Sen. Baucus hopes to introduce comprehensive health reform legislation this summer

Senate Finance Committee Chair Max Baucus (D-Mont.) on Tuesday said enacting comprehensive health reform this year is his "top priority," the Philadelphia Inquirer reports.

Baucus -- who spoke to reporters at the Kaiser Family Foundation in Washington, D.C., at an event sponsored by the Foundation, Families USA and the National Federation of Independent Business -- said, "Now it's time to move from first steps to giant steps." He added, "There's never been a better moment. The stars are all aligning. ... I don't know if any president has been as committed as President Obama" (Vitez, Philadelphia Inquirer, 3/4). Baucus said, "I'd like to have us ready for the floor by June or July, before the August recess" (Armstrong/Wayne, CQ Today, 3/3). Full implementation of comprehensive reform would take up to three years, according to Baucus (Edney, CongressDaily, 3/3).

Baucus said co-authoring a bill with Finance Committee ranking member Chuck Grassley (R-Iowa) is a possibility. Baucus also said he does not support a single-payer system, but rather a blending of public and private options to expand coverage to all U.S. residents. He said, "We need to come up with a uniquely American solution," adding, "I think we'd be spending capital inefficiently to pursue single payer. I think there should be choice, flexibility, in our reform package. This is not a single-pay country" (Philadelphia Inquirer, 3/4).

Baucus did not offer details about what potential legislation could entail, but he said that he hopes the cost of the package could be completely offset (Werner, AP/Miami Herald, 3/3). "We're going to pay for it. It's not going to add to the deficit," he said. Of potential offsets Baucus said, "I'll be taking the temperature of senators to see which measures are either the path of least resistance or which measures are more popular." He said that President Obama's plan to limit itemized tax deductions for the wealthiest households as a way to help fund reform, included in the budget plan he released last week, is "interesting," but added that he supports limiting the tax exclusion for employer-sponsored health plans (Edney, CongressDaily, 3/3). He said, "I do not want to eliminate that deductibility to companies," but "I do think it should be trimmed or limited. It's regressive. It skews the system" (Philadelphia Inquirer, 3/4). Baucus said, "I think that tax provision should be on the table" (Smith, Reuters, 3/3). He also said that one of his priorities is "delivery reform" and that physician payments should be based on the quality of care provided. "That's the biggest opportunity," he said, adding, "It's going to be the driver" of reform (Tumulty, Time Magazine, 3/3).

Next Moves

Baucus this week will meet with Senate Finance Committee members from both parties to discuss his plan to divide work on reform into several areas of importance, according to sources. These separate issues include cost control, insurance coverage and improvement of payment systems, CongressDaily reports. He also said that he and Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) have spoken regularly by phone and are "moving in tandem" on the matter (Edney, CongressDaily, 3/4). In addition, Baucus said he is meeting with the leaders of House health care committees (AP/Miami Herald, 3/3). Baucus said a White House health care summit scheduled for Thursday "jump starts" the overhaul process. According to Baucus, the summit will bring together lawmakers and interest groups "to start asking the next level of questions" (Marcus, Bloomberg, 3/3).

Waxman

House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) -- speaking at a conference sponsored by the Federation of American Hospitals on Tuesday -- said he expects his panel to approve overhaul legislation before the August recess. According to Waxman, an overhaul should build on the employer-based coverage system, Medicare, Medicaid and CHIP. He added that "there has to be a significant role for both" public and private coverage in any potential overhaul, noting that such an approach would minimize conflict between those supporting a single-payer system and those supporting a private sector-based system.

Although he lauded Obama's proposal for a $630 billion reserve fund that would serve as a down payment on health care reform, he was "non-committal" about how to raise the other "$600 billion or so" required for an overhaul, CQ HealthBeat reports. He said that overhaul legislation could differ at the committee level, but that a unified bill would be developed for introduction on the House floor. Waxman also said that he and House Ways and Means Committee Chair Charles Rangel (D-N.Y.) and House Education and Labor Committee Chair George Miller (D-Calif.) are "all working hard and are determined to pull in the same direction" on overhaul legislation (Reichard, CQ HealthBeat, 3/3).

Blunt, Warner

Also speaking at the FAH conference, House Republican Health Care Task Force Chair Roy Blunt (Mo.) said that Republicans would not support a plan that gives the government a major role in the private coverage market, adding, "When the government is a competitor, then eventually there is no competition left." He also said, "Remember, when the government sets the price, it never gets the price right." He said he supports a "government-organized" system, similar to the Medicare prescription drug benefit. Blunt also said Republicans would support a system that sought to increase competition in the health care market.

Sen. Mark Warner (D-Va.) told FAH members that they should be careful not to oppose reductions in federal provider payments that could be included in an overhaul. According to Warner, if such a reform effort failed, hospitals would face "politically driven cuts" that would compel them to find ways to keep health care costs from doubling to more than $4.3 trillion over the next two decades (Kivlan, CongressDaily, 3/3).

Editorial, Opinion Piece

Summaries of a USA Today point/counterpoint discussing Obama's plan for overhauling the health care system appear below.

• USA Today: Obama's "goal of extending coverage to many of the U.S.' 46 million uninsured people is one we've long shared," but if "he does not get serious about controlling costs ... he will not only miss his goal, he will make a bad fiscal outlook even worse," a USA Today editorial states. It continues, "As more money has flowed into medical service, providers have found ways to spend it with expensive new drugs and medical technologies," which "has created many useful treatments," but also has "helped to drive up costs further and pushed more Americans into the ranks of the uninsured." It adds, "Costs have also risen because the industry has been shielded from the buffeting forces that have forced other industries to become more efficient. When third parties foot most of the bill, consumers care about little beyond their copayments." However, "Obama's plan would throw yet more money at health care," according to the editorial. It concludes, "Reforming health care is going to require the castor oil of cost control along with the candy of expanded coverage," and "Thursday would be a good time to acquaint the public with its options" (USA Today, 3/4).
• Elise Gould, USA Today: "Arguing that current budget deficits necessitate a timid approach to health care reform is like advising somebody out of work with a broken leg that now is no time to buy crutches," Gould, director of health policy for the Economic Policy Institute, writes in a USA Today opinion piece. She adds, "By the end of this year, the number of uninsured people in the U.S. will be easily 50 million," and over "a three-year period, the number of people who go for a spell without insurance is roughly double that, leaving them wide open to health and financial catastrophe." According to Gould, "Even the lucky ones with insurance are at risk." She continues, "In short, both long-run budget and short-run economic reasons demand health care reform sooner rather than later." She adds, "President Obama's budget makes a realistic and substantial down payment on reform," and lawmakers "know that there's more money out there to be saved through intelligent reform. Those who argue for delay really don't have a leg to stand on" (Gould, USA Today, 3/4).

Broadcast Coverage

NPR's "Tell Me More" on Tuesday included a discussion with money coach Alvin Hall about the need for health reform ("Tell Me More," NPR, 3/3).