Real Work on Health Care Reform to Begin

By Susan Brinkmann, OCDS
Staff Journalist

Now that the Senate Finance Committee version of health care reform has passed, the real work of trying to craft a bill will begin.

Members of the Senate Finance Committee voted 14-9 in favor of Sen. Max Baucus’ health care reform plan yesterday. The vote was mostly along party lines with the exception of Sen. Olympia Snowe (R-ME) who broke ranks with Republicans to vote for the bill.

With all five congressional health care bills finally out of committee, the White House and top Democrats must now merge the different bills into versions that can win a majority in the House and get the 60 votes needed to pass in the Senate.

Senate Majority Leader Harry Reid is tasked with merging the two bills approved by the Senate, the just-passed Finance Committee bill and another more liberal version passed earlier this year by the Senate Health, Education, Labor and Pensions Committee. The Finance Committee bill has no public plan and no requirement that employees provide coverage while the Health Committee bill includes a public plan and a mandate that employers help cover their workers. These are only two of dozens of crucial differences between the bills that must be reconciled in a way to gain enough votes for passage.

At the same time, the unpopular House Speaker Nancy Pelosi has been at work for weeks trying to blend legislation approved by three House committees. It is almost certain that the resulting bill will include a government option, but the details of the plan have caused serious splits in the rank and file that House leaders have been thus far unable to reconcile.

Another persistent bone of contention is the abortion funding contained in the House bills, and the Speaker’s refusal to allow a vote on an amendment that would explicitly prohibit abortion from being funded under the proposals. Rep. Bart Stupak of Michigan, the leading pro-life Democrat in the House says he has enough votes to prevent any bill from coming to the floor unless a vote is permitted on his amendment.

This could be a crucial vote because recent polls show the majority of Americans are opposed to funding abortion in health care reform. Pro-choice lawmakers nervous about the 2010 elections may deem it politically unwise to vote against such an amendment.

Eventually, the final House and Senate version will then have to be merged and voted on again by both houses of Congress.

FoxNews is reporting that in response to this Herculean challenge, Pres. Obama is sending White House Chief of Staff Rahm Emanuel to Capital Hill today to try to bridge the divide between legislators who are for and against a public plan, an option that has caused a serious split in the rank and file.

The President himself acknowledged the difficulty of the task ahead during comments made in the Rose Garden after Tuesday’s Senate vote.

“Now is not the time to pat ourselves on the back,” he said. “Now is the time to dig in and work even harder.”

Trouble is already looming on the horizon, however. Douglas Elmedorf, the Congressional Budget Office chief, said during committee debate that he could not confirm the impact of the bill on total health spending across the country and on insurance premiums.

“We can’t assess the effects on national health expenditures,” he said. “There are so many conflicting forces, we have not been able to assess the effect on premiums.”

This is bad news for many legislators who spent the August break in town hall meetings where constituents blasted them for the deficit, among other things.

It also does little to reassure consumers after a study commissioned by America’s Health Insurance Plans found that current health care legislation would add $1,700 a year to the cost of family coverage and $600 for individuals in 2013, when most of the major provisions in the bill would be in effect.

This report did little to comfort the overwhelming majority of Americans who say they’re happy with their current plan and don’t want a change.

With the 2010 elections looming, it may be almost as difficult for lawmakers to craft a consensus plan as it will be to convince their colleagues to vote for it.

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