Senate health bill could come this week, 'compromise' public option now seems likely

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Oct 27 2009

Senate Democrats will need to move quickly if they want to pass some version of health overhaul legislation by the end of the year.

The Associated Press: With "time growing short," Senate Democratic leaders "still face key decisions..." In the Senate, that "means deciding whether legislation will give the government a role in the marketplace at all, and if so, what rights individual states would have in deciding whether to participate." The Senate is weighing its final choices as negotiators work to merge the bills from Senate Finance and from Health, Education, Labor and Pensions Committees. The latest talks have focused around getting rid of any mandate on businesses to provide health insurance for their employees (Espo, 10/26).

The Wall Street Journal reports that the Senate's finalized health bill could be ready as soon as early this week, when the leaders will submit the bill to the Congressional Budget Office for scoring. Senate Majority Leader Harry Reid "spent the weekend shoring up support for the bill from Democrats in the chamber. But some key moderate Democrats signaled Sunday that they remain uneasy about main planks of the legislation." Although some details could change, the "broad outlines are becoming more clear" (Adamy and Hitt, 10/26).

Politico reports that Sen. Chuck Schumer also believes 60 votes are within sight. But "Senate Minority Leader Mitch McConnell said that Democrats still have work to do in rallying support within their ranks, pointing to last week's overwhelming vote to strike down a so-called doc fix to Medicare physician reimbursement that would have added nearly $250 billion to the deficit. A group of Democrats crossed party lines on the vote" (Isenstadt, 10/25).

The New York Times: "Several Democratic senators voiced optimism on Sunday that Congress would pass a health care bill containing at least the germ of a government-run insurance program. Their expectations were grudgingly seconded by Senator John McCain, the Republican presidential candidate in 2008. 'I think the Democrats have the votes, and in the House, Blue Dogs bark but never bite,' Mr. McCain said on CBS's 'Face the Nation,' using the nickname for conservative Democrats."

Democrats who said they see a public plan passing include Sens. Claire McCaskill, of Missouri; Chuck Schumer, of New York; and Russ Feingold, of Wisconsin. Sen. Ben Nelson, D-Neb., said he was willing to look at the proposal if the Senate allows states to opt out of that part of the plan (Berger, 10/25).

CNNMoney: "Senate Majority Leader Harry Reid, D-Nev., is poised to proceed with plans to introduce a Senate health care bill with a public health insurance option that would allow states to opt out, a senior aide to Reid told CNN on Sunday. The aide, who did not want to be quoted by name when talking about private deliberations, said a final decision would be made Monday. Reid is likely to make the move without having firm commitments of support from 60 senators, the number needed to break a filibuster, according to the aide" (Bash, 10/26).

Bloomberg: "The Senate is considering a version of the public option that would have to negotiate rates with providers, as private insurers do, likely resulting in higher reimbursements. There are other compromises, including (Maine Republican Sen. Olympia) Snowe's plan to trigger a public option if there isn't enough affordable insurance on the market" (Jensen and Litvan, 10/26).

Reuters has a rundown of the different proposals for a public plan in both the Senate and the House including the opt out plan, the trigger plan, a "robust" plan offered in the House, one with negotiated rates and one that would instead set up non-profit cooperatives (Smith, 10/25).

Politico reports that Democrats are trying to make the benefits start by 2010 to sell the plan to the public: "With Republicans expected to make next year a referendum on health care reform, Democrats are quietly lobbying to push up the effective dates on popular programs, so they'll have something to run on in the congressional midterms. Democrats are anxious to mix the good with the bad since some of the pain would be phased in early, including more than $100 billion in industry fees that critics say could be passed on to consumers." Billions in new taxes in the plans will already come due in 2010 (Budoff Brown, 10/25).

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.