Difficult issues will remain even if Senate Democrats pass health bill

Senate Majority Leader Harry Reid, D-Nev., made two major changes to the Senate's version of the health overhaul legislation - removing the proposed "public option" and restricting abortion coverage - that have helped ease tension enough to secure more votes for the bill, but left advocates with much to complain about.

Politico: "Just hours after a critical Monday morning vote in the Senate," - cementing Reid's changes - "Democrats were already talking about future changes to the health reform effort in hopes of calming a revolt among liberal activists. Sen. Tom Harkin (D-Iowa), chairman of the Health, Education, Labor and Pensions Committee, predicted the government health insurance option long favored by liberals would be part of that second look" (Brown and O'Connor, 12/21).

Politico: A separate story examines other thorny issues, including Medicare cuts and a tax on costly "Cadillac" health plans provided by insurers. Deep cuts to Medicare could limit lawmakers options in finding future areas for savings, and the tax could eventually hit more middle-class workers. "Neither the Medicare nor the tax numbers can be easily ignored in what could be a game-changing fight now triggered by the need to twice raise the debt ceiling in a matter of months" (Rogers, 12/22).

The Washington Post: On abortions, the latest Senate language is meant to win support by Sen. Ben Nelson, D-Neb., a moderate, antiabortion Democrat who was also wavering on the bill for other reasons. The provision has also "achieved a rare feat: It is drawing contempt from both sides." The awkward compromise could require people who receive government subsidies to help buy health insurance to write two premium checks each month, one for health coverage and a separate one, around $1 per month, for abortion coverage (MacGillis, 12/22).

Kaiser Health News/McClatchy: "Amid all their squabbling over health care legislation, congressional Democrats agree on the need to regulate how insurers spend their customers' money." The bill would require insurers to spend at least 80 percent of the premiums they collect on medical care. (The House version raises that number to 85 percent). States that have enforced similar regulations did not manage to contain premiums (Appleby, 12/21).

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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.