2009-09-23
The
Senate Finance Committee began consideration of Committee Chairman Max Baucus’
(D-MT) long-awaited health
reform proposal.
Chairman Baucus has spent months negotiating with a small bipartisan group
of senators known as the “Gang of 6” in an effort to secure Republican
support for his proposal. However, he was unable to reach a compromise that could, at least
initially, garner support from both sides of the aisle. Consequently,
Chairman Baucus expects to continue to make substantial changes to his proposal
through the Committee “mark-up,” a process in which amendments to the bill are
offered and voted on.
The Baucus proposal is more conservative than the versions already
considered by the Senate Health, Education, Labor, and Pensions Committee, and
the House committees. The proposal is estimated to cost less than $800 billion over 10
years in contrast to the trillion-dollar price tag of the House legislation. As
presented to the Committee, the Baucus proposal would require most
individuals to have health insurance, expand the Medicaid program, provide
subsidies for lower- and middle-income workers to purchase health insurance, and
provide a marketplace for individuals and small businesses to purchase health
insurance, but it does not include a government or public insurance option.
The proposal also includes a one-year fix for the Medicare Physician Fee
Schedule, averting a 20 percent cut scheduled to go into effect on January 1,
2010, and replacing it with a 0.5 percent increase.
It appears that Republican opposition to the proposal remains over a number of
issues, including language in the proposal related to individual coverage
mandates, abortion language, Medicaid expansion, coverage for illegal
immigrants, and rebates for generic drugs. Chairman Baucus plans to have
his committee vote to approve the bill by the end of the week and by that time
not only hold together the Democrats on the panel but add some Republican
support as well. Sixty votes are needed to advance legislation to a
vote by the full Senate. With the recent death of Senator Kennedy, the
Democrats currently count 59, including Independent Senators Joe Lieberman and
Bernie Sanders. If Senator Baucus is unsuccessful in engaging support from any
of the Republicans on his committee, Senate leaders have indicated they would
attempt to consider the measure in the Senate under a process known as
reconciliation, which is tied into the budget process and allows for
consideration under a simple majority of 51 votes. It appears that the House of
Representatives is awaiting the outcome of the Senate Finance Committee’s
deliberations before proceeding with further action on its bills.
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