Senate Democratic leaders prepare for floor action on health bills; public plan still the flashpoint

Democrats are preparing for floor action, with much of the attention centered on the Senate Finance Committee's final vote and merging two Senate reform bills.

The Associated Press on combining the Finance Committee version with the more liberal one advanced by the Senate Health, Education, Labor and Pensions Committee: "This merger is so rare that Senate Majority Leader Harry Reid has never attempted it on any piece of legislation — much less one as complex as President Barack Obama's top legislative priority. ... Everything about health overhaul legislation seems to be unusually complicated, but this process is particularly so because of the disparities between the bills and Obama's goal of keeping the cost at $900 billion over 10 years. Reid won't go it alone; he will get some help from the White House and the committee chairmen." The two bills differ on inclusion of a government-run public plan and levels of subsidies for the poor to buy insurance (Werner, 10/5).

The New York Times: "The Finance Committee is expected to approve its bill this week, after receiving cost estimates from the Congressional Budget Office. And while the panel made numerous changes over seven days of public debate, the core components of its more centrist proposal, developed in months of bipartisan talks, are still intact" (Pear and Herszenhorn, 10/3).

CongressDaily: "Senate Finance Chairman Max Baucus said his committee will convene again Tuesday. Sen. Olympia Snowe, R-Maine, the only committee Republican who might cross sides to vote for the health bill, remained on the fence late last week. … While most of the work so far has fallen to committees and party leaders, the wait for the bills to get to the floor provides a window for President Obama to play a bigger role in the debate, some lawmakers said" (Edney and Hunt, 10/5).

Time: The next steps of the health overhaul effort will test the skills of House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid. That "test could begin as early as next week. Reid canceled a scheduled weeklong break so that the Senate could get down to work immediately after Columbus Day. He plans to begin with what one aide described as a 'bed-check vote' on Oct. 13, which could be an early indication of his ability to hold his Democrats together against the threat of a filibuster" (Tumulty, 10/5).

Roll Call reports that moderate Senate Democrats are feeling more and more pressure to support a health bill that includes a public insurance option, "and many appear prepared to fall in line with Democratic leaders" as long as the bill they back can stand up to home state scrutiny. "To seal the endorsement of moderates, Democratic leaders are working to wrap the controversial elements of reform in a politically attractive message to the centrists' conservative-leaning constituents. That could include the addition of provisions aimed directly at problems or issues in each Senator's state, such as tweaks to state funding formulas for federal programs, aides said" (Drucker and Pierce, 10/5). 

McClatchy Newspapers/Miami Herald report that while "The Finance Committee draft includes cooperatives, or nonprofit member-run companies organized on a state, local or regional basis to purchase insurance ... Sen. Thomas Carper, D-Del., is floating a proposal to allow states to create their own public options. [Republican Sen. Olympia] Snowe has proposed allowing public options only if state health-insurance markets prove uncompetitive" (Lightman, 10/4). 

Meanwhile, The Hill reports that "Reid and Baucus have staked out opposing positions on the central question of a government role in health reform — Reid has consistently stood in favor, but Baucus has consistently said the idea doesn't have enough Senate support. Instead, Baucus has inserted insurance co-operatives into the bill that is scheduled for a final vote on Tuesday" (Rushing, 10/6).

All sides will eventually have to figure out where they stand and what can pass muster, The Hill reports in a second story: "President Barack Obama and Democratic leaders in the House and Senate, all of whom support the public option, cannot afford to brush aside the liberals who compose the majority of their party. But the centrists represent a crucial voting bloc in the House and a handful of much-needed votes in the Senate" (Young, 10/5).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.