Pressure began to build on Democratic lawmakers seeking to pass healthcare reform to make some sort of concrete progress.
As Democrats talk reform ...
... GOP gets ball rolling with insurance-related bills
Republican lawmakers beat them to the punch by introducing their own healthcare bill last week, while closed-door meetings by the powerful Senate Finance Committee on the matter yielded no agreement on how to proceed.
But Democratic leaders say that congressional meetings focused on introducing a reform bill have been productive.
On May 20, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Sen. Chuck Grassley (R-Iowa), the committees ranking member, held a private meeting to discuss ways to pay for a broad overhaul of the U.S. healthcare system. Eight hours later, they jointly called the session productive but tempered expectations that an agreement could be reached on some of the more controversial initiatives now under discussion.
The meeting officially completed a trilogy of so-called legislative walkthroughs, where lawmakers, staffers and other invited guests go over measures that could become the building blocks for a massive healthcare reform bill due later this summer. The goal, they say, is to determine whats viable and what isnt in a bipartisan fashion.
So far it has been a heavy lift, but Baucus insists there has been movement. You can feel a convergence in what we all have to do, he said. Its clear that some measures are starting to evolve toward a little more agreement than othersif not consensus.
One area of apparent agreement is that an effort to expand health insurance coverage would not include undocumented immigrants. In talking about it, Baucus called the issue a political land mine. Were not going to cover undocumented aliensundocumented workers, he told reporters one day after the private committee meeting. Its too politically explosive.
The comments were made after the senator was asked about the chances that a bill could achieve universal health coveragea provision both the American Hospital Association and Americas Health Insurance Plans have said would be crucial to an overhaul of the U.S. healthcare system.
Government estimators have said that upward of 94% of Americans could be covered under proposals now being considered. That number, if reached, would help hospitals, which lose billions of dollars each year when they treat the uninsured. A portion of those losses are then passed on to those who have insurance, adding on the low end about $1,100 to premium costs, Baucus said.
Amanda Engler, a spokeswoman for the Texas Hospital Association, said that such an exclusion would hit border states the hardest, though others would also feel the pinch.
Also under discussion is tax-exemption for not-for-profit hospitals (See story below).
Separately, in a May 21 letter sent to members of the Senate, the AHA said that its members have expressed resounding concern that a public health plan option could exacerbate the underpayment of providers by paying rates at Medicare or Medicaid levels. Both government programs pay providers less than the actual cost of care, and a proposed payment rule would shave another $22 billion in hospital payment over the next decade, the AHA said.
Last week, two groups that have been crucial in building on-the-ground support for a health reform bill wavered in their backing for a number of tax provisions that lawmakers are eyeing to help pay for the effort. The Service Employees International Union and Health Care for America Now, along with Citizens for Tax Justice, offered an alternative list of tax increases that would put the onus on the top income earners in the U.S. rather than the middle or lower classes.
At issue are a series of proposed tax hikes on everything from sugar-based soft drinks to alcoholic beverages.
Most pressing to the labor groups, however, are proposals that would cap an exclusion for employer-provided health insurance based on the value of the health plan or employee income or both.
Such exclusions likely would hit workers in states where unions tend to be the strongest, though others, too, would be crunched, said Anna Burger, secretary treasurer of the SEIU.
I think this is not a popular issue with workers in America, Burger said on a conference call.
Meanwhile, it was a group of Republicans from both the House and Senatemany of them on the very committees now engaged in the health reform effortthat fielded one of the first bills to reshape the health system. Introduced by Sens. Richard Burr of North Carolina and Tom Coburn of Oklahoma, and Reps. Paul Ryan of Wisconsin and Devin Nunes of California, the bills would give individual or grouped states broad authority to create and manage an open-market insurance exchange while giving individuals and families a tax credit of up to $5,700 to help pay for coverage.
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