afford health care.
The bill does have sweeping implications for individuals, insurance companies and employers:
--Individuals. Almost all Americans would be required to obtain health care coverage, or pay significant fines. Some exceptions would apply for those with certain religious objections. Starting in 2013, tax credits would be offered to help low- and middle-income Americans afford coverage.
Consumers will be able to shop for and compare insurance plans in new exchanges, which would be Web portals created by state governments within federal guidelines.
--Insurers. The bill eventually bans carriers from limiting coverage based on pre-existing conditions.
Also, insurance companies and plan administrators would have to pay an excise tax on plans that cost more than $8,000 for individuals and $21,000 for families. Baucus says that this provision is a central mechanism to help pay for extending coverage to the currently uninsured, but many Republicans are leery of taxing these so-called Cadillac plans at such a high rate.
--Employers. Companies would not be required to provide insurance for their workers, but firms with more than 50 employees would face stiff fines if they don't offer health care coverage. Baucus did include some tax credits and other measures aimed at encouraging small businesses to offer insurance plans.
--The health care industry. To help pay for the full package, the bill includes new annual fees that will be charged to pharmaceutical manufacturers, medical device manufacturers, health insurance providers and clinical laboratories. Finance Committee staffers say the fees, which will be allocated across the industries according to market share, are aimed at recouping some of the profits these firms will make from millions of new taxpayer-subsidized customers.
On the controversial issue of illegal immigrants and health care, which prompted the "you lie" outburst during Obama's recent speech to Congress, Baucus is walking a fine line. Individuals seeking tax credits to purchase health care coverage through new state exchanges would be required to provide their Social Security number and date of birth to prove their eligibility. But the measure appears to fall short of the demands for tougher checks demanded by some Republicans.
One Vote
In releasing the bill, Baucus defended it as a sensible compromise.
"It represents an effort to reach common ground and a real chance for health care reform," Baucus said. "And it is a balanced, common-sense bill that can pass the Senate."
But even Sen. Chuck Grassley, the ranking Republican on the Finance Committee, has already signaled displeasure.
"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 that we set forth when this process began," he said.
Democrats hope they will still be able to attract some Republican support before the committee votes. They need at least one Republican vote — and no Democratic defections — to avoid a filibuster.
Copyright 2022 NPR. To see more, visit https://www.npr.org. 9(MDAzMjM2NDYzMDEyMzc1Njk5NjAxNzY3OQ001))
