The timing of the conference committee is unclear because the Senate is struggling to approve its $848 billion legislation, which it began debating during the last week of November. The House passed a $1.05 trillion measure on November 7.

Health care reform is the top domestic political priority of President Barack Obama, who has pushed Congress to finish a bill by the end of the year.

That timetable is likely to slip into January because of the difficulty that Senate Majority Leader Harry Reid, D-Nevada, is having in securing the 60 votes necessary to avoid a filibuster. Intense House-Senate negotiations on the final bill would delay the process even more.

Andy Stern, president of the Service Employees International Union, isn’t satisfied with the Senate bill because it likely will not include a government-run public insurance program for people under 65. Unions also are displeased that the Senate version is financed in part by a 40 percent tax on high-cost insurance plans.

Organized labor is enthusiastic about the House version, which contains the so-called public insurance option and is paid for in part by a surtax on wealthy Americans.

The Senate bill continues to be revised during negotiations between Reid and other Democrats. Reid has been working for weeks to secure the backing of wavering members of his party, whose caucus totals 60, so that it can overcome procedural maneuvers by 40 Senate Republicans to kill the bill.

“It’s time for the Senate to send this bill to conference where the real work can be done,” Stern said in a conference call with Washington reporters.

He dismissed the idea that congressional leaders would forgo a conference committee and have the House vote on the Senate version, which would speed getting the bill to Obama’s desk.

“This is not going to be the Senate bill being pingponged back to the House,” Stern said.

Richard Trumka, president of the AFL-CIO, joined Stern on December 17 in criticizing the Senate bill, which he said in a statement "bends toward the insurance industry," fails to curb costs "and in its financing asks working people and the country to pay the price, even as benefits are cut."

Stern acknowledged that it would be difficult to get the public option put back in a final bill if it is taken out in the Senate version. But he would not say whether the SEIU would oppose a final bill devoid of a public option—or one that included the so-called “Cadillac tax.”

He praised the health care measures for extending coverage to 30 million Americans who currently lack it, expanding Medicaid, offering subsidies for low-income people to buy insurance, and prohibiting insurance companies from denying coverage based on pre-existing conditions.

Stern said the union will determine its stance after evaluating the final product.

“We’re going to improve the quality of the bill, then we’ll decide,” he said.

Unions would more likely embrace the measure if the excise tax on high-cost insurance plans was dropped. The Senate version levies a 40 percent tax on the total value of coverage above $8,500 for individuals and $23,000 for families.

Debbie Sweeney, a member of the SEIU and a payroll clerk for a small town in Connecticut, said that she and her colleagues—secretaries, clerical workers, librarians—gave up salary increases to boost their health care coverage.

“We are not high-paid executives,” Sweeney said on the SEIU conference call. “And somehow or other in Washington they’ve determined our health care plan is a Cadillac plan.”

Business groups also are seeking to remove the excise tax in House-Senate negotiations, arguing that it would hit many employer plans because the tax threshold is indexed to inflation rather than health care prices. 

In a December 15 letter to Senate leaders, the American Benefits Council criticized several elements of the Senate bill. For instance, it said that a tax on retiree drug subsidies would force many seniors out of their company coverage and into Medicare.

“We are unable to support the Senate bill in its current form and are increasingly disturbed that significant progress has yet to be made to address the problems it poses for employer-sponsored health care,” wrote James Klein, ABC president.

Business and labor differ, though, on the public option. Stern wants Obama to weigh in during House-Senate negotiations to make some of the changes labor is seeking.

“We’re encouraging him to step in at the end of this process, when his position really matters,” Stern said.

—Mark Schoeff Jr. 

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