Hurdles ahead for health care reform

Democratic senators on Wednesday rallied for a health care reform bill in the first public committee debate of the measure as Republicans seized on incomplete cost estimates and ensuring adequate coverage.

The Senate Health, Education, Labor and Pensions Committee’s meeting comes with 51 days remaining before President Obama’s self-imposed deadline - the August recess - for his top legislative priority. It’s Congress’ first whack at a major overhaul of the complicated system since President Clinton’s failed bid in the early 1990s.

“Today is an historic day,” said Sen. Christopher J. Dodd, acting chairman of the HELP Committee. “No issue affects more Americans. In fact, there is not a single American who doesn’t have a stake in the success of our work. … In the richest country in the world, you shouldn’t have to be well-off to get well.”

The committee is considering creating a government-run public insurance plan for the nation’s 46 million without coverage, as well as ways to slow escalating health care costs. It comes as a new report shows that 86 percent of Americans say health reform is an important part of economic recovery and as new reform proposals are introduced from a group of former Senate leaders.

The health care debate is largely coming down to the bottom line. The Congressional Budget Office, Congress’ accountant, delivered a blow to the HELP bill earlier this week when it estimated that the portion of the bill that’s been written will cost $1 trillion and still leave about 37 million people uninsured.

Republicans argued that they can’t move forward on a bill that’s incomplete. Mr. Dodd said he left it that way to encourage bipartisan discussion - and therefore not fully priced by the CBO.

“I regret that we find ourselves here today, marking up this bill,” said Sen. Michael B. Enzi of Wyoming, ranking Republican member of the HELP Committee. “Rather than considering the partisan bill before us, I wish that we could instead be marking up a bill that could gain real bipartisan support and make a difference for America.”

In contrast, Sen. Max Baucus, Montana Democrat and chairman of the Senate Finance Committee, which also is crafting a health care bill, said this week that his committee’s bill will come in at about $1 trillion, despite an early CBO estimate that the committee’s bill would be $1.6 trillion. Mr. Obama has put up about $950 billion in health care savings to help fund a reform bill.

Committee leaders said Wednesday their bill won’t be introduced until July - later than anticipated - in order to rework the financing in light of the CBO estimate. The Finance Committee’s bill appears to be more politically viable as Republicans balk at the HELP committee plan.

Sens. Baucus and Charles E. Grassley, longtime bipartisan allies on the Finance Committee, have been crafting a bill that would reform the industry and pay for it.

“We said we wanted a bipartisan bill since the first of the year. We’re still headed in that direction,” said the Iowa Republican, adding that the public option, mandates and whether to tax some health care benefits continue to be sticking points.

Meanwhile, new reform proposals were released by House Republicans as well as a bipartisan group headed by former Senate Majority Leaders Tom Daschle, Bob Dole and Howard Baker.

The proposal by the former senators suggests a ban on restrictions for pre-existing conditions, state and regional health insurance exchanges, a tax credit for premiums and a mandate that all Americans purchase coverage. It has prompted letters of support for their effort from Mr. Obama, Mr. Baucus and Mr. Grassley.

The bill from House Republicans did not provide many financing specifics, but did propose to ban insurance restrictions on pre-existing conditions, stop a government-run health care program and promote wellness and prevention efforts.