Baucus works to iron out Medicaid, abortion and costs in health reform bill

Sen. Max Baucus is addressing the final questions in his Senate Finance Committee health care reform bill and plans to offer it Wednesday, opening the way for a committee vote next week and a floor vote the week after.

CongressDaily: "Baucus and his group of five other senators have a list of about 12 to 15 member concerns with the bill that they need to work to clear up, Senate Budget Chairman Kent Conrad said Monday. Baucus met with Finance Committee Democrats Monday evening to discuss their issues. … One of the thornier issues remaining to be worked out with Republicans is abortion and language that would prohibit the use of federal funds for them. Baucus said Monday the group of six negotiators is looking at an amendment adopted by the House that would explicitly prohibit using federal dollars to fund abortions. … The Senate negotiators also will talk with governors later (Tuesday), which is part of the reason for the mark coming out Wednesday instead of today, to assuage fears that their already stretched budgets will not be able to handle the Medicaid expansion that will be part of the overhaul. Baucus was not specific but said the senators are 'pretty satisfied' with the expansion" (Edney, 9/15).

Bloomberg: "Baucus wants to expand Medicaid so that those making below 133 percent of the federal poverty level qualify, with states and the federal government sharing in costs. States would pick up a greater share of the cost over time. Baucus said yesterday governors will find that the impact on states won't be as large as initially expected. 'The Medicaid expansion won't cost states nearly as much as they initially feared,' he told reporters" (Litvan, 9/15).

The Wall Street Journal: "Conrad (D., N.D.), a key senator in the negotiating group, said the bill would cost less than $880 billion. Mr. Baucus confirmed that the nonpartisan Congressional Budget Office told the group the overall price tag for the proposal was lower than earlier estimated, but said that it is 'still moving a bit'" (Yoest, 9/14).

The New York Times: Baucus said he'd "include in his bill a proposal by the Obama White House to bar illegal immigrants from buying health coverage through a new insurance marketplace, or exchange, even if the illegal immigrants were willing and able to pay the full cost. The White House said that hospitals would still be required to provide emergency treatment to illegal immigrants and that the federal government would continue to reimburse hospitals for unpaid bills, a cost that now runs $250 million a year" (Herszenhorn, 9/14).

The Associated Press: "The three Republicans — Mike Enzi of Wyoming, Chuck Grassley of Iowa and Olympia Snowe of Maine — are under intense pressure from leaders of their own party, some of whom have publicly dismissed Baucus' framework as a Democrat's plan. Baucus may not be able to get any of them to agree. But all three have invested much time and energy in the talks, and Baucus seems to have a chance of persuading at least Snowe" (Werner and Alonso-Zaldivar, 9/14).

Roll Call: "But courting the GOP Senate trio has proven difficult. The White House and Senate Democrats are willing to have an exclusive relationship with Snowe, but she doesn't seem so sure herself and appears to prefer safety in numbers. Asked Monday how important it was for Grassley and Enzi to support the package as well, Snowe said, 'I think it's important for us to reach a consensus within the group, if that's at all possible'" (Pierce and Drucker, 9/15).

The New York Times reports that Enzi and Grassley "have requested numerous major changes" in the proposal. The Times adds: "A summary of the senators' views, prepared by the Finance Committee, says Mr. Enzi believes that the federal government should pay '100 percent of the cost of the Medicaid expansion, in order to avoid an unfunded mandate' for states, which ordinarily share Medicaid costs with the federal government. Mr. Enzi and Mr. Grassley have also objected to the fees that Mr. Baucus wants to impose on health insurance companies, clinical laboratories and manufacturers of medical devices. Such fees would help finance coverage of the uninsured" (Pear and Herszenhorn, 9/14).

The Washington Post: "But the chairman said Monday night that he will move forward Wednesday with or without Grassley, Enzi and Snowe, the most moderate Republican involved in the negotiations. He said the bipartisan group, known as the Gang of Six, would continue to negotiate until the full committee begins work on the bill next week" (Montgomery and Murray, 9/15).

This is part of Kaiser Health News' Daily Reports - a summary of health policy coverage from more than 300 news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Reports here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.