After more than a year of planning and months of negotiations with Republicans, Sen. Max Baucus, D-Montana, stood alone at the podium in the Senate Finance Committee hearing room on Wednesday, September 16.
Baucus, who is the committee’s chairman, addressed dozens of reporters on the $774 billion health care reform proposal that his panel will begin amending next week.
Although none of the three Republicans who have been working with Baucus—Sens. Charles Grassley of Iowa, Mike Enzi of Wyoming and Olympia Snowe of Maine—joined him in introducing the measure, Baucus is confident that it will eventually garner backing from both sides of the aisle.
“By the time we get to final passage in this committee, we will find Republican support," Baucus said. “This is a good bill. This is a balanced bill. It can pass the Senate.”
So far, three House committees and the Senate health committee have produced legislation—all of which include an employer mandate and a government-run insurance program for people under 65, a so-called public option.
It would mandate individual insurance coverage and provide tax credits for the purchase of insurance on a national exchange for individuals and families between 100 and 133 percent of the federal poverty level. The bill envisions capping health care expenditures at 13 percent of an individual’s income.
Employers that do not offer a health plan would have to reimburse the government up to $400 per employee who uses a tax credit to buy insurance.
The Congressional Budget Office says the measure would cover 94 percent of non-elderly Americans and reduce the deficit by $49 billion over 10 years. One of the primary ways it raises revenue is by imposing a 35 percent tax on high-cost insurance plans.
Those details provide plenty of opportunities for attacks from the left and right of the political spectrum. Baucus faces an enormous challenge in securing Republican support while keeping liberals on board.
The measure will have to get 60 votes in the Senate to overcome a filibuster, unless Democrats use a parliamentary maneuver that requires only 51. The Democratic caucus totals 59 senators.
Grassley, the senior Republican on the finance committee, is not abandoning the health care reform process. He and his Republican colleagues will have a chance to alter the bill during next week’s markup process.
But he is concerned that Baucus is moving the bill forward to meet an “artificial deadline” for congressional action set by the Democratic leaders and the White House.
Grassley also worries that GOP priorities will evaporate when the Senate finance and health committees merge their bills.
“There’s no guarantee that a Finance Committee bill, even if it becomes bipartisan, will stay that way after it leaves the committee,” he said in a September 15 statement.
Baucus may lose some liberals because the bill doesn’t include an employer mandate. “It’s another example of the difficulties in finding balance,” Baucus said.
The levy on high-priced insurance plans may undermine support from organized labor and its supporters on Capitol Hill. But Baucus sees that provision as a way to reduce health care spending.
“It’s a tax, frankly, on insurance companies,” Baucus said. “It’s appropriate to get the fat out of insurance companies.”
Labor also fiercely protests the lack of a public option, a stance that is echoed by House Democratic leadership, who say the government would provide competition to private insurers.
“The House bill clearly does more to make coverage more affordable for more Americans and provides more competition to drive insurance companies to charge lower premiums and improve coverage,” House Speaker Nancy Pelosi said in a statement.
But Baucus is convinced his plan—or something close to it—is the only way to cobble together the coalition needed to pass a bill.
“This is our moment in history,” Baucus said. “This is our chance to reform health care in America. We cannot let this moment pass.”
—Mark Schoeff Jr.