Monday, September 14, 2009

One More Health Care Reform Delay

Late Monday Senate Finance Chairman Max Baucus announced he will not release his chairman's mark of the Finance Committee health care reform bill until Wednesday, and it will be another week after that before his committee begins marking up the draft. Of all the five House and Senate committee bills, the Baucus mark is expected to be closest to the "plan" described by President Obama in his speech to the joint session of Congress last week, and its release is anticipated by all factions involved in the debate over health care reform.

During the negotiating session Monday, Baucus excused all staff from the room for half an hour so there could be a frank and free exchange among the three Democrat and three Republican negotiators about the 12 to 15 member concerns with the still secret draft of the Finance Committee legislation. After the meeting, Oregon Senator Ron Wyden said "The flash point is all about affordability." Sources say Baucus has reduced the overall ten year cost of his proposal to about $800 billion by making further cuts in the levels of health premium subsidy to those earning up to 300% of poverty wages. Baucus now proposes to limit subsidies for those earning 300% of poverty level income to the extent premiums would be more than 13% of total family income. Other Democrats wanted that number limited to 9% of family income.

Massachusetts Senator John Kerry said the negotiators do not expect any immediate support for Chairman Baucus' mark of the legislation, but that "It's not going to be the bill that we're going to vote on, because we are going to amend, we are going to have a tug of war still."

Some of the most contentious issues which remain, pending release of the Baucus draft bill Wednesday, are Republican demands for specific language banning the expenditure of federal government dollars to pay for abortions, language prohibiting enrollment of illegal immigrants in public or private health insurance in the United States, the question of co-ops versus a government run insurance plan, and finally, the additional burden Medicaid enrollment expansion will put on state governments. One reason for Chairman Baucus' decision to delay release of the bill is the discussion Monday and perhaps Tuesday with various state governors to address their Medicaid funding concerns.

The final Baucus mark is expected to run between 1,500 and 2,000 pages in length. Once it has been released, I will do my best to quickly bring you information on key elements of the Baucus plan compared with the Obama speech and the other four pending bills.
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