Health care proposal mandates coverage, drops public option

Sen. Max Baucus will reveal his panel's compromise health care reform plan on Wednesday.
The chairman of the Senate Finance Committee unveiled a summary of his long-awaited health care reform bill Wednesday, setting the stage for a legislative showdown on President Obama’s top domestic priority.

The bill crafted by Sen. Max Baucus, D-Montana, would cost $856 billion over 10 years and mandate insurance coverage for every American. The bill — released with no Republican support — would not add to the federal deficit, Baucus said in a written statement. The measure drops the public option favored by Obama and many Democratic leaders, according to a statement. As expected, the plan instead calls for the creation of nonprofit health care cooperatives. As with other reform proposals, the bill would bar insurance companies from dropping a policyholder in the event of illness as long as that person had paid his or her premium in full. It would add new protections for people with pre-existing conditions and establish tax credits to help low- and middle-income families purchase insurance coverage. Insurance companies also would be barred from imposing annual caps or lifetime limits on coverage. Individuals, however, would be fined up to $950 annually for failing to obtain coverage; families could be fined as much as $3,800. The plan also would create health insurance exchanges to make it easier for small groups and individuals to buy insurance. “The cost of America’s broken health care system has stretched families, businesses and the economy too far for too long. For too many, quality, affordable health care is simply out of reach,” Baucus said. “This is a unique moment in history where we can finally reach an objective so many of us have sought for so long.” The Republican Senate leadership ripped the proposal, arguing it would impose unreasonable new tax burdens while cutting vital government programs. “This partisan proposal cuts Medicare by nearly a half-trillion dollars and puts massive new tax burdens on families and small businesses to create yet another thousand-page, trillion-dollar government program,” said Senate Minority Leader Mitch McConnell, R-Kentucky. “Only in Washington would anyone think that makes sense, especially in this economy.” The Senate Finance Committee is the last of five congressional committees needed to approve health care legislation proposals before the topic can be taken up by both the full Senate and the full House of Representatives. Various forms of the legislation proposed by Democrats have already cleared three House committees, as well as the Senate Health, Education, Labor and Pensions Committee. The release of the bill comes a day after Obama delivered a fiery defense of his embattled plan to overhaul health care, telling a raucous union audience in Pennsylvania that “now is the time for action” and “the time to deliver.” “When are we going to say enough is enough” he asked a national AFL-CIO convention. “How many more workers have to lose their coverage How many more families have to go into the red for a sick loved one … We have talked this issue to death year after year, decade after decade.” Baucus has led months of negotiations with five other committee members — three Republicans and two Democrats — on what is considered the only proposal that could win bipartisan support in Congress.

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GOP Sens. Olympia Snowe of Maine, Charles Grassley of Iowa and Mike Enzi of Wyoming — the three Republicans involved in the so-called “Gang of Six” — all still had concerns Tuesday that had not been sufficiently addressed, Snowe, Grassley and other Republican sources indicated. GOP sources close to the senators stressed that they intend to keep negotiating and plan to offer amendments. Wednesday morning Baucus said he was optimistic that the bill would ultimately win GOP votes. “I think when we finally vote on the bill … there will be Republican support,” he told reporters on Capitol Hill. “They’ll become a little more familiar with it” in the days ahead, he said, and they will have several opportunities to offer amendments during the full committee’s consideration of the bill. Baucus also noted that it is “very similar” to the framework laid out by Obama during the president’s speech to Congress last week. In a statement issued Tuesday evening, Grassley said among the outstanding issues to be resolved are the costs to taxpayers, affordability for individuals, preventing taxpayer money from funding abortions, screening out illegal aliens, limiting medical malpractice lawsuits and lowering the overall costs. Grassley also said he wanted assurances from Democratic leaders in Congress that the bipartisan measure under negotiation would remain unchanged after the Finance Committee passes it. Meanwhile, Democratic Sen. Jay Rockefeller of West Virginia said he would oppose the Baucus proposal because it lacks a government-funded public health insurance option favored by Obama and liberal Democrats. “By being against this bill, I am putting down a marker, which I think others should put down, too, who might feel the same way I do,” Rockefeller said. He called the Baucus proposal an attempt to gain one or two Republican supporters, rather than a bill that would set good policy for the nation. Baucus said the negotiators were tackling a range of controversial issues, including medical malpractice, ensuring a denial of benefits to illegal immigrants and expanding federal support for Medicaid. Another of the Finance Committee negotiators, Sen. Kent Conrad, D-North Dakota, said the negotiators also considered a provision to specifically prohibit any provisions in the health care proposal from funding abortion. One key sticking point between many Democrats and Republicans remains the question of whether to create a government funded public health insurance option. Republicans unanimously oppose the public option as an unfair competitor that would drive private insurers out of the market, which they say would bring a government takeover of health care. Democratic supporters reject that claim, saying a nonprofit public option would be one choice for consumers who also could sign up for private coverage. Conrad has proposed creating nonprofit health insurance cooperatives as an alternative to the public option. Obama, a supporter of the public option, also cited the idea of cooperatives as a possible middle-ground during his speech to Congress last week.

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