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Health-care advances, GOP vote gained
by James Oliphant
Legislation that would transform the nation's healthcare system cleared a significant hurdle today, as the Senate Finance Committee voted 14-9 for a sweeping overhaul.
Just one Republican, Sen. Olympia J. Snowe of Maine, voted for the bill. But that represented a victory for the White House, which had heavily courted Snowe, and it allowed overhaul advocates to claim that there was a vestige of GOP support for the measure.
"Is this bill all that I would want? Far from it," Snowe said in announcing her vote. "But when history calls, history calls."
The bill would require Americans to have health insurance, provide federal subsidies to help low-income workers buy insurance, establish new insurance marketplaces, regulate health insurer practices, and expand Medicaid. The plan as drafted is estimated to cost $829 billion over the next 10 years.
Some cast the vote in landmark terms.
"This is our opportunity to make history," said Finance Committee Chairman Max Baucus (D-Mont.). "Now is the time to get this done."
The long-anticipated committee vote sets the legislation up for debate on the Senate floor. But first its terms must be reconciled with those of a bill passed by the Senate Health, Education, Labor and Pensions Committee this summer.
"I never count chickens before they are hatched, but this is obviously another step forward,'' President Barack Obama said after Snowe announced her support and the Senate Finance Committee was nearing its vote today.
Senate Majority Leader Harry Reid (D-Nev.), will work behind the scenes with help from the White House to craft a compromise in the coming days. Because the Finance bill explicitly sets forth how the bill would pay for the cost of covering uninsured Americans as well as set penalties for the failure to have insurance, its terms are expected to comprise the bulk of the bill that ultimately is debated on the floor.
Floor debate could begin before the end of the month.
Despite the committee' s approval, key provisions of the legislation remain to be resolved, including whether the bill ultimately will include some form of a government-run health insurer, the so-called "public option." Some senators favor a provision that would allow states to exempt themselves from providing a government option to consumers--a bid to sway moderates who otherwise might oppose a mandatory plan.
It's unclear whether Reid will include any sort of a public option in the bill during the merger process or instead invite an amendment during the Senate floor debate.
Also, there remains some significant disagreement about whether to pay for the expansion of healthcare coverage to millions of uninsured Americans with an excise tax on high-end insurance plans--as well as the threshold at which that tax would take effect.
Furthermore, the insurance industry has objected strenuously to the Finance Committee's loosening of the requirement in the bill that all Americans to purchase health insurance. The committee approved an amendment that weakened the penalties for failing to buy a plan.
Still, the Finance Committee's endorsement was undeniably a signature moment in a healthcare debate that has consumed Capitol Hill for much of the year. The vote was the culmination of months of work by Baucus and members of the committee. Prior to the vote, the committee met for eight contentious days and considered 135 amendments to the bill.
Up until the vote, the support of some Democrats such as Sens. Jay Rockefeller (D-W.Va.) and Ron Wyden (D-Ore.) remained in doubt. All eyes, however, were on Snowe, whose imprimatur was deemed critical for Baucus and the White House to claim that there was some vestige of bipartisan support for the effort and to help create a 60-vote supermajority in the Senate to ward off a potential Republican filibuster.
The Maine moderate remained cagey about her vote until today's meeting, as many believed she would withhold her approval to ensure she would maintain a role as the final bill is written. In remarks prior to the vote, she made clear that her support going forward hinges on maintaining the bill's $829 billion price tag.
"My vote today is my vote today," Snowe said. "It doesn't forecast what my vote will be tomorrow."
Congressional Democrats have strived to keep the cost of the bill beneath $900 billion. The Finance bill does that, and the Congressional Budget Office has estimated it would shave the federal deficit by $81 billion over the next decade, as well.
Before a packed committee room this morning, senators on the committee alternately praised and criticized the bill prior to the vote, with Republicans arguing that the bill would result in higher premiums for Americans and higher taxes for businesses.
Sen. Charles Grassley (R-Iowa.), the senior Republican on the committee, complained that Democratic leaders in the Senate scuttled a series of bipartisan talks between the so-called Gang of Six that occurred over the summer. He charged the bill had "moved leftward" as a result.
"Today, we see the fears that we had were legitimate and justified," Grassley said. "I still hold out hope the doorway to bi-partisanship will be opened once again."
Sen. Orrin Hatch (R-Utah), too, slammed the process, saying that the ultimate bill would be written by Reid without GOP input. "It almost seems like hundreds of hours of debate were all for naught," Hatch said. "The real bill is currently being written behind closed doors."
Many Democrats addressed a report released Monday by an insurance industry trade group, that claimed that the bill would cause premiums for many Americans to skyrocket. Sen. John Kerry (D-Mass.) attempted to debunk the report and suggested that the report would fuel momentum for a public option as a means to make the insurance market more competitive. "It's a powerful argument, frankly, of why we should have a public plan," Kerry said.
As it stands, the bill would result in 94 percent of Americans having insurance, Baucus said, with 23 million taking advantage of new insurance exchanges that would be created by the bill and 14 million added to Medicaid rolls. The bill would subsidize the cost of insurance for Americans who earn incomes just above the federal poverty level. It would also prohibit insurance companies from denying or rating coverage based on preexisting medical conditions.
Some Democrats have expressed reservations about the bill, even as they voted for it. Sen. Blanche Lincoln (D-Ark.), a moderate up for reelection next year, said her support for the bill today did not mean she would vote for it on the Senate floor. She said her constituents remained concerned about the legislation.
"Americans out there are frightened," Lincoln said. "They're alarmed about big bills that are difficult to understand."
Wyden continued to insist the bill did too little to ensure that middle-class Americans would be able to afford health insurance. He predicted that in its current form, many working families would choose to be exempted from the mandatory insurance requirement because they will not be able to afford a suitable plan.
"People want coverage. People want coverage to be affordable," Wyden said. "We've got a lot more work to do with respect to affordability."
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