Senate health reform players prepare policy positions

With debate scheduled to begin as early as Monday, senators are preparing their arguments for or against health care reform, Bloomberg reports. "All 58 Senate Democrats and the two independents who caucus with them backed [Senate Majority Leader Harry] Reid's bid to start debate this week. Even so, at least four have said they won't support the final product without changes, and concessions Reid made to two of them won't be the last he's likely to offer lawmakers." Even to start debate, Reid made deals with Sen. Mary Landrieu, D-La., to help pay for more of that state's Medicaid program and Sen. Ben Nelson, D-Neb., who "secured assurances from Reid that a proposal to strip the insurance industry's antitrust exemption wouldn't be in the legislation" (Jensen, 11/30).

The New Orleans Times-Picayune reports that some criticize the deal Landrieu made with Reid. "She had sold her vote, critics cried, in what they called the 'Louisiana Purchase.' … Landrieu's quest to tinker with the formula was executed at the behest of the (Louisiana Gov. Bobby) Jindal administration to solve an unintended consequence of the worst natural disaster in American history." Louisiana's Medicaid program covers 26 percent of its residents (Tilove, 11/28).

The Hill reports that even Reid himself is facing mounting pressure, this time from unions uninspired by some of the Senate's provisions in the health reform bill. "According to union officials, the bill's employer mandate needs to be expanded to include all employers." Unions also support a "robust" public option and eliminating an excise tax on high-cost insurance plans — so-called "Cadillac" plans (Bogardus, 11/30).

USA Today reports that Nelson still has misgivings about abortion funding in federal programs in the bill while Sen. Olympia Snowe, R-Maine, will support only a "trigger" to start a public option for health insurance if insurance companies don't meet a still-yet-determined affordability factor. Also throwing a wrench in that plan is Sen. Roland Burris, D-Ill., who says he will only support a bill with a "strong public option." USA Today also looks at how Senate Minority Leader Mitch McConnell, R-Ky., and Sen. Blanche Lincoln, D-Ark, are approaching the debate (Fritze, 11/30).

The Associated Press/The Washington Post reports on Snowe and her fellow Maine Senator Susan Collins, also a Republican. "Collins wants to curb health care costs. She was front and center helping Democrats pass President Barack Obama's economic stimulus plan, but only after working to scale back costs. … Yet independence is what makes Snowe and Collins popular back home, where pragmatism tends to trump partisanship" (Miga, 11/30).

Still another player in the debate is Massachusetts Sen. Paul Kirk, Sen. Edward Kennedy's replacement, though he has remained largely out of the spotlight, The Associated Press/The Examiner reports. "His biggest plunge into the health care fight was a little-noticed speech on the Senate floor citing the urgent need for health care reform, praising bipartisanship and lauding a government-run insurance option, the so-called 'public option'" (Miga, 11/28).

Finally, The Hill reports in a separate story that Nelson and Sen. Arlen Specter, D-Pa., will be in a precarious position when debate begins on the reform bill to explain their support of it — if they do support it — after they signed anti-tax pledges. Specter signed the pledge as a Republican; "an aide said the Pennsylvania lawmaker has repeatedly stated that he is committed to voting for a fiscally responsible bill that does not add to the deficit" (Bolton, 11/28).

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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.