Influential Senate Democrats eager to produce a more progressive health care reform bill will push this week for a public option and to require employers to provide insurance, pitting liberal Democrats against both their party’s moderate members and Republicans in major battles.
As the Senate Finance Committee enters its second week of debate, Democratic Sens. John D. Rockefeller IV of West Virginia and Charles E. Schumer of New York plan to try and insert a public option, a government-run insurance plan proponents say will help contain medical costs by competing with private insurers.
“We’re going to have a full-blown debate in the committee,” Mr. Schumer said. “This is the starting gate, and we know that it will get better and better as we move on.”
Mr. Schumer concedes that the public option is the “underdog” in the moderate-conservative panel led by Sen. Max Baucus, Montana Democrat.
If Democrats can’t get the public option tacked onto the bill in the Finance Committee, they’ll have another shot when the Finance Committee bill is merged with another health bill from the Senate Health, Education, Labor and Pensions Committee. There will be yet another chance when the bill gets to the Senate floor. Final changes would be made when the House and Senate bills are merged.
“True health care reform cannot be realized without a strong public insurance option that works for American families, and I intend to offer this amendment in the Senate Finance Committee,” Mr. Rockefeller said.
Mr. Baucus, who kept the public option out of his proposal because he says it won’t pass the full Senate, said he plans to hold debate on the proposal Tuesday morning when the committee restarts debate on about 500 amendments.
“This bill, for a lot of colleagues, is not their first choice,” Sen. Ron Wyden, Oregon Democrat, said last week. “It’s not exactly a surprise. I’m one of them. But this debate isn’t about any of us individually … it’s about getting a win for the health and economic security of the American people.”
The public option is unlikely to pass out of the committee. No Republican is expected to vote for it, so supporters would need 12 of the 13 Democrats on the panel to support it, which is unlikely to happen.
On Saturday, Republicans renewed their call for the Democratic-run Congress to slow down the process, saying Democrats are ignoring the public’s concerns in a rush to pass President Obama’s top domestic agenda item.
“The American people expect us to get this right and to do it in an open, honest and bipartisan debate. That’s what they deserve,” said Republican Sen. Johnny Isakson of Georgia in his party’s weekly radio and Internet address. “But that’s not what they’re getting from the Democrats on Capitol Hill.”
Only one of the panel’s Republicans, Sen. Olympia J. Snowe of Maine, appears to be considering supporting the public option. Republicans overwhelmingly oppose both the proposal they consider a government intrusion into the free market and the overall bill, which they say is too costly.
But some of the other proposals put together by Democrats have a better shot.
Sen. John Kerry of Massachusetts wants to introduce a requirement that employers provide insurance and reduce the difference insurers can charge based on age. The so-called employer mandate is popular with Democrats who argue that employers have a moral requirement to share some of the burden of universal coverage.
Republicans say it’s an unnecessary and costly request.
The provision was left out of Mr. Baucus’ proposal, which was based on extensive bipartisan negotiations, in favor of so-called “free-rider” incentives to encourage employers to provide insurance, such as fees on a company if its employees end up taking government subsidies.
“The free-rider provision … winds up inadvertently discriminating against low-income workers,” Mr. Kerry said, arguing that employers would have a disincentive to hire low-income employees.
Wal-Mart Stores Inc., the nation’s largest private employer, has supported the mandate, though many other business groups have opposed it.
Mr. Kerry introduced another amendment that would require insurance companies to limit the price difference they charge young and old patients. But, possibly because he doesn’t think it would pass the committee, he withdrew it and said he plans to offer it on the Senate floor.
The expected fights over the public option and employer mandate will escalate the combative tenor of the committee debate, which all week focused on battles between Democrats and Republicans on issues related to the politically potent bloc of senior citizen voters.
Democrats tried to woo seniors with promises of cheap prescription drugs and access to preventive care. Republicans, saying there is no way to cut $500 billion from Medicare without impacting patients, failed in a bid to eliminate the Democrat-led Medicare proposal that supporters say will find the savings in waste and inefficiencies in the federal health care plan for the elderly.
The last of five health care bills being developed by Congress, the Baucus plan bars insurance companies from refusing to cover a person based on previous medical conditions, creates an insurance exchange where companies would compete to provide federally guaranteed benefits, and helps the uninsured get coverage with subsidies.
Mr. Baucus’ plan was seen as the last great hope for a bipartisan measure until negotiations between a triumvirate of lawmakers from each party failed to produce a measure that attracted broad support.