Senate panel wraps up work on health care

UPDATED:

The Senate Finance Committee managed to fend off significant changes to its health care reform plan as it looks ahead to passing the bill — and a decision over whether to include the public plan — off to Senate Majority Leader Harry Reid.

As early as next week, the bill could go to Mr. Reid, Nevada Democrat, who has the difficult task of trying to meld the Finance bill with a more liberal reform plan approved by the Health, Education, Labor and Pensions (HELP) Committee.

The Finance Committee ended its debate early Friday morning and will vote for final passage once it has a preliminary cost estimate, likely next week. Chairman Max Baucus, Montana Democrat, told the panel that it would only vote on the bill if it is deficit neutral or creates a surplus.

Mr. Baucus has said that he expects to have the votes. Sen. Olympia J. Snowe of Maine, the only Republican who is open to voting for the bill, told reporters she isn’t sure yet of her vote. “I have a lot to think about,” she said. “This is the first step in a long journey.”

The next step in that journey will come as Mr. Reid determines whether the bill that goes to the Senate floor, which he said he expects to happen the week of Oct. 12, contains the government health insurance plan, called the public option, and requires employers to offer insurance coverage. The HELP Committee bill contains both, but the Finance plan does not. contain a public plan. It’s less clear whether the public option has the votes in the Senate. Eventually, those bills will need to be combined as well.

In a win for public-option advocates, the Senate Finance Committee voted Thursday to allow states, if they choose, to pool individual tax credits to negotiate private insurance coverage for the poor.

The proposal from Sen. Maria Cantwell, Washington Democrat, would allow states to collect the tax subsidies designated for individuals within 133 to 200 percent of the federal poverty level — income under $44,100 for a family of four — and negotiate with a private insurance company to provide coverage.

Miss Cantwell called it a “public plan with market forces,” and said the best way to drive down health costs is to negotiate prices with insurance companies.

In one of its last moves, the panel agreed to further reduce the penalties imposed on individuals who defy the requirement to obtain health insurance. Individuals who aren’t poor would face a penalty of only $750 per year, down from the $3,800 originally proposed.

In a separate vote, committee Republicans failed in their attempt to cut out fee and tax increases on middle-income individuals, accusing Democrats of violating President Obama’s pledge to not raise taxes on families making less than $250,000.

Mr. Baucus has kept his reform plan largely intact since the mark-up process began two weeks ago.

During the long process that’s often gone until 10 p.m., he has kept two small notes in front of him, he told reporters. One is a smiley face, to keep smiling, and the other, “Do not take the BAIT,” to resist Republican talking points. So far, the reminders seemed to work.

He was able to fend off a push from liberal Democrats to insert a true public option. Republicans put up several unsuccessful attempts to scale back cuts to Medicare funding, eliminate new fees for private insurers, and restrict taxpayer funding of abortions or coverage for illegal immigrants.

Despite Mrs. Snowe’s comments, Sen. Charles E. Grassley of Iowa, the top Republican on the panel, said Thursday there is no chance of bipartisan support.

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