Senate Health Committee to begin reform mark up today, finance to follow next week

Jun 18 2009

Senate Democrats are scrambling to reduce the price tag of reform proposals, which initial estimates place at $1.6 trillion, The Wall Street Journal reports.

"The Finance Committee is looking to cut more than $500 billion from current government health spending over 10 years, according to people familiar with the negotiations. One idea in play, according to two people involved, is to enhance the prescription-drug benefit available to seniors through Medicare, which would benefit pharmaceutical companies, and possibly offer a tax break to drug makers that offer free medicine to the needy. In return, the industry would go along with plans to allow generic versions of biologic medicines and other programs that would cut their Medicare and Medicaid reimbursements" (Meckler and Hitt, 6/16).

Senators could cut costs by lowering the threshold for a federal subsidy to lower-income Americans to buy insurance, senators told Politico: "Lawmakers have proposed federal subsidies for lower-income families with incomes 500 percent above the poverty line to purchase coverage through a government exchange. But since generous subsidies might encourage people to bolt employer-based insurance policies and go into the exchange, the committee could reduce the amount of subsidies, (Sen. Kent) Conrad (D-N.D.) said" (Brown, 6/16).

The Associated Press: Despite "numerous uncertainties," Sen. Christopher Dodd, D-Conn., said the Senate Health, Education, Labor and Pensions Committee would begin formal work Wednesday on the panel's legislation. "The meeting would mark the first public drafting session in either chamber" on a health reform bill.

"At the Senate Health panel, officials said that after penciling in subsidies for families with incomes as high as $110,000, or 500 percent of the federal poverty level, they would limit the help to families with up to $88,000 in income, or 400 percent of the poverty level. A preliminary CBO estimate on that measure, released Monday, calculated a cost of $1 trillion" (Espo, 6/17).

To stop a projected migration of families out of their employer insurance, senators are trying to lower the amount of subsidies to make option that less attractive, CongressDaily reports: "Lawmakers could potentially limit access to the exchange as well, possibly by opening it only to those without an offer of employer-based insurance. CBO estimated Monday in its analysis of Senate Health, Education, Labor and Pensions Democrats' healthcare overhaul bill that 10 million Americans would voluntarily leave employer-based coverage for the exchange" (Edney, 6/17).

The Associated Press reports in a separate story that the HELP Committee will meet daily through next week to work toward finalizing a proposal and the Finance Committee will release its version of a bill next week: "Major cuts in Medicare and Medicaid will pay for some of the new costs but senators disagreed among themselves over whether to tax employer-provided health benefits - something Obama campaigned against. Also elusive was a compromise with Republicans on a new public insurance plan, which the GOP opposes. … Business groups were working overtime to soften any requirement for employers to provide coverage for their employees or face fines. Most large employers already offer health care, but senators are looking at requiring certain levels of care, so businesses fear a scenario in which the government would force them to offer more or different coverage than they already do" (Werner, 6/17).

Roll Call reports that as the bills get closer to finalization, Democrats seemingly care less about what Republicans want: "Disagreement over the public plan option has grown into an obstacle overshadowing whatever agreement there might be on other aspects of reform. The cost of an overhaul - and how to pay for it - are also extremely contentious issues. With most Democrats committed to including a robust, government-run insurance component in the reform legislation, the Senate majority is now angling to pass a transformative bill that can attract a few Republicans" (Drucker, 6/17).

But CQPolitics reports that Republicans continue to step up attacks over costs: "'What has been scored is astronomical,' said Senate Minority Leader Mitch McConnell , R-Ky. 'It is not ready to go forward.'" Also, Rep. Chris Lee, R-N.Y., offered criticisms while comparing the Kennedy bill with a plan offered by a group of House moderate Republicans: "'The plan Democrats are proposing is a very radical solution with a lot of unknowns and an unaffordable price tag" (Wayne, 6/17).