The Senate Finance Committee pushed into its eighth day of negotiations—one of the longest negotiations in its history according to its chairman—before lawmakers ultimately emerged with a health reform package that garnered praise by Democrats even while potentially locking out any Republican support.
On the eighth day ...
Senate bill earns Dem praise; GOP support unlikely
On the final day, which leaked into the early morning hours of Oct. 2, Senate Finance Committee Chairman Max Baucus (D-Mont.) beat back a number of GOP challenges and helped steer passage of a handful of key changes that may leave the biggest imprint yet on legislation meant to reshape the healthcare system.
“We can be very proud tonight of what we have done,” Baucus said. “We are offering a fiscally responsible bill that takes good ideas from both sides of the aisle.”
The half-dozen or so amendments, approved after debate that was at times as contentious as it was passionate, includes measures that will keep intact the State Children's Health Insurance Program, shield middle-class workers from high out-of-pocket costs, and create something akin to a public health plan.
Final passage of the overhaul package is expected this week. As it stands, the committee's blueprint costs a little more than $900 billion over the next 10 years.
The flurry of late-week activity resulted in major legislative initiatives.
Sen. Maria Cantwell (D-Wash.) introduced a measure that gives states the flexibility and funding they need to develop their own health insurance plans. The provision allows states the leeway to use federal dollars to create what would amount to a public health plan for people making between 133% and 200% of the federal poverty level, or $44,100 for a family of four. Anyone under that threshold is eligible for Medicaid under the Senate's bill.
Under the provision, which passed the Senate Finance Committee on a 12-11 vote, state governments could use their share of federal money that otherwise would have gone toward subsidies to negotiate with insurance companies for high-quality, low-cost coverage.
“This hits the sweet spot,” Cantwell said. “It's a public plan, but negotiated with the private sector.” A similar model has been in use in Washington for more than two decades, she said.
If Cantwell's amendment proved pragmatic, then Sen. Jay Rockefeller's (D-W.Va.) eleventh-hour pitch to save the federally backed SCHIP proved passionate.
The Baucus plan would have effectively moved children now enrolled in SCHIP into private health insurance plans as part of an open marketplace called an “exchange.”
Rockefeller said that the move would result in a needless loss of benefits for kids. “I don't think there's any reason to dismantle a program that works,” he said. “Please be reasonable.”
Rockefeller has a long history with the program and its expected demise has fueled his opposition to the reform package.
The plea proved successful. After it was approved on a 12-9-1 vote shortly after midnight, a choked-up Rockefeller launched into a story about how his early days as a volunteer in West Virginia working with the very poor shaped his political underpinnings.
Other lawmakers put their markers down as well. In a rare bipartisan amendment, Sens. Charles Schumer (D-N.Y.) and Olympia Snowe (R-Maine) teamed up to draft a measure that eases the amount of the fine individuals and families have to pay if they don't buy insurance.
The issue centers on the affordability of health plans. Snowe, who represents a critical GOP vote but who has nevertheless stayed noncommittal to the package, said she would rather see the penalties waived altogether, but settled on the compromise.
The late-night push on Oct. 1 capped a busy week that saw a number of changes that were attached to the health reform measure. Amendments that change how community health centers and physicians in rural areas get reimbursed were also OK'd.
Currently, they'll be attached to a bill that extends health insurance coverage to almost all Americans, in part by requiring the purchase of insurance and providing federal subsidies.
It also handcuffs the insurance industry from kicking people out of their plans or denying them coverage in the first place. The committee plans to vote on the bill this week. It will then fall to Senate Majority Leader Harry Reid (D-Nev.) to merge it with a bill already passed by another committee. Once merged, it would move to a final vote.
“As a result of this work, we are now closer than ever before to finally passing reform that will offer security to those who have coverage and affordable insurance to those who don't,” President Barack Obama said in a written statement.
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