Senate Finance Committee holds second closed-door meeting on health care reform; details of House Energy and Commerce Committee overhaul plan leaked

The Senate Finance Committee and the House Energy and Commerce Committee on Thursday both worked on health care proposals aimed at overhauling the U.S. health care system, CQ Today reports.

In its second of three closed-door meetings, the Finance Committee came to "early, broad agreement" on some issues but continued to disagree over a public option as part of a reform bill. Meanwhile, portions of an overhaul plan being developed by the Energy and Commerce Committee were leaked on Thursday, after Democrats on the committee held a closed-door session on the topic earlier this week (Armstrong, CQ Today, 5/14).

Finance Committee

A main point of contention among attendees of the eight-hour Finance Committee meeting was whether to create a public health insurance option as part of a reform plan, the AP/Salt Lake Tribune reports. Committee members examined several different models for a public option: a plan that would be administered directly by the federal government, similar to Medicare; a plan that would be administered by regional liaisons under contract with the federal government; a plan that would allow states to choose whether to have a public option and how to run it; and a plan that would require a public option to be regulated under the same rules as private insurers (Alonso-Zaldivar, AP/Salt Lake Tribune, 5/14).

Committee Chair Max Baucus (D-Mont.) said that there was no agreement among attendees on a public option (Young, The Hill, 5/14).

Ranking member Chuck Grassley (R-Iowa) said of a public option, "In its purest form that Democrats might offer it, it's a problem." He added, "But when you've got three or four different ways of offering it, it's possible" (CQ Today, 5/14). Grassley also said, "We might be able to find a consensus" (The Hill, 5/14). In a speech on the Senate floor on Thursday, Grassley said that he would rather "create stronger rules and regulations for the private insurance market" than establish a government-run health insurance option (Norman, CQ HealthBeat, 5/14).

There were some issues in which general bipartisan agreement was reached, Politico reports. Republicans and Democrats appeared to find consensus over a requirement that every U.S. resident have health coverage. Grassley and Baucus said that there is general agreement within the committee that one of the only ways to lower health insurance costs is by finding a way to bring every resident into the system (Budoff Brown, Politico, 5/15). According to CQ Today, there also was general bipartisan agreement on the creation of a health insurance exchange where uninsured U.S. residents could shop for coverage using a simple standardized format (CQ Today, 5/14).

Baucus plans to mark up a health reform bill in June and introduce it on the floor in July. Baucus said, "We've got a lot of work to do and we're going to find a way to do it. It's important to keep momentum going. It's also important to do it right." Grassley said, "We're still on schedule," adding, "This isn't necessarily the place to narrow the differences. This is a place to get an understanding of the differences." However, Senate Majority Whip Richard Durbin (D-Ill.) and Senate Budget Committee Chair Kent Conrad (D-N.D.) both expressed doubts about the timeline. "I think it'll be very difficult to keep that schedule," Conrad said (The Hill, 5/15).

House Energy and Commerce Committee

A summary from the House Energy and Commerce Committee meeting was leaked on Thursday in which committee Democrats outlined their proposals for health care reform legislation, the Washington Times reports (Haberkorn, Washington Times, 5/15). Among the proposals being considered is a requirement that U.S. residents have health insurance and the federal government subsidize the cost of coverage for families with incomes up to $88,000. In addition, the plan also would require that employers offer coverage to full-time employees or pay a percentage of their payroll to the government (Alonso-Zaldivar/Werner, AP/Raleigh News & Observer, 5/15).

The committee also called for the establishment of a "national health exchange," in which private and public plans could compete. The exchange would first be open to U.S. residents without employer-sponsored health insurance and small businesses, but eventually would be available to large businesses as well, according to CQ HealthBeat.

The summary also included a proposal that would establish a new public plan run by HHS that "would be subject to the same market reforms and consumer protections as private plans," and "would have geographic adjusters for price." The summary stated that the plan, which would be separate from the exchange, would not be subsidized by the government and "would build on Medicare providers and rates, similar to the practices of private plans today." The proposal would create a public advisory committee to recommend benefits packages, loosely based on the Federal Employees Health Benefit Program, that would be available through the exchange (Reichard, CQ HealthBeat, 5/14).

The proposal would also include a cap on annual out-of-pocket health care costs for U.S. residents. The proposal did not come with an estimate on its overall cost (AP/Washington Times graphic, 5/15).