KHN's Mary Agnes Carey discusses the latest developments in Senate, House reform bills

Jun 10 2009

Democrats on the Senate Health, Education, Labor and Pensions (HELP) Committee today released their health care reform bill called "Affordable Health Choices Act." Kaiser Health News Senior Correspondent Mary Agnes Carey discusses the bill with the Kaiser Family Foundation's Jackie Judd.

Listen to Interview (mp3)

Q: Mary Agnes, you've been been working her way through the 600-page document. What have you found?

A: Well, there are a lot of major goals that they want to accomplish with this legislation that many people involved in the health care debate want. For example, if you like your health insurance, you get to keep it. They hope they'll reduce health care costs by greater use of health information technology and prevention. They want to cut waste, fraud and abuse. They want to invest more money in training doctors and nurses and medical professionals. And they also want to invest more in long term care services so that the elderly can live independently in their homes. But there are two hot-button issues that have been intentionally left off the table by Democrats. Those are the public plan option and also the employer mandate. The HELP committee is having a hearing this Thursday, they say they want to talk to Republicans about these issues to try to get consensus. And they're also talking about a markup later this month on June 16th, where the committee will then continue to discuss the bill and move it along in the legislative process.

Q: It was Sen. Chris Dodd who released this on behalf of Sen. Ted Kennedy who is ailing and is not on Capitol Hill at the moment. What did Dodd say more specifically about his reasoning for leaving out two of the most contentious issues?

A: They want to work with Republicans. They know that Republicans are upset about these, they're concerned about a government-run option on health care. Many Republicans are worried that this is going to hurt private health insurers, that it will cost the government a considerable amount of money to get into this: "why is the government being involved in this?" And also they're very concerned about telling employers that "you have to offer health insurance." So the hope is: if you take two of the most combative issues off the table, Republicans will work with (Democrats) to get a compromise. But already we're seeing Republicans on that committee who are upset. For example, the ranking Republican on that committee, Mike Enzi, R-Wyo., is saying that from what he's seen of the bill, the final product would have to look very different. He called it, in his words, "a partisan wish list that puts us on the road to government-run health care." He remains extremely concerned about this public plan option idea. So we can see there's still quite a bit of tension over those issues.

Q: On the House side, Democrats also put out their plan. What does that one look like?

A: Today, we had the heads of the committees which have jurisdiction - Ways and Means, Energy and Commerce and Education and Labor put out the outline of their bill. There are many elements in here that we've heard about: an employer mandate, an individual mandate, subsidies to help low- and middle-income individuals afford coverage. Again, the public plan is there. There's language about stopping insurers from discriminating against you and not giving you health insurance if you have a pre-existing medical condition. A health insurance exchange, which I'm sure we'll also see in the Senate bill. And also some changes in Medicare to make more efficient delivery of care. So there are some of the ideas the Democrats were talking about today.

Q: Has there been any Republican reaction on the House side to that?

A: Again, Republicans have expressed a lot of concerns about an employer mandate, about a public plan. They're worried about this. And I think they'll be looking through more options. You'll hear more of the elements of a plan, but those are two of the hot areas of concern for them. They simply are worried that if the bill is too big, it'll drive health care costs up too much, and not help reduce the growth in health care costs, which many in the health reform debate want to happen this year.

Q: Why did House Democrats choose a different kind of political strategy in rolling out their legislation? They did tackle some of the more contentious issues.

A: There has been very little bipartisanship in the House between Democrats and Republicans this year. And health has been no exception. When you look at the committees with jurisdiction, watching the hearings and listening to the key members, there has not been a lot of common ground. At this point, I think that Democrats simply say, "Look, this is what we want in our bill, we have the votes to pass it. If Republicans want to come with us, that's great, but this is our strategy. This is what we're doing, we're getting it out there to our members so that we can proceed with our legislative activity. And I think they feel really strongly about this. So they're moving forward.

Q: Back on the Senate side, we're waiting to hear about a bill from the Senate Finance Committee. What's the timeline there?

A: Sen. Max Baucus, who's the chairman of that committee, has been saying that he hopes to introduce a bill the week of June 16th, and then mark it up the week afterwards. He mentioned today that they're continuing to work on that bill. So that's the timeline for that at this point.