Senate might see health overhaul vote slip into 2010

Democrats are, by many accounts, a long way from agreement among their own members on a health care reform bill.

Politico reports that "Democrats have blown so many deadlines for getting health reform done this year that insiders are increasingly skeptical they can finish by year's end — and some even suggest the effort might slip to a new deadline, before the State of the Union address." Currently, Senate Majority Leader Harry Reid still looking for 60 votes to start debate and still waiting for Congressional Budget Office cost estimates in order to finish writing the legislation. "Democrats signaled that those estimates would not be ready this week, casting further doubt on their ability to finish reform this year." Sen. Kent Conrad said passage of the bill by Christmas would be "a challenge."

"In order to have a shot at a year-end bill signing, Reid would have to introduce a bill this week and wrap it up by Thanksgiving, giving House and Senate leaders the month of December to reconcile the differences between the two bills and pass the conference report through both chambers" (Frates and Budoff Brown, 11/3).

CongressDaily: "In a barbed letter Monday to Senate Republicans who expressed concern about the transparency of the process, Reid also said that 'if we are able to overcome your opposition to permitting the Senate to even debate this important legislation, all members will have the opportunity to offer amendments.'"

"'I have no intention of rushing this process or blocking senators from offering alternatives,' Reid added" (Edney and Friedman, 11/3).

The Washington Post: "Senate Democratic leadership aides said they don't expect the Congressional Budget Office to deliver an official cost analysis of the Senate health-care reform legislation until next week at the earliest -- just in time for lawmakers to leave town for a three-day Veterans Day break scheduled for Nov. 11-13." That would leave just a week before the Thanksgiving break, too short a time to finish consideration, The Post reports (Murray, 11/2).

CBS News reports that even when the bill gets to the Senate floor, its fate is not certain: "For one thing, it is unclear whether the public option will be able to survive the Senate, or whether moderates and conservatives would approve an amendment to strip the provision from the legislation" (Condon, 11/2). 

In a separate story,  Politico reports on the "long list of policy differences both small and large that must be reconciled before a bill can go to the president's desk." The policy differences include the price tag, tax credits to help people buy insurance, the Medicare "donut hole" to provide a 50 percent discount on brand-name drugs and negotiating Medicare drug costs. There are also differences in the chambers on premiums for older people through age-rating, mandates to purchase coverage, the Medicaid expansion and the role of national (or state-based) insurance exchanges (Budoff Brown and O'Connor, 11/3).

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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.