Senators move closer to centrist health reform bill

Lawmakers working on a bipartisan health care reform bill in the Senate Wednesday signed on some centrist Democrats who believe they could support the reform and sell it to constituents back home over the recess, The New York Times reports.

One of them, Senator Evan Bayh, who is up for re-election next year in the swing state of Indiana, said it was clear to everyone that Congress needed to do three things: control costs for Americans who already have insurance, slow the growth in spending on Medicaid and Medicare to ease the deficit, and provide health coverage to the millions of uninsured."

Sen. Chris Dodd, acting chairman of the Senate Health, Education, Labor and Pensions Committee, said he hoped the Senate would have had a unified bill by now, but said that Senators now had something to talk about with people at home (Herszenhorn and Pear, 8/5).

The Washington Post: "Even if the partnership does not result in legislation, Democratic leaders are already contemplating ways to preserve much of what it produces as they look to unite their party and pick up Republican votes when the health-care debate moves to the Senate floor in the fall. … Committee negotiators say the outstanding issues include how to structure a Medicaid expansion to make it fair to individual states; how to establish subsidy levels to maximize assistance to the uninsured; and how to squeeze savings from Medicare without imposing an undue burden on seniors or compromising the quality of care" (Murray and Montgomery, 8/6).

CQ Politics on Medicaid talks: "Democrats envision a large Medicaid expansion as part of their health care overhaul to cover millions of low-income people who do not qualify under current law and either do not have access to private insurance or cannot afford it. … The Finance Committee is considering expanding Medicaid to cover families earning up to 133 percent of the poverty level, or about $29,300 in 2009. It is not clear if the committee would allow more childless adults to qualify for the program. Unless Congress funds a mandatory expansion in Medicaid eligibility exclusively with federal funds, any change that covers more people would hit state budgets hard" (Wayne, 8/5).

The Hill reports on Democrats' message that an overhaul won't include tax increases: "Senate Democrats highlighting the lack of individual income tax hikes in their bill will come as a relief to nervous House Democrats who pressured their leadership to at least scale back the new tax in their bill to only affect people earning more than $1 million a year. But by making an unfavorable comparison of the House bill to theirs, Senate Democrats also are taking aim at the House leaders and liberals who support taxing the wealthy to pay for healthcare" (Young, 8/5).

In the meantime, the Center on Budget and Policy Priorities said Wednesday that the Finance Committee plans to mandate that employers provide insurance for employees or pay for the average subsidy cost per employee who use an exchange to purchase insurance, CongressDaily reports. "The provision would not require employers to contribute to the costs of employees with higher family incomes. Such an employer coverage mandate, the CBPP and other groups said, will have a negative impact on low-income and minority workers" (Master, 8/6).

The group also agreed on an expanding the reach of MedPAC, a Medicare advisory board, to control costs, Dow Jones/The Wall Street Journal reports. "According to (Senate Finance Committee Chairman Max) Baucus (of Montana), a strengthened MedPAC, which he referred to as the 'Medicare Preservation Commission,' would have the power to recommend changes to Medicare payment rates aimed at cutting costs. The changes would automatically be enacted if Congress didn't come up with a substitute package that cut costs by the same amount." "Good Progress" has been made on the proposal, an aide told Dow Jones (Yoest and Vaughan, 8/5).